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Mammogram (cont.)

Do I need to follow-up with my doctor after my mammogram?

If your mammogram is normal, you can wait to have another mammogram at the interval that your doctor has recommended. If you experience any problems with your breasts or changes in the breasts such as a breast lump, breast pain, nipple thickening or discharge, or a recent change in breast size or shape, must be evaluated by a physician. You should always mention anything suspicious to your doctor.

  • To help diagnose breast disease, the doctor will take a medical history that will include questions on your general health, symptoms and their duration, age, menstrual status, number of prior and actual pregnancies, drugs taken, and relatives with benign breast conditions or breast cancer.
  • During the physical exam, the doctor will look carefully at your breasts both while you are sitting and lying down. You will be asked to raise the arms over the head or let them hang by the sides. The doctor will check the breasts for any changes in the skin, any discharge from the nipples, or any difference in appearance between the two breasts. Then, using the pads of the fingers looking for lumps, the doctor examines the entire breast, the underarm, and the collarbone area.

What are the risks of mammogram screening?

The benefit of mammography screening outweighs the risk of any harm from the radiation. Currently it is estimated that ionizing radiation needed for a mammogram is lower than the dose of cosmic radiation to which a passenger on an intercontinental flight may be exposed, or a skier on a mountain over 3,000 meters. Use of low-dose radiation gives doctors the ability to repeat the mammogram once a year, beginning after age 40 to 50 years. A mammogram could be prescribed for women with personal or family history of cancer of the breast or other organs, regardless of her age.

Those patients who have not entered menopause need to make sure they are not pregnant before obtaining a mammogram due to the small potential radiation exposure.

For women who have a breast implant, there is an extremely small chance that the pressure placed on the implant during the mammography will cause a rupture or break. If this occurs, a surgical operation may be needed to have the implant replaced.

In a small number of cases, the accuracy of the mammogram is lower than usual.

  • For women with breast implants, the ability of mammography to detect abnormalities is reduced because the content of the implant (a gel or a liquid) may block the view and because the scar tissue surrounding the implant tightens. Additional X-ray views may be required, and other imaging tests such as MRI may be required in this population.
  • False-positive readings on a mammogram occur when cancer is not present, but a mammogram is read as abnormal. Most of these false-positive readings will turn out not to be cancer. At all ages, 5% to 10% of mammograms are abnormal and are followed up with additional testing (a fine-needle aspiration [or sampling], surgical biopsy, or ultrasound).
  • False-negative findings occur when mammograms appear normal even though breast cancer is actually present and are more common in younger women than in older women. Currently, the rate of false-negatives in mammography is around 8% to 10%.

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