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Mammography FAQ

What is a screening mammogram?

A screening mammogram is an X-ray of the breast used to detect breast changes in women who have no signs or symptoms of breast cancer. It usually involves two X-rays of each breast. Mammograms make it possible to detect tumours that cannot be felt. Mammograms also can find microcalcifications (tiny deposits of calcium in the breast) that sometimes indicate the presence of early breast cancer.

How are screening mammograms and diagnostic mammograms different?

A diagnostic mammogram is an X-ray of the breast that is used to check for breast cancer after a lump or other sign or symptom of breast cancer has been found. Signs of breast cancer may include pain, skin thickening, nipple discharge, or a change in breast size or shape. A diagnostic mammogram also may be used to evaluate changes found during a screening mammogram, or to view breast tissue when it is difficult to obtain a screening mammogram because of special circumstances, such as the presence of breast implants. A diagnostic mammogram takes longer than a screening mammogram because it involves more X-rays in order to obtain views of the breast from several angles. The technician may magnify a suspicious area to produce a detailed picture that can help the Clinical Director make an accurate diagnosis.

What are the benefits of screening mammograms?

Research has confirmed that routine screening mammography is effective from age 40, and can reduce the number of deaths from breast cancer. In women at moderate or high risk, annual mammography is effective from age 35 onwards.

What are some of the limitations of screening mammograms?

Even though mammography can detect tumours that cannot be felt, finding a small tumour does not mean that a woman’s life will always be saved. Mammography may not help a woman with a fast-growing or aggressive cancer that already has spread to other parts of her body before being detected.

What is a false negative in a mammogram?

False negatives occur when mammograms appear normal even though breast cancer is present. Overall, mammograms miss up to 20 percent of the breast cancers in older women that are present at the time of screening. False negatives occur more often in younger women than in older women because the dense breasts of younger women make breast cancers more difficult to detect in mammograms. As women age, their breasts usually become more fatty (and therefore less dense), and breast cancers become easier to detect with screening mammograms.

 

What is a false positive in a mammogram?

False positives occur when mammograms are read by a radiologist as abnormal, but no cancer is actually present. All abnormal mammograms should be followed up with additional testing (a diagnostic mammogram, ultrasound and/or biopsy) to determine if cancer is present. False positives are more common in younger women, women who have had previous breast biopsies, women with a family history of breast cancer and women who are taking oestrogen (for example, hormone replacement therapy).

What happens if mammography leads to the detection of ductal carcinoma in situ (DCIS)?

Over the past 30 years, improvements in mammography have made it possible to detect a higher number of tissue abnormalities called DCIS. DCIS, or Ductal Carcinoma In Situ is the presence of malignant cells that are confined to the milk ducts of the breast. The malignant cells have not yet developed the ability to invade the surrounding breast tissue. DCIS does not usually cause a lump, so it cannot usually be detected during a clinical breast exam. However, mammography is able to detect 80 percent of DCIS cases. Some of these cases later become invasive cancers. It is not possible to predict which cases of DCIS will progress to invasive cancer. Therefore, DCIS is usually removed surgically. Until recently, DCIS often was treated with a mastectomy, but breast-conserving therapy (breast-sparing surgery plus radiation therapy) is now standard practice for many women with DCIS. Women who have been diagnosed with DCIS should talk with one of our partner breast surgeons to make an informed decision about optimal treatment.

What should women with breast implants do about screening mammograms?

Women with breast implants can continue to have mammograms. (A woman who had an implant following breast cancer surgery should ask her doctor whether a mammogram of the reconstructed breast is necessary.) It is important to inform the mammography facility about breast implants when scheduling a mammogram. The technician and radiologist must be experienced in X-raying patients with breast implants. Implants can hide some breast tissue, making it more difficult for the radiologist to detect an abnormality on the mammogram. If the radiographer performing the procedure is aware a woman has breast implants, steps can be taken to make sure that as much breast tissue as possible can be seen on the mammogram. Many women with breast implants complain over increased mammography discomfort compared with life before breast implants.

What is digital mammography?

Both digital and conventional mammography use X-ray radiation to produce an image of the breast; however, conventional mammography stores the image directly on film, whereas digital mammography takes an electronic image of the breast and stores it directly on a computer. This allows the recorded data to be enhanced, magnified or manipulated for further analysis.

How is digital mammography different from conventional (film) mammography?

The difference between conventional mammography and digital mammography is like the difference between a traditional film camera and a new digital camera. Aside from the difference in how the image is recorded and stored, there is no other difference between the two. In September 2005, preliminary results from a large clinical trial (research study) of digital versus film mammography were published. These findings show no difference between digital and film mammograms in detecting breast cancer for the general population of women in the trial.

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