A mammogram is a specialized X-ray image of the breast, used as a screening and diagnostic tool for breast cancer. Its purpose is to detect changes in breast tissue that could indicate cancer, often before any physical symptoms appear. Early detection through mammography can identify cancers when they are small and localized, which generally increases the likelihood of successful treatment.
General Screening Guidelines
Guidelines for routine mammogram screenings for individuals at average risk vary among health organizations. The American Cancer Society (ACS) suggests women aged 40 to 44 have the option to start annual mammograms. For women aged 45 to 54, the ACS recommends yearly mammograms. After age 55, the ACS indicates women can switch to mammograms every other year or continue annual screenings, if in good health and expected to live at least 10 more years.
The American College of Radiology (ACR) and the Society of Breast Imaging recommend annual mammograms starting at age 40 for women at average risk. The U.S. Preventive Services Task Force (USPSTF) advises women at average risk for breast cancer to start mammogram screening at age 40 and continue every two years until age 74. Average risk is defined as having no personal history of breast cancer, no strong family history, no known genetic mutations like BRCA, and no prior chest radiation therapy before age 30.
Factors Influencing Earlier Screening
Certain circumstances or risk factors may necessitate beginning mammogram screenings earlier than general guidelines suggest. A strong family history of breast cancer, particularly in a first-degree relative (mother, sister, or daughter), can influence the recommended starting age. For instance, if a first-degree relative was diagnosed with breast cancer at a young age, individuals might be advised to start screening 10 years prior to that relative’s diagnosis age, generally not before age 30. Genetic predispositions can significantly elevate individual risk.
Genetic mutations, such as those in the BRCA1 or BRCA2 genes, increase the lifetime risk of breast cancer. For individuals with these mutations, annual mammograms are often recommended to begin around age 30, and may be supplemented with breast magnetic resonance imaging (MRI). A history of radiation therapy to the chest, especially before age 30, also warrants earlier and more frequent screening. Some benign breast conditions, while not cancerous, can elevate future breast cancer risk. A personalized risk assessment by a healthcare professional is important to determine the most appropriate screening schedule.
Preparing for Your First Mammogram
Preparing for your first mammogram involves a few simple steps to ensure clear images and a comfortable experience. On the day of your appointment, avoid applying deodorants, antiperspirants, lotions, creams, powders, or perfumes to your breasts, chest, or underarms. These products can contain metallic substances that may appear as white spots on X-ray images, mimicking abnormalities and potentially leading to inaccurate readings or additional testing. If you forget, many facilities provide wipes for removal.
Wearing a two-piece outfit, such as a shirt and pants or a skirt, is advisable. This allows you to remove only your top and bra during the procedure. During the mammogram, your breast will be placed on a support plate and compressed with a plastic paddle for a few seconds. This compression spreads out the breast tissue evenly, reduces its thickness, and ensures a clear view while minimizing the radiation dose. While compression can cause temporary discomfort, the process is brief, typically lasting only 20 to 30 seconds per image. Inform the technologist about any breast concerns or implants you may have, as this assists them in obtaining the best images.
Understanding Your Mammogram Results
After your mammogram, a radiologist, a doctor specializing in interpreting medical images, will examine the X-rays for any signs of breast changes. The results are usually compiled into a report and sent to your healthcare provider, who will then communicate them to you. This typically occurs within a few days to a couple of weeks, depending on the facility.
Sometimes, initial mammogram results may be unclear or show an area needing further investigation. In such cases, your healthcare provider might recommend additional imaging tests, such as an ultrasound or magnetic resonance imaging (MRI), or even a biopsy. Needing follow-up imaging does not necessarily mean cancer is present. Most findings requiring further evaluation turn out to be benign, meaning they are not cancerous. For instance, many suspicious findings are simply cysts, dense tissue, or an unclear image, and approximately 80% of breast biopsies do not result in a cancer diagnosis.