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Summary Article: MAMMOGRAPHY from Encyclopedia of Wellness

Breast cancer is the most common cancer in women. According to recent figures from the Centers for Disease Control and Prevention (CDC), more than 200,000 U.S. women are diagnosed with breast cancer and more than 40,000 die each year (“Fast Facts”). One important weapon in the battle against the disease is the use of mammography. The test, known as a mammogram, screens the breast using x-ray technology, to find cancer before it is discovered during a self-exam of the breast or a clinical exam by a doctor or nurse. There are two types of mammograms, a screening mammogram for women who have no known problem and a diagnostic mammogram that is used to evaluate a patient or as a follow-up to earlier x-rays that showed an abnormality.

Studies show that regular mammograms can increase a woman's chances of discovering early stage breast cancer when it is more likely to be curable. However, in 2009, the United States Preventive Services Task Force, an independent panel of experts appointed by the Department of Health and Human Services to examine health questions, recommended less frequent mammograms for women and recommended that women start breast cancer screening later in life at age 50 rather than age 40. Their recommendations did not include the small group of women with unusual risk factors for breast cancer. The best advice for any women is to check with their physician and consider individual risk factors. The test can also be helpful for men, who also get breast cancer. In men, the cancer can occur at any age but is most common in men between the ages of 60 and 70 years. Still, male breast cancer is uncommon, for every 100 cases of breast cancer, less than one is diagnosed in men (“Fast Facts”). The American Cancer Society, American College of Surgeons, American Medical Association, and the American College of Radiology all recommend annual mammograms for women past the page of 40 and as requested by their physicians for men.

New technology in mammography now includes the use of magnetic resonance imaging (MRI), ultrasound, and digital imaging. While these technologies improve the quality of the breast image and improve the actual diagnosis, they have not replaced traditional or standard mammography as the best way to spot breast cancer. In fact, according to the results of a trial funded by the National Cancer Institute, led by investigators at the University of North Carolina at Chapel Hill, digital mammography was neither better nor worse than standard mammography in finding breast cancers except in the cases of women with dense breasts when digital was superior.

According to researchers, a chief advantage of digital mammography is that radiologists can fine-tune the images to make any abnormalities more noticeable. No matter which type of equipment is used, both digital and standard mammography equipment must be certified by the U.S. Food and Drug Administration (FDA) according to the Mammography Quality Standards Act (MQSA). The MQSA took effect October 1, 1994, and called for FDA certification of all mammography equipment and facilities, including hospitals, outpatient clinics, doctors’ offices, or other clinics.

A screening mammogram is conducted by having a woman stand and face the mammography machine. She must wear a hospital gown or other covering so that she can expose each breast, which is then placed on a plastic or metal film holder approximately the size of a placemat. The technician lowers the machine until the breast is compressed as flat as possible between the film holder and a paddle or rectangle, again the same size of a placemat. The compression lasts for seconds as the x-rays are taken. While compression is uncomfortable, it is necessary to provide the best view of breast tissue, especially in the case of dense breast tissue. Screening mammograms find some 85 percent of breast cancers.

The radiologist then examines the x-rays to determine the appearance of the breasts and creates a report with the details. A mammogram with no abnormalities receives a rating of BIRADS1, based on the Breast Imaging Reporting and Data System (BIRADS), created by the American College of Radiology. A BIRADS2 is benign or noncancerous if one or more abnormalities were found but are variations of normal. The rating system extends to BIRADS5, which means an abnormality has been found that appears highly suggestive of cancer and a biopsy is recommended.

Since the biggest risk factors for developing breast cancer are age or a positive family history of the disease, guidelines recommend an annual screening mammogram for every woman at age 40 and younger for those women with more risk factors. According to the American Cancer Society one in eight women in the United States will develop breast cancer so education about yearly mammograms and monthly breast self-examination may make a difference. An early diagnosis may mean successful treatment while an end-stage diagnosis may reveal little can be done for the patient.

See also Cancer; Centers for Disease Control and Prevention (CDC).

References
  • American Cancer Society (ACS). www.cancer.org.
  • Digital Mammography Better for Some Women.” Staying Healthy from the Faculty of Harvard Medical School. August 21, 2006.
  • Fast Facts.” Centers for Disease Control and Prevention (CDC). 2010. www.cdc.gov/cancer.breast/basic_info/fast_facts.htm.
  • Mammography in Women over Forty Catches Disease Earlier.” Women's Health Weekly, August 14, 2003, 14.
  • National Cancer Institute. Office of Cancer Communications. NCI/Cancer Information Service. http://cancernet.nci.nih.gov.
  • Smith, Robert A.; Debbie Saslow; Kimberly Andrews Sawyer; Wylie Burke; Mary E. Costanza.American Cancer Society Guidelines for Breast Cancer Screening: Update 2003.” Cancer (May-June 2003): 141-70.
  • U.S. Cancer Statistics Working Group. “United States Cancer Statistics: 1999-2007 Incidence and Mortality Web-Based Report.” Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute. 2010. http://apps.nccd.cdc.gov/uscs/.
  • Sharon Zoumbaris
    Copyright 2012 by Sharon Zoumbaris

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