Mammography is an examination, which is crucial in fight against the breast cancer. This form of cancer is very common in women in developed countries. Timely diagnosis is essential for successful therapy and survival. In many developed countries, regular mammography is a part of special screening programs. The concept of such program is an examination performed in a large part of target population.
The mammograph is simply told a special subtype of an X-ray machine. When examined, the breast tissue is slightly compressed by a special plate to ensure better quality of the resulting image and this allows to use lower amount of radiation energy. The image is evaluated by a physician to exclude presence of any suspicious lesions.
The actual test does not require any special preparation. The woman should only undress upper half of her body shortly before the examination.
Mammography is indicated in examination of unknown lumps in the breast where we want to evaluate its precise location, size and distinguish benign structures from the breast cancer. When the examination is a part of screening program, it is performed regularly (usually annually) in asymptomatic women from certain age, aiming to find as many asymptomatic breast cancers in screened population as possible. Women with significantly high risk of breast cancer (occurrence of breast cancer or other gynecological malignancies in close relatives) may have a special mammographic preventive program.
Mammography is able to visualize adipose breast tissue of older women, but it is less reliable in examination of young women, where we prefer breast ultrasound. In addition, the ultrasound does not expose the women to radiation.
The safety of mammography is discussed. It is an X-ray examination and it exposes the breast to radiation. Because the radiation is carcinogenic, there is a possibility that mammography may be paradoxically the causative factor of breast cancer occurrence. However, it is difficult to confirm this suspicion due to the lack of evidence.
As always, we should think pragmatically. The mammography exposes women to small amount of radiation and the risk of causing a breast cancer exists. However, given the number of lives that mammography has saved by early diagnosis of asymptomatic cancers, we must consider the risk as minimal and acceptable.