Mammogram

Overview of Treatment

Mammography is a medical imaging procedure that uses low-dose X-ray technology to examine breast tissue. It is primarily used for early detection of breast cancer lesions, especially for screening asymptomatic women, or for diagnosing breast abnormalities such as lumps or discharge. This non-invasive test provides detailed tissue images and is currently the most common tool for breast cancer screening.

Types and Mechanisms of Screening

Mammography can be divided into traditional film-based and digital types. Traditional mammography transfers images onto film, while digital systems generate electronic images instantly, allowing adjustments of brightness and contrast to enhance the detection of small lesions. During the procedure, the breast is compressed and fixed to ensure image clarity. After X-ray penetration, fat, glandular tissue, and abnormal tissue appear in different shades of black and white on the image, assisting physicians in identifying potential tumors or microcalcifications.

Indications

• Routine breast cancer screening for women over 40
• Follow-up for individuals with a history of breast cancer or genetic risk factors (such as BRCA gene mutations)
• Secondary confirmation of abnormal mammography results

Usage and Dosage

Patients need to remove their upper clothing, and each breast is placed on the X-ray machine’s compression paddle, with 2-4 images taken from different angles. The total examination takes approximately 15-30 minutes. The radiation dose for a single exam is about 0.3-0.7 millisieverts (mSv), which is lower than the annual background radiation exposure in the natural environment (about 3 mSv).

Benefits and Advantages

• Can detect lesions as small as 0.1 cm that are not palpable
• Digital technology improves detection rates of dense tissue lesions
• Non-invasive with short examination time
• Aligns with the Ministry of Health and Welfare’s recommendation for biennial screening for women aged 45-69

Risks and Side Effects

Main risks include:

• False-positive results leading to unnecessary follow-up tests
• Reduced lesion visibility in dense breast tissue
• Cumulative radiation exposure from repeated examinations over time, requiring risk assessment

Precautions and Contraindications

Pregnant women should avoid the procedure unless there is a high clinical suspicion of malignancy. Before the exam, avoid using deodorants, powders, or lotions on the underarm or chest area, as they may interfere with image quality. Women with very dense breast tissue may need additional ultrasound or MRI examinations. Those who have previously undergone radiation therapy to the breast should inform the medical staff.

Interactions with Other Treatments

Mammography is often combined with ultrasound to differentiate cysts from solid tumors. If suspicious lesions are found, further procedures such as fine-needle aspiration biopsy or core needle biopsy may be necessary. Comparing current images with past images helps track disease progression.

Effectiveness and Evidence

Studies show that regular mammography can reduce breast cancer mortality by 20-30%. The US Preventive Services Task Force recommends biennial screening for women aged 50-74. For women aged 40-49, screening frequency should be based on individual risk assessment. Women with dense breast tissue may need additional imaging techniques to improve accuracy.

Alternatives

Ultrasound has higher sensitivity for dense tissue but cannot fully replace mammography. Magnetic Resonance Imaging (MRI) can be used as a supplementary test for high-risk groups but is more costly and not a routine screening tool. Positron Emission Tomography (PET-CT) is mainly used for metastasis tracking in advanced cases. The choice of imaging method depends on clinical needs.

 

Frequently Asked Questions

What preparations are needed before undergoing mammography?

It is recommended to avoid deodorants, powders, or lotions on the underarm or chest area before the exam, as they may interfere with image quality. Wear two-piece clothing for convenience. If you have had other breast examinations (such as ultrasound or previous X-rays), bring relevant reports for the doctor’s reference.

Does mammography cause pain?

Some individuals may experience brief compression or discomfort, but most can tolerate it. During the procedure, the breast is gently squeezed between the compression paddles to fix the position, with pressure adjusted based on individual sensitivity. If pain is significant, inform the technician immediately for adjustment.

How often should mammography screening be performed?

It is generally recommended that women over 40 have a mammogram every year. Those with a family history of breast cancer or high-risk factors may be advised to start earlier or have more frequent screenings. Discuss a personalized plan with your healthcare provider.

Does an abnormal result mean I have breast cancer?

An abnormal result may be caused by fibrocystic changes, benign tumors, or other factors, and does not necessarily indicate cancer. Further assessment with ultrasound, MRI, or biopsy will be performed to confirm the diagnosis.

Is the radiation exposure from mammography harmful?

The radiation dose from a single exam is very low, approximately equivalent to 2-3 weeks of natural background radiation, well below international safety standards. The benefits of regular screening outweigh the theoretical risks, and it is recommended to follow medical advice for necessary examinations.