Mammography Techniques and Risks
Expert Quote
Meet our Medical Experts »“Don't worry too much about discomfort during a mammogram. Without that compression, we might miss cancer. If you know that your breasts get very sensitive during some part of your menstrual cycle, try to schedule around it. But ten minutes of discomfort should never be a reason not to have a mammogram. ”
Susan Greenstein Orel M.D.
Film screen mammography
Film screen mammography involves minimal radiation exposure. A skilled technologist positions and compresses the breast between two plates. Then a highly specialized camera takes two pictures of each breast from two directions. Mildly uncomfortable for most women, mammography can be painful for some. But compression of the breast is necessary to flatten and reduce the thickness of the breast. The X-ray beam should penetrate as few layers of overlapping tissues as possible.
If you've had breast surgery for another reason, such as a benign biopsy or surgery to reduce the size of your breasts, the radiologist will want to know where those scars are in case the scar tissue has to be distinguished from another kind of breast abnormality. If you've had breast cancer surgery, small metal balls will be taped on your skin to mark your scar. Your scar defines the site with the highest risk of recurrence.
At least one radiologist, a doctor specializing in imaging the body, reads the mammogram. Having 2 radiologists read your mammogram reduces the chance of missing a problem by about 10-15%. Some centers routinely have your mammogram read twice, but this is expensive, and most insurance companies won't pay for it. You can also get a "second opinion" on your mammogram from a computer. This is called computer-aided detection ("CAD"). The computer finds any area that has any extra thickness to it. The doctor then examines each area and decides if it needs further evaluation.
Digital mammography
Digital mammography uses the same technique as film screen mammography, except that the image is recorded directly into a computer. The image can then be enlarged or highlighted. If there is a suspicious area, your doctors can use the computer to take a closer look. Right now, what doctors can see with digital mammography is not quite as clear as what they can see with film, and the technique is more expensive and not as widely available. But in the future, digital mammography will be more common. Your radiologist may read your mammogram with the help of computer-aided detection ("CAD") programs, and transmit your mammogram to you and your doctor electronically.
Radiation risks
Modern-day mammography only involves a tiny amount of radiation—even less than a standard chest X-ray.
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