Will a Mammogram Save Your Life?

Mammogram - How Does a Mammogram Work?

A mammogram can help to detect breast cancer at the earliest stage and it's an important part of our fight against the breast cancer epidemic. Mammography has been available to women for decades now - and yet even in countries like the UK where these tests are available to all women for free, there is still not full participation by all women in the screening programs.

Some of these tests are performed when there is nothing at all to find on breast examination - no lumps and no suspicious problem areas. This is called a screening mammogram. In some countries these screening tests are offered on a mobile basis - with a large truck staffed by specialist nurses and doctors and with all the necessary gear turning up at a supermarket or at a factory and providing all that is needed for a drop in one stop shop approach.

The other kind of mammogram is called a diagnostic mammogram and this is done when a screening test shows a suspicious area or when the person is aware of a lump in the breast or of some other symptom that could relate to breast cancer. The actual technique of the test is pretty much identical - but extra views or more targetted views might be needed if the test is being done on someone who actually has a lump.

New digital techniques allow the images to be enhanced and make the screening and diagnostic tests easier for doctors to read. Digital mammography is probably more accurate at picking up problems in women under the age of fifty, or for those who have not yet had their menopause.

The latest versions of breast cancer guidelines say that if a woman over the age or thirty discovers a lump in the breast then both a diagnostic mammography test and an ultrasound scan of the breast should be performed. Ultrasound is a good test to show if a lump is solid or full of fluid - like a simple cyst might be for example. A lump with fluid in it looks dark or black on ultrasound - a solid area looks white because of the way that the sound waves from the ultrasound bounce off it.

When a breast mass is solid, its alignment and shape provide clues as to whether it is benign or cancerous. Usually a benign mass is horizontally aligned with smooth borders, while one that is malignant is vertically aligned with irregular borders. The nature of a solid mass can be clarified by performing an image-guided core-needle biopsy. During this procedure, ultrasound or mammography is used to help a radiologist extract a tissue sample from the mass with a needle. A pathologist evaluates the sample.

But ... for some women who have found a lump in the breast, both the mammogram and the ultrasound might be normal. This is obviously good news but if the lump persists then doctors advise having repeated checks - and in rare cases, if the lump is still present after a month or two - a minor operation to remove it or biopsy it should be performed.

Mammograms and breast ultrasound can save lives. So can self examination of the breasts. When did you last check yourself? Are you breast aware?