Mammography and frequently ask questions

Yumnam Samita Devi *

Normal (left) versus cancerous (right) mammography image :: Pix - National Cancer Institute/Wikipedia

1: Introduction : Any Lump in the Breast should never be neglected. In younger patient they are generally benign but breast cancer is very common in woman over 50 years. Lack of awareness, late diagnosis and Inadequate treatment are important reasons for poor outcome of the treatment for breast cancer in India.

2: Mammography – It is one of the specific type of breast imaging technique to diagnose Breast Cancer using a low dose X-Ray In short it is called a picture of Breast. Ultrasonography along with Mammogram gives better understanding of the breast lump in younger woman USG.

Screening Mammogram – It is done once a year and under the guidance of doctor for “high risk” group as a part of the general health check up in healthy womanDiagnostic Mammogram – It is used to evaluate a patient with abnormal clinical findings like lump in breast. Mammogram combine with USG gives better understanding of the breast lump and local lymphatic system

3: High Risk Group – People who have more chance of developing Breast Cancer
1. Woman age between 30 to 70 years;
2. Early Menstruation;
3. Late or no pregnancy;
4. Menopause after 55 yr;
5. Dense Breast;
6. Personal history of Breast Cancer;
7. Family history of Breast Cancer;
8. Family Infrastructure;
9. Breast disease;
10. Physically inactive;
11. Obesity;
12. Oral Contraceptives Pills;
13. Alcohol & Smoking;
14. Dietary Pattern;
15. Stress;

4: Frequently ask questions (FAQ’s)

1. What is Mammogram?
It is an X-ray of the breast.

2. Why should I do Mammogram?
Mammogram can detect the lump before it is palpable. Early diagnosis and adequate treatment saves life.

3. Is Mammogram Painful?
Depends on the pain threshold capacity of the individual, yes of course it may cause some discomfort during the time of pressing. Some woman say its painful , while some say its like pinching.

4. Is Mammogram safe?
Yes. It is not an invasive procedures and safe. Should not be done in pregnant women and lactating (breast feeding) mothers.

5. How long does it take to do Mammogram?
Mammogram takes 10–15 minutes, sometimes repeat pictures may require and may ask to wait another 5 minutes.

6. Is Mammogram done under anesthesia?
No. There is no requirement for sedation or anesthesia.

7. How is Mammogram done?
Single breast in Position is compress with adequate pressure in between two clear plates, the plates are attached to a highly specialized camera which takes picture of breast simultaneously from two different directions. The technique is repeated on the other breast.

8. Who should undergo Mammogram?
Woman of age 50 years and above. Woman who have been suggested to have a mammogram done by their doctor irrespective of their age. Any lump in breast or other suspected clinical findings.

9. Where can I go for Mammogram?
Any hospital where Mammogram is available

10. I am just 20 years old should I do mammogram? If yes why? If no why?

No you are not eligible for mammogram, because of the dense breast tissue mammogram may not give desire result, instead your doctor may advice Ultrasonography, if at all required.

11. Which age group should prefer Mammogram and why?
50 years and above. At this age due to hormonal changes there may be changes in the breast. Breast tissue are less dense and mammogram will be the right choice for early detection of any abnormalities.

12. I am a breast feeding mother of 42 years. Can I do Mammogram?
No, during breast feeding Mammogram is not advisable, if needed USG may be suggested.

13. How frequently should I do a Mammogram?
Once a year during general health check up.

14. What are the benefits of doing Mammogram If I don’t have any breast problem?
Early detection of breast cancer, in fact it will save your life on time.

15. My breast is swollen and very tender can I do Mammogram?
First discuss with a Physician in case of such symptoms. Ideally in tender breast Mammogram is not suggested as it may be very painful. Doctor may give you some medication to treat the symptoms and plan accordingly for the mammogram or Ultrasonography.

16. I have some rashes on my breast can I go for Mammogram?
Wise decision will be first discuss with a physician in case of symptoms. Rule out the root cause of the rashes. All skin changes on a breast are not necessarily a sign of breast cancer. On the other hand it may be inflammatory breast cancer also. Hence it is good to investigate thoroughly.

17. What is the approximate cost of Mammogram?
Depends on the institution. Cost is always not an important factor. A reliable center and a good radiologist are important.

18. Which Doctor should I contact for Mammogram?
Your family Physician/Local Surgeon, Gynecologist may recommend better.

19. I have done regular Mammogram and unfortunately the report shows breast cancer, What next I should do ? / which specialist doctor I should discuss for further treatment ?
Preferable visit a hospital where there is Oncology department (Cancer treatment), if not at nearby any hospital. Discuss the report with a Breast cancer doctor (Surgeon/Medical Oncologist/Radiation Oncologist).

20. Why Ultrasonography adjunct Mammogram in some hospital? Is it not an unnecessary expenditure to the patient?
In a dense breast tissue of young patients sometimes Mammogram may not give satisfactory report in such cases the radiologist will combine mammogram with a breast USG it gives a clear understanding in diagnosis and helps in and treatment planning.

21. Can only Mammogram confirm breast cancer and start treatment of breast cancer?
Mammogram is one of the investigation tool for the diagnosis of breast cancer, but treatment can start only after tissue sampling report and final confirmation of cancer. Core Biopsy and Fine Needle Aspiration cytology (FNAC) are two method of confirming the presence of cancer.

22. What are the other investigations required to stage breast cancer apart from mammogram?
Apart from Mammogram other investigations include biopsy, X-rays and Scans to see the extent of the disease.

23. Is the radiation of Mammogram harmful?
Not really, the radiation exposure in Mammography is very minimal. It is much higher in CT scan.

24. Is there any Vaccine available to prevent from Breast Cancer?
No.

25. Any specific food or fruits to be taken to prevent from Breast Cancer?
Not really, just focus on balance diet, avoid junk and process food and juice.