Every October is Breast Cancer Awareness Month. It is a good time to think about breast cancer prevention. I know many women who schedule their mammogram in October every year for this reason. I thought we could talk about some of the common questions I hear about mammograms.
What is a mammogram?
A mammogram is a special type of low-dose X-ray of the breasts. It is used to look for changes in breast tissue that may not be felt during a breast exam. Mammograms can find abnormalities that are much smaller than you might feel on an exam.What is the difference between a screening mammogram and a diagnostic mammogram?
A screening mammogram is done to screen for breast cancer in women who have no symptoms of breast cancer. This type of mammogram involves two X-rays of each breast, which look at the breasts from two different angles. They can detect lumps or tumors that cannot be felt. They can also find calcium deposits, which might indicate that breast cancer is present.
A diagnostic mammogram is used to look for signs of breast cancer after a woman has symptoms or signs of breast cancer, such as a breast lump (found by the patient or the doctor), discharge from the nipple, or changes to the size, shape, or skin of the breast, or maybe a lump in the armpit. It may also be done to evaluate any concerning findings on a screening mammogram, or to get a good picture of areas that don’t show up well on a screening mammogram. A diagnostic mammogram is usually done on one breast only. It involves more X-rays, and sometimes even magnification, to get the best possible picture of the area of concern.
What if your screening mammogram shows something concerning?
Here are some of the possible tests you might have done after an abnormal screening mammogram:
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Diagnostic mammogram – As detailed above, this is often the first test done to evaluate an abnormal finding on a screening mammogram.
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Ultrasound – An ultrasound uses sound waves to create a different kind of picture of the breast. It can tell if a lump is solid or a fluid-filled cyst. This is sometimes done at the same appointment as the diagnostic mammogram.
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MRI – This can create a very detailed picture of the breast tissue.
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Biopsy – May be done by a specialty radiologist or a surgeon. A needle is used to remove some tissue or fluid from the area of concern, which is then reviewed by a pathologist to look for cancer changes.
Can you have a mammogram if you have breast implants?
Yes, women with breast implants can and should have screening mammograms. You will need to let the mammogram facility know ahead of time that you have breast implants. They will schedule your appointment with a technician who is experienced in performing the X-rays with implants present. You may need extra views done to get a complete picture of the breast tissue.
Can a mammogram in a mobile van be as good as one done at a hospital?
Yes! You can get a high-quality mammogram in a mobile van, a breast clinic, a private radiology office, or a hospital radiology department, and even some doctor’s offices. The Food and Drug Administration (FDA) certifies mammography facilities by inspection every year. To be certified, they must meet strict quality standards for their X-ray equipment and their staff. Before making an appointment for your mammogram, you can ask if the facility has FDA certification. You can also check the FDA website to see if the facility is FDA-certified by using this link: Mammography Facilities (fda.gov)
Is there anything special you need to do to get ready for a mammogram?
The facility will likely tell you about any special instructions; just ask when you make the appointment. Here are some general instructions:
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When making the appointment, avoid the week before you expect your period (if you are still having periods). Your breasts will be less tender and less swollen, which makes the mammogram less uncomfortable and makes the pictures better too.
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When making the appointment, tell the facility if you have breast implants.
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Don’t use any deodorant, perfume, lotion, or powder on the day of your mammogram. These things can cause shadows on the X-ray.
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Wear a shirt with pants or a skirt, so you can undress from the waist up for the test.
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If you have previously had mammograms at a different facility, ask that facility to send your previous mammogram X-rays to the new facility before your test. The radiologist can then compare the X-rays to see if there is anything new or changing.
If you have any questions about mammograms, please log into your account and send us your question. We are here to help.
Dr. Anita Bennett MD – Health Tip Content Editor