Monday, October 1, 2007

Mammograms

First, please, refer to my post on breast self-exam. It is important to do your monthly self-exam. It is important to do it properly. Also, check out this article on breast changes during your lifetime that are not cancer from the National Cancer Institute.

Mammography is a low-dose x-ray system to examine breasts. A mammography exam, commonly known as a mammogram, is used to aid in the diagnosis of breast diseases in women. Mammograms are used for both screening and diagnosis. (normal, credit)

Screening Mammogram
Mammography can show changes in the breast up to two years before a patient or physician can feel them. Cure rates are much higher when the breast cancer can be found at this stage. Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40.

The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening.

Diagnostic Mammogram
Diagnostic mammography is used to evaluate a patient with abnormal clinical findings—such as a breast lump or lumps—that have been found by her or her doctor. Diagnostic mammography may also be done after an abnormal screening mammography in order to determine the cause of the area of concern on the screening exam.

Important Things to Know and Do Prior to Mammogram

Before scheduling a mammogram, discuss any new findings or problems in your breasts with your doctor. At the time of the mammogram, inform the radiologist (or the techs) of any prior surgeries, hormone use, and family or personal history of breast cancer. Try not to schedule your mammogram for the week before your period if your breasts are usually tender during this time. The best time for a mammogram is one week following your period. Always inform your doctor or x-ray technologist if there is any possibility that you are pregnant.

  • Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium spots.
  • If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam. Or try to use the same facility each year so they will already have prior mammograms.
  • Ask when your results will be available; do not assume the results are normal if you do not hear from your doctor or the mammography facility. Make sure you state who should get a copy of your mammogram results--family doctor, general surgeon, oncologist, plastic surgeon, etc.

What a Mammogram Can Show

The radiologist will look at your x-rays for breast changes that do not look normal. The doctor will look for differences between your breasts. He or she will compare your past mammograms with your most recent one to check for changes. The doctor will also look for lumps and calcifications.

  • Lumps (or "mass")--The size, shape, and edges of a lump sometimes can give doctors more information about whether or not it is cancer. A growth that is benign often looks smooth and round with a clear, defined edge. On the other hand, breast cancer often has a jagged outline and an irregular shape. (benign lump, photo credit)
  • Calcifications--A calcification is a deposit of the mineral calcium in the breast tissue. Calcifications appear as small white spots on a mammogram. There are two types:
  1. Macrocalcifications are large calcium deposits often caused by aging. These are usually not cancer.
  2. Microcalcifications are tiny specks of calcium that may be found in an area of rapidly dividing cells. If they are found grouped together in a certain way, it may be a sign of cancer. (photo credit)

Depending on how many calcium specks you have, how big they are, and what they look like, your doctor may suggest that you--1) have a different type of mammogram that allows the radiologist to have a closer look at the area, 2) have another screening mammogram, usually within 6 months, or 3) have a biopsy done.

Mammograms are not perfect, but are currently the best method to find breast changes. If your mammogram shows a change in your breast, sometimes other tests will be needed to better understand it. These follow-up tests include ultrasound or more mammograms views. The only way to find out if an abnormal result is cancer is to do a biopsy. It is important to know that most abnormal findings are not cancer.

References

3 comments:

jmb said...

Thank you for this post Dr Ribates. I have long standing calcification and I am constantly moved back and forth from the screening to the diagnostic program here.
I will check the links you have here.
regards
jmb

Cindie said...

I had a mammogram on February 1st and I got a postcard from my Doctor's office stating that it was fine.

Yesterday I received a notice in the mail stating that they hoped by now I had been in touch with my Physician as my mammogram was abnormal and I needed further evaluation.

Of course this would happen on a weekend and so I am unable to talk to anyone. I have a family history of breast cancer .... a mom and a paternal GM so I am concerned.

There needs to be better follow up in the medical community.

rlbates said...

I agree, they should have got it right on the first postcard. Sorry.