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A diagnostic mammogram is an X-ray examination of the breasts. This is carried out when a person, their doctor or another health professional discovers unusual signs or symptoms in one or both breasts; that is, a lump, tenderness, nipple discharge or skin changes. The mammogram confirms whether the changes are benign (non-cancerous) and no treatment is needed, or whether the changes indicate possible breast cancer and further tests and treatment may be required.
Your doctor would refer you for this procedure, as mammography is a sensitive test to show breast cancers and benign causes of breast symptoms, particularly in women aged older than 40 years.
If you have menstrual or monthly periods, it is best to have your diagnostic mammogram appointment 1 week after the start of your period. The breasts will not be as tender at this time and you will not feel as much discomfort or pain for the few seconds when the breasts are pressed between two plates to take the X-ray pictures or images.
If you have breast implants, please let the hospital, clinic or radiology practice know, so they can schedule a longer appointment. The presence of implants needs more time to make sure clear images are taken.
When you make the diagnostic mammogram appointment, you will be told not to wear any deodorant, perfume, lotion or talcum powder on the day of your appointment, because these substances may show up as shadows on your mammogram. If you have had previous mammograms at other centres, please bring them with you to your appointment, so they can be compared with the new diagnostic mammogram. It is better to wear a two-piece outfit, so you only need to undress from the waist up.
When you have undressed, a radiographer will explain the mammography procedure to you and ask a few questions; for example, ‘have you had a prior mammogram?’, ‘do you have a history of prior breast procedures’, ‘do you have a family history of breast disease?’. Your breasts will then be put, one at a time, between two special plates and compressed (pressed down) between the plates by the X-ray machine for a few seconds while X-rays are taken. Two views of each breast are taken as a minimum.
The mammography and the compression are carried out by a specially trained radiographer (medical imaging technologist). While the compression may be uncomfortable and perhaps painful, it lasts only seconds. Without compression, the X-rays would be blurry, which makes it hard to see any abnormality. Compression also reduces the amount of radiation required for the mammogram.
After effects are rare. You may experience breast tenderness, bruising or, very occasionally, minor splitting of the skin if your skin is fragile. Please tell the radiographer who is doing the test if you tend to bruise or have skin that breaks easily.
Standard diagnostic mammography takes between 10–15 minutes. Sometimes extra views are taken, which will take longer. If you have breast implants, the mammography will take approximately 30 minutes, because it takes more time to make sure clear images are taken.
Like all X-rays, having a mammogram exposes you to some radiation, but only a small amount. Scientists estimate that there is less than a 1 in 25,000 risk of a mammogram causing breast cancer (see InsideRadiology: Radiation Risk in Medical Imaging for Adults and Children).
Such risk is far outweighed by the benefit of early detection of breast cancer, significantly reducing the death rate from the disease and providing better treatment options. The Health Protection Agency of the United Kingdom estimates the risk of an additional cancer in a lifetime from a single mammographic examination to be in the low-risk range: 1 in 100,000 to 1 in 10,000.1 The risk of developing cancer from a mammogram is no greater than developing cancer from exposure to the natural background radiation accumulated from the normal environment in 1 year.
If you have breast implants, there is an extremely small risk of damage to the implant.
For women with a lump that can be felt, 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 with needle biopsy, may be necessary to find out the cause of the lump.
You may have heard of women having dense breasts. Dense breasts are where there is a large amount of glandular tissue present that could mask and obscure the detection of breast abnormalities.
If your doctor believes you may have dense breasts and you have a significant breast symptom, or a strong history or personal history of breast cancer, they may recommend you have a breast ultrasound (see InsideRadiology: Breast ultrasound) as well as a mammogram.
The benefits of mammography far outweigh the risk. Multiple scientific studies have provided plenty of evidence that early diagnosis and treatment of breast cancer can save lives.
Early detection increases the likelihood of a cancer being successfully treated and often allows for greater treatment options.
The X-rays are taken by a radiographer (medical imaging technologist), who has received specialist training in the field of mammography. The mammograms are then read and interpreted by a radiologist (a specialist doctor with training in breast imaging), who will provide your referring doctor with a report of the examination.
Diagnostic mammography is carried out in hospital radiology departments, breast clinics or private radiology practices.
The time it takes your doctor to receive a written report on the test or procedure will vary depending on:
Please feel free to ask the private practice, clinic, or hospital when the written report will be provided to your doctor.
It is important that you discuss the results with your doctor, either in person or on the telephone, so that they can explain what the results mean for you.
Page last modified on 31/8/2018.
RANZCR® is not aware that any person intends to act or rely upon the opinions, advices or information contained in this publication or of the manner in which it might be possible to do so. It issues no invitation to any person to act or rely upon such opinions, advices or information or any of them and it accepts no responsibility for any of them.
RANZCR® intends by this statement to exclude liability for any such opinions, advices or information. The content of this publication is not intended as a substitute for medical advice. It is designed to support, not replace, the relationship that exists between a patient and his/her doctor. Some of the tests and procedures included in this publication may not be available at all radiology providers.
RANZCR® recommends that any specific questions regarding any procedure be discussed with a person's family doctor or medical specialist. Whilst every effort is made to ensure the accuracy of the information contained in this publication, RANZCR®, its Board, officers and employees assume no responsibility for its content, use, or interpretation. Each person should rely on their own inquires before making decisions that touch their own interests.