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mammogram is a special X-ray image of the breast. Two X-rays are
taken for each breast. The X-rays are usually done by a trained woman radiographer.
The mammograms are then reported by a radiologist. Recent advances
in mammography equipment and techniques have resulted in women now only
receiving a small radiation dose, which is about the same as that received
every year from normal background radiation. The benefits of
being screened for breast cancer far outweigh any potential risks of
radiation from a mammogram examination.
Mammography is the most effective, non invasive and the best
way to detect early breast cancer especially when it is too small to be
felt by the patient or the doctor. For this reason, breast screening is
now available to all women aged 40 and above. Mammography complements but
cannot replace monthly breast self examination (BSE) and regular physical
examination.
Mammography is usually not painful but may be uncomfortable
especially in women with smaller breasts. Each breast is gently squeezed
and flattened by a special device when the x-ray images are taken. This
lasts for a few seconds and will not harm the breast. The entire
examination will take approximately half an hour.
The present guidelines for screening of asymptomatic women
(women who do not have any symptoms related to the breast) are:
- At
age 35-40: baseline mammogram
- At
age 40-49: mammograms at one or two year intervals
- At
age 50 and above: annual mammograms
Symptomatic women, that is women who have signs or symptoms
related to the breast like a lump, nipple discharge, mastalgia (breast
pain), unexplained decrease or increase in breast size or appearance, will
require a mammogram to resolve the particular problem.
This may sometimes require additional images where the
abnormal area seen on the mammogram is further compressed to give a
clearer picture. A palpable lump or an abnormality detected on screening
mammogram may also require further examination like breast ultrasound or
special mammographic procedures such as stereotactic guided fine
needle aspiration cytology (FNAC), core biopsy or wire
localisation.
Mammography may be the key to successful treatment
and cure of the disease. However, mammography can fail in detection of
some cancers since not all breast carcinomas produce a recognisable change
in the mammogram and this occurs more often when the woman has dense
breast tissue. Palpable cancers are not always visible and visible cancers
are not always palpable.
No special preparation is required for a mammogram. However,
it is advisable to wear separates (two piece garments) – sarong, skirt
or pants with a button-through top. This is helpful for the mammographic
positioning and also for an ultrasound examination, if needed. The women
are advised not to use deodorant, talcum powder or perfume which may cause
artifacts on the X-ray film and which may require a repeat examination.
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