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Mammography is an x-ray examination of the breast. It is used to detect and diagnose breast disease in women who either have breast problems such as a lump, pain, or nipple discharge, as well as for women who have no breast complaints. The procedure allows detection of breast cancers, benign tumors, and cysts before they can be detected by palpation (touch).
Mammography cannot prove that an abnormal area is cancer, but if it raises a significant suspicion of cancer, tissue will be removed for a biopsy. Tissue may be removed by needle or open surgical biopsy and examined under a microscope to determine if it is cancer.
The recent development of digital mammography technology shows promise for improved breast imaging, in particular, for women less than 50 years of age, women with dense breast tissue, or women who are premenopausal or perimenopausal. Digital mammography provides electronic images of the breasts that can be enhanced by computer technology, stored on computers, and even transmitted electronically in situations where remote access to the mammogram is required. The procedure for a digital mammography is basically performed the same way as a standard mammogram. 3D mammography also known as tomosynthesis, is a promising new technology providing three dimensional (3D) images of the breast, which further assists the radiologists in detecting cancer
With computer-aided detection (CAD) systems, a digitized mammographic image from a conventional film mammogram or a digitally acquired mammogram is analyzed for masses, calcifications, or areas of abnormal density that may indicate the presence of cancer. The images are highlighted by the CAD system for further analysis by the radiologist.
Each breast has 15 to 20 sections, called lobes, which are arranged like the petals of a daisy. Each lobe has many smaller lobules, which end in dozens of tiny bulbs that can produce milk.
The lobes, lobules, and bulbs are all linked by thin tubes called ducts. These ducts lead to the nipple in the center of a dark area of skin called the areola. Fat fills the spaces between lobules and ducts.
There are no muscles in the breast, but muscles lie under each breast and cover the ribs. Each breast also contains blood vessels and vessels that carry lymph. The lymph vessels lead to small bean-shaped organs called lymph nodes, clusters of which are found under the arm, above the collarbone, and in the chest, as well as in many other parts of the body.
A screening mammogram is an x-ray of the breast used to detect breast changes in women who have no signs of breast cancer. It usually involves two x-rays of each breast. Using a mammogram, it is possible to detect a tumor that cannot be felt.
A diagnostic mammogram is an x-ray of the breast used to diagnose unusual breast changes, such as a lump, pain, nipple thickening or discharge, or a change in breast size or shape.
A diagnostic mammogram is also used to evaluate abnormalities detected on a screening mammogram. It is a basic medical tool and is appropriate in the work-up of breast changes, regardless of a woman's age.
Mammography has been used for about 30 years, and in the past 15 years technical advancements have greatly improved both the technique and results. Today, specialized equipment, used only for breast x-rays, produce studies that are high in quality but low in radiation dose.
Mammography may be used either for screening or to make a diagnosis. Women older than 25 years should undergo diagnostic mammography if they have symptoms such as a palpable lump, breast skin thickening or indentation, nipple discharge or retraction, erosive sore of the nipple, or breast pain.
A mammogram may be used to evaluate breast pain when physical examination and history are not conclusive. Women with breasts that are dense, "lumpy," and/or very large may be screened with mammography, as physical examination may be difficult to perform. Women who are at high risk for breast cancer or with a history of breast cancer may be routinely screened with mammography.
The American Cancer Society recommends the following screening guidelines for early detection of cancer in women who have no symptoms:
In addition, the following guidelines by age are recommended: