Diagnostic Mammography

Authors: Dr Helen Frazer*
                            A/Prof Liz Wylie *

What are the prerequisites for having diagnostic mammography done?

Diagnostic mammography is performed in symptomatic patients, that is patients who have signs or symptoms of breast cancer such as a palpable lump, nipple discharge, skin changes etc.

What are the absolute contraindications for diagnostic mammography?

There are no absolute contraindications for diagnostic mammography.

What are the relative contraindications for diagnostic mammography?

Diagnostic mammography is rarely performed in women under 30 years, due to the density and radiation sensitivity of the breast tissue. Pregnancy and breastfeeding are also relative contraindications due to exposure to radiation. Radiation protection measures can be put in place to obtain mammograms on these patients. Lactating breasts are more sensitive to radiation, with regard to the likelihood of cancer being induced, compared with the breasts of women who are not breast feeding. However, this small risk must be balanced against the risk of missing the diagnosis of breast cancer as breast cancer does occur sometimes in pregnant and breastfeeding women.

What are the adverse effects of diagnostic mammography?

The risk of getting breast cancer from diagnostic mammography is very low. Very occasionally bruising or splitting of the skin occurs. Implant rupture has been reported however the risk is very low.

The Health Protection Agency of the United Kingdom estimates the risk of an additional cancer in a life time from a single mammographic examination to be in the low risk range: 1 in 100 000 to 1 in 10 0001. This is the same risk of developing a cancer as that which arises from exposure to the natural background radiation accumulated from the normal environment in 1 year.

Are there alternative imaging tests, interventions or surgical procedures to diagnostic mammography?

For women with a palpable lump, it is important to note that mammography does not detect all breast cancers, even when the cancer has caused a lump that can be felt. In such a circumstance, a normal mammogram does not mean that the lump can be ignored. In this situation, other diagnostic tests such as breast ultrasound, fine needle aspiration or vacuum assisted core biopsy may be necessary to find out the cause of the lump.

Reference:

  1. X-rays – How safe are they?
    http://webarchive.nationalarchives.gov.uk/20140714084352/http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1194947388410
*The author has no conflict of interest with this topic.

Page last modified on 26/7/2017.

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