General Health

Mammography: Best tool for breast cancer screening

Breast cancer has caused significant morbidity and mortality across the globe and early detection and prompt treatment of breast cancer could improve a woman’s chances of survival.

A mammogram is a low-dose x-ray picture of the breast obtained to look for initial signs of breast cancer, sometimes up to three years before it can be felt and before women experience symptoms – when it is most treatable.

Screening mammograms usually involve two or more x-ray pictures, or images, of each breast and can detect microcalcifications (tiny deposits of calcium) that could indicate the presence of breast cancer; however, they may not be adequate to determine if the cancerous growth or tumor is benign or malignant with certainty.

Mammograms are performed to check for breast cancer development or clinical signs or symptoms of cancer such as a lump, breast pain, thickening of breast skin, nipple discharge, or a change in breast and/or nipple size or shape; however, these clinical signs may also indicate benign conditions has been developed is known as a diagnostic mammogram.

A diagnostic mammogram can also be used to evaluate changes found during a screening mammogram or to view breast tissue when it is difficult to obtain a screening mammogram because of certain circumstances such as the presence of breast implants.

Preparation and procedure

Don’t wear deodorant, lotion, powder or perfume under your arms or on your breasts on the day of your examination. Make the staff aware if you have breast implants since more pictures may be required than a regular mammogram. Carry your previous mammograms, if any, to facilitate comparison and monitoring.

You are made to stand in front of a special X-ray machine. A technologist will place your breast on a plastic plate. Another plate will firmly press your breast from above for a few seconds. The plates will flatten the breast, holding it still while the X-ray is being taken. You will feel some pressure. The steps are repeated to make a side view of the breast. The other breast will be X-rayed in the same way. Each woman’s mammogram may look a little different since all breasts are a little different. The images are reported by a radiologist.


An abnormal mammogram may not always indicate the presence of cancer; however, additional mammograms, biopsies, tests or other radiological and non-invasive examinations such as ultrasound may be required to make a definite diagnosis. A radiologist will carefully examine a mammogram to look for areas of unusual configuration or increased breast density or regions that differ from normal in size, shape, edges and margins of normal tissues.

Microcalcifications appear as very bright specks on mammograms and may indicate malignancy. The regions of pathological abnormality could represent several breast abnormalities such as cysts, fibroadenomas and tumors including invasive ductal and invasive lobular cancer, and ductal carcinoma in situ (DCIS).

Thermograms produce images that show heat patterns and blood flow near the surface of the body. Another test performed for breast cancer screening is the nipple aspirate a test in which a breast pump is used to collect fluid from a woman’s nipple to screen for abnormal and potentially cancerous cells. It should be remembered that thermograms and nipple aspiration tests are not substitutes for mammography.

Recent advances in mammography

Three recent advancements in mammography include digital mammography, computer-aided detection and breast tomosynthesis.

  1. Digital mammography or full-field digital mammography (FFDM) is a mammography type in which the x-ray film is replaced by electronics for converting x-rays into mammographic images of the breast. FFDM efficiency enables the generation of higher quality images with lower radiation doses. The generated images are then transferred to a computer for review by the radiologist.
  2. Computer-aided detection (CAD) systems search digitized mammographic images for abnormalities in density, mass, or calcifications that could be indicative of cancer. The CAD system highlights these areas on the images, alerting the radiologist for careful assessment in that region.
  3. Digital breast tomosynthesis (DBT) is a three-dimensional (3-D) mammography assessment in which multiple images of the breast can be captured and reconstructed at different angles. The radiation dose required for some DBT systems is slightly higher than that for standard mammography; however, it remains within the FDA-approved safe levels for radiation from mammograms.


Pooja Toshniwal Paharia

Dr. Pooja Toshniwal Paharia is a Consultant Oral and Maxillofacial Physician and Radiologist, M.DS (Oral Medicine and Radiology) from Mumbai. She strongly believes in evidence-based radiodiagnosis and therapeutic regimens for benign, potentially malignant, or malignant lesions and conditions either arising from the oral and maxillofacial structures or manifesting in the associated regions.

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