A mammogram is an imaging procedure that uses low-dose X-rays to screen for and detect changes in breast tissue. This specialized screening tool is designed to find potential abnormalities, such as small masses or tiny calcium deposits, often before they can be felt. For the procedure to be successful, a clear and unobstructed image of the breast is required. Therefore, most items worn near the chest and neck must be removed to ensure image clarity.
Jewelry That Must Be Removed
Any jewelry that falls within the imaging field needs to be taken off before the examination begins. This includes all necklaces and pendants, regardless of their size, as they can drape across the chest and interfere with the X-ray beam. Piercings located on the chest or nipple must also be removed for the same reason. The metallic components of these items will directly overlap with the breast tissue being imaged.
While items like rings or bracelets are not typically in the direct imaging path, some facilities recommend removing them as a precaution. This is often recommended to prevent loss or damage of personal belongings or for patient comfort during positioning. The imaging technologist will provide a private space for undressing and securing your belongings prior to the procedure.
How Metal Affects Mammogram Results
The primary reason for removing metal is rooted in the physics of X-ray imaging. Mammography equipment is highly sensitive and relies on the subtle difference in X-ray absorption between dense breast tissue and less dense surrounding fat. Metal is extremely dense and absorbs nearly all the X-rays that hit it.
This high absorption creates a dense, bright white shadow on the resulting image, which is known as an artifact. This artifact can obscure the surrounding breast tissue. If a small mass or a cluster of microcalcifications is hidden beneath a metal artifact, it may lead to an inaccurate reading. The presence of artifacts often necessitates a repeat scan to capture a clear image, which increases the time and radiation exposure for the patient.
Essential Non-Jewelry Preparation
Preparation for a mammogram extends beyond removing jewelry and includes careful attention to the skin in the chest and underarm area. Patients must avoid applying deodorants, antiperspirants, lotions, powders, or perfumes to this region on the day of the exam. The reason for this is that many of these products contain metallic compounds, most commonly aluminum.
When viewed on an X-ray, the particles from these personal care products can appear as tiny, bright white spots. These spots may be misinterpreted by the radiologist as microcalcifications. This confusion can lead to a false positive result, causing unnecessary anxiety and potentially requiring additional diagnostic procedures, such as a follow-up mammogram or ultrasound. If you forget and arrive at your appointment with a product applied, the facility will provide wipes to thoroughly clean the area before the examination begins.