Mammography

1. Uncover the role of mammography in early breast cancer detection. Find out about the risks, limitations, and benefits of this crucial diagnostic tool.
2. Get insights into the significance of mammography in breast cancer screening and diagnosis. Understand its benefits, risks, and the compression process.

Mammography is a crucial diagnostic and screening tool that utilises low-energy X-rays to examine breast tissue. It plays a vital role in the early detection and diagnosis of breast diseases, including breast cancer.

Digital Mammography: Advancing Breast Imaging

Digital mammography offers a more advanced mammography system, replacing traditional X-ray film with detectors that convert X-rays into digital signals. These detectors, similar to those in digital cameras, produce images of the breast that can be viewed on computer screens or printed on special film.

Computer-Aided Detection (CAD): Enhancing Mammography Interpretation

Computer-aided detection (CAD) employs computer algorithms to analyse mammographic images, highlighting suspicious areas that may indicate the presence of cancer. CAD serves as a valuable tool for radiologists, guiding their attention to areas that warrant further scrutiny.

Common Applications of Mammography

1. Breast Screening for Early Detection:

   The American Cancer Society recommends annual screening mammography for women starting at age 40. Early detection of breast cancers through mammograms increases the likelihood of successful treatment and breast-conservation therapies.

2. Diagnosing Breast Symptoms:

   Mammography is also used to diagnose breast-related symptoms, such as lumps, pain, or nipple discharge.

Benefits of Mammography

1. Enhanced Detection of Small Tumours:

   Breast imaging improves a physician's ability to detect small tumours, which translates into more treatment options and a higher cure rate for women with early-stage breast cancer.

2. No Residual Radiation:

   Unlike other diagnostic procedures, X-rays do not leave any residual radiation in the body after the examination.

3. Minimal Side Effects:

   X-rays typically do not cause any side effects within the diagnostic range.

What to Expect During and After Mammography

1. Compression Discomfort:

   During the procedure, you may experience pressure on your breast as it is compressed by a paddle. Discomfort is common, especially for women with sensitive breasts. Scheduling the procedure during the least tender phase of your menstrual cycle may help alleviate discomfort.

2. Purpose of Breast Compression:

   Breast compression is essential for:

   • Even Breast Thickness: It ensures that all breast tissue is adequately visualized.
   • Dispersing Tissue: It spreads out the tissue, reducing the likelihood of small abnormalities being obscured by overlying tissue.
   • Lower X-ray Dose: It allows for a lower X-ray dose by imaging a thinner layer of breast tissue.
   • Minimizing Motion Blur: It keeps the breast still to minimize image blur caused by movement.
   • Reducing X-ray Scatter: It improves image sharpness by reducing X-ray scatter.

Risks and Complications of Mammography

1. Radiation Exposure:

   While rare, there is a slight risk of cancer from excessive exposure to radiation. However, the benefits of early cancer detection far outweigh this minimal risk.

2. False Positive Results:

   Approximately 5% to 15% of screening mammograms require further testing, such as additional mammograms or ultrasounds. The majority of these tests reveal normal results. If an abnormality is detected, a follow-up or biopsy may be necessary. Most biopsies confirm the absence of cancer.

3. Pregnancy Concerns:

   Women should inform their physician or X-ray technologist if they suspect they might be pregnant.

4. Breast Implants:

   Breast implants can obscure parts of the breast tissue, requiring more images than a standard mammogram, with and without displaced implants. Older or weakened implants may experience ruptures, but the risk is very low. The risk of breast cancer far outweighs the implant rupture risk.

5. Interpretation Challenges:

   Interpreting mammograms can be difficult for women younger than 40 or hormone users due to dense breast tissue.

6. Sensitivity to Radiation:

   Breast tissue in women younger than 40 is more sensitive to radiation, even though mammograms use low-dose X-rays.

Limitations of Mammography

1. Limited Diagnostic Certainty:

   Initial mammographic images alone are often insufficient to definitively determine the presence of a benign or malignant disease. If a suspicious finding is detected, your radiologist may recommend further diagnostic studies, such as an ultrasound or magnetic resonance imaging (MRI).

2. Interpretation Variability:

   Interpreting mammograms can be challenging due to individual variations in normal breast appearance. Prior breast surgeries may also complicate image interpretation.

3. Comparison with Previous Examinations:

   Radiologists may need to compare current mammograms with previous examinations to assess changes over time.