What Is a Mammogram?

Mammograms can save lives by spotting breast cancer at an early stage when it is most easily cured. Mammograms can also help cancer treatment.

Whether you are a woman or a man, you’ve no doubt heard about mammograms and you’re aware they are used to screen for breast cancer. But you may not know exactly what these imaging tests are or how the types of mammograms, and their uses, can differ. For example, while mammograms play a key role in spotting breast cancer early, they are also used in the staging and treatment of the disease.

Because breast cancer is the most common malignancy diagnosed in American women, according to the American Cancer Society (ACS), the odds are someone you know has been diagnosed with breast cancer — or will be one day. That’s why it’s important to get the facts about what is a mammogram.

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Understanding a mammogram

A mammogram machine uses low dose x-rays to create images of your breasts so abnormalities or changes in breast tissue can be spotted.

You stand in front of the mammogram machine while a technologist positions your breast on a plastic plate. This plate and another one from above compress your breast, spreading the tissue apart. While going through this process with both breasts and having your breasts feel “flattened” temporarily can feel a little uncomfortable, it creates higher quality images. It also allows less radiation to be used. In fact, mammograms now involve far less radiation exposure to breasts than occurred in the past with earlier machines.

X-ray images are taken from above and from the side of both of your breasts. Usually, a total of four x-ray pictures are made, although the technician may take a few more mammogram images, if any pictures need to be re-done or it appears an area of a breast needs additional scrutiny.

If you have breast implants, let the mammography center know when you make an appointment. Implants can make it more difficult for an abnormality to show up on a mammogram image, the National Cancer Institute explains. The mammogram technologist needs to be aware you have implants to take special steps to see as much of the breast tissue as possible. A technique called implant displacement views may be used to push the implant back against the chest wall and pull breast tissue forward for more clear mammogram image.

Understanding mammogram imaging

Older mammogram machines typically produced images on large sheets of film. Today, digital mammograms are common. These newer generation mammograms record digital images saved as computer files. The images are rapidly and conveniently available to radiologists (physicians who are specialists in “reading” x-rays to check for changes that may indicate cancer), oncologists, and other doctors involved in a patient’s care.

Another newer type of mammogram is being used in many hospitals and medical imaging centers. Usually called a 3-D mammogram (the technical name is digital breast tomosynthesis), these high-tech mammograms appear to find more breast cancers, but they are not yet covered by all insurance, the ACS points out.

The 3-D mammograms appear to be especially helpful for women with dense breasts because the technology provides better imaging of their breasts. In addition, some studies have shown 3-D mammograms provide such detailed imaging they reduce the odds a woman will be called back for more imaging due to something questionable being found in a standard mammogram image.

Screening and diagnostic mammograms

• Screening mammograms produce images of breast tissue to check for cancer in women who have no signs or symptoms, such as a lump. Usually, the x-ray pictures are taken to look for tumors that can’t be felt and to check for tiny deposits of calcium, called microcalcifications, which can sometimes be a sign of breast cancer.
• Diagnostic mammograms take longer than screening mammograms because more images are taken from more angles to evaluate breast cancer symptoms, such as lumps, breast pain, thickened skin, nipple discharge, and change in breast size or shape. Diagnostic mammograms are also sometimes used to screen women who were previously treated successfully for breast cancer to check for any recurrence.
• Contrast-enhanced mammograms (CEM) and 3-D mammograms are used with other imaging techniques, including ultrasound and magnetic resonance imaging (MRI), to help guide biopsies and to determine the stage, size, and prognosis of a breast tumor. These specialized views can not only help a doctor to pinpoint the size and location of a tumor but also assess the surrounding tissues and nearby lymph nodes.

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