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Understanding Mammography, Benefits and Risks

Mammography is a vital tool in the early detection of breast cancer. This specific type of imaging uses low-dose x-rays to identify potential abnormalities, which can then be further investigated. mammography can be instrumental in detecting cancer before symptoms develop, when treatment is most effective. Therefore, it is important for women to have regular mammograms as part of their overall health and wellness routine. mammography has been shown to reduce mortality from breast cancer, making it a crucial screening tool for all women.

If you have past mammograms, make sure you let your doctor know, bring them with you on the day of your exam. In addition, don't wear any jewelry or tight clothing. You may be given a gown to change into. Also, avoid putting deodorant, talcum powder or lotion under your arms or on your breasts as they might worsen the clarity of the mammogram images.

What is Mammography?

Mammography is a low-dose x-ray system used to examine the breasts, which can help detect and diagnose breast diseases in their early stages.

An x-ray is a commonly used medical imaging device that helps doctors treat and diagnose conditions. A patient must be exposed to a small dose of ionizing radiation in order for the machine to produce pictures of the inside of their body. There have been three recent advances in the field of mammography: digital mammography, computer-aided detection, and breast tomosynthesis.

Digital mammography, or full-field digital mammography (FFDM), has improved x-ray films by using electronics that creates pictures of the breast from x-rays. These systems are closely related to what is found in digital cameras. Digital mammography is very efficient, it allows you to take much better pictures and has a lower dose of radiation. Once the picture has been taken, the images of the breast are then transferred to a computer so it can reviewed by the radiologist. The patient's experience during a digital mammogram is similar to having a conventional film mammogram.

Computer-aided detection (CAD) systems serve as a second set of eyes by scanning digitized mammographic images for any indications of cancer, such as density, mass, or calcification. If the CAD system highlights any areas of concern on the images, it will notify the radiologist so they can give that specific area more attention.

Breast tomosynthesis, also called three-dimensional (3-D) mammography and digital breast tomosynthesis (DBT), is an advanced form of breast imaging. This process entails capturing multiple images of the breast from different angles which are then reconstructed into a three-dimensional image set. In other words, 3-D breast imaging operates in a similar fashion to computed tomography (CT) imaging where a series of thin "slices" are assembled together - this creates a three-dimensional reconstruction of the body.

While some doses of radiation for breast tomosynthesis systems can be slightly higher than the dosage used in standard mammography, it’s within the FDA’s approved safe levels for radiation from mammograms. Some systems have doses very similar to conventional mammography.

A few large population studies have revealed that screening with breast tomosynthesis results in improved breast cancer detection rates and fewer "call-backs," which refers to scenarios where women are called back from screening for additional testing because of an abnormal finding that may have been reported.

What does the mammography equipment look like?

The mammography unit is a machine that uses x-rays to take pictures of the breasts. The unit is used only for breast exams and has extra parts to keep the person getting the exam from being exposed to too much x-ray. These units have a device to hold and squish the breast so the technologist can get a good image from different angles.

Breast tomosynthesis is a type of digital mammography, but not all digital mammography machines are equipped to perform tomosynthesis imaging.

Mammography systems have made big advancements in the last few years. Take Medsource Imaging for example, their Selenia Dimensions system’s 3D Mammography exam offers unique breast tomosynthesis technology that can detect an average of 41% more invasive breast cancers than the 2D alone.

Although mammography is the best way to screen for breast cancer currently, it does not guarantee that all breast cancers will be found. This can be a trying time for the individual, emotions are usually very high and rightfully so. When this occurs, it's known to be a false negative result. On the other hand, when a mammogram looks abnormal but no cancer cells are actually there, this is referred to as a false-positive result. It's important to know how those two differ from one another.

Screening mammographic images themselves are often not enough to determine the existence of a benign or malignant disease with certainty. If there are abnormalities, your radiologist may recommend further diagnostic studies.

Not all breast cancers show up on mammograms, so it's crucial to keep this in mind. Also, because every woman's breasts look different, correctly interpreting a mammogram can be tricky. Additionally, an image may not be as accurate if there is powder or salve on the breasts, or if you have had breast surgery. It can be difficult to see some types of breast cancer, so a radiologist may want to compare the image to ones from past examinations.

What are the benefits vs. risks?

Benefits

  • Screening mammography can help reduce the risk of death due to breast cancer. This is a very useful medical system for detecting many different types of breast cancer, it can also find invasive ductal and invasive lobular cancer.
  • Screening mammography can help improve your doctors chances to detect small tumors. When cancers are small, this usually means that you’ll have more treatment options to consider.
  • The use of screening mammography increases the detection of small abnormal tissue growths confined to the milk ducts in the breast, called ductal carcinoma in situ (DCIS).
  • No radiation stays in your body after an x-ray exam. 
  • X-rays usually have no side effects in the typical diagnostic range for this exam.

Risks

  • There’s always a small opportunity that excessive exposure to radiation can cause cancer. Even so, since the amounts of radiation are so small in medical imaging, the benefit of an accurate diagnosis far outweighs any risk involved.
  • The dose of radiation for this procedure is going to differ. Be sure to consult with your doctor to learn more about X-ray and CT exam radiation. 
  • False positive mammograms can happen, in fact, 5-10 percent of screening mammograms will usually require more testing - this may include additional mammograms or ultrasounds. Most of these tests turn out to be normal.
  • If you are pregnant, please tell your doctor or x-ray technologist immediately. 

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