Qestion: What is mammography?
A. Mammography is the process of taking an x-ray picture of the breast; a mammogram is the x-ray film image itself. Usually, two views of each breast are taken, one from the side and one from above. This way, the physician can identify abnormalities such as very small lumps, areas of calcification, or other changes that occur before they can be felt by a woman or her physician.
There are two types of mammograms: screening mammograms and diagnostic mammograms. Screening mammograms are breast x-rays for women who have no symptoms of breast cancer. Diagnostic mammograms may be necessary for a woman who has symptoms of a breast problem or a breast lump.
Question: When should women start getting mammograms and how often? (or, How often should women go for a mammogram?)
A. Both the National Cancer Advisory Board and the National Cancer Institute recommend that women over forty get screening mammograms every one to two years, if they are at average risk for breast cancer. Women with higher risk for breast cancer should discuss with their physicians to determine at what age and how often they should seek mammograms. The agencies caution that women in their forties have a 30 percent chance of having a "false-positive" mammogram; at the same time, because younger women have denser breasts, they also have a 1 in 4 chance of a missed tumor detection with current mammogram technology.
Question: How can a woman prepare for mammography?
A. First, you should check with the office where you'll be having the mammogram for any specific instructions. In general, preparation involves the following:
- You shouldn't wear any deodorant, perfume, powders, or ointments of any sort in the underarm area or on the breast on the day of the exam. These products may cause shadows to appear on the mammogram.
- You should wear a blouse with a skirt or slacks, rather than a dress, to the mammography facility. You will have to undress above the waist for the exam.
- If possible, you should schedule a mammogram 1 week after your menstrual period, since your breasts may be less tender than just prior to or during your menstrual period. The exam should not be painful although the compression of the breast during the exam may cause some discomfort.
Question: How do I know if I'm going to a "good" mammography facility?
A. Until just a few years ago, a woman could go to a mammography facility and not know if the machine was 20 years old or whether the individual who positioned her for the test or interpreted the x-ray findings was well trained. Today, as a result of implementation of the Mammography Quality Standards Act by the Food and Drug Administration, the nation's mammography facilities must meet high standards for technical quality, safety, and staff training, or fail to be certified by the FDA. Under this law, facilities that are not FDA certified -- with a prominently displayed seal of approval -- are operating illegally. To help you find the certified facility closest to you, a full listing of FDA-certified facilities is available by calling 1-800-4-CANCER, or by checking the FDA's web-site.
Question: I don't have a lot of money to spend on these tests. Are they expensive? Is there a way I can get mammograms at a reduced cost?
A. Yes, income is no barrier to getting mammograms. Working with the departments of health in each state in the country, the Centers for Disease Control and Prevention has implemented the Breast and Cervical Cancer Early Screening Program, which provides mammograms and Pap smears (for cervical cancer detection) at low to no cost to women in financial need. Contact your state department of health in your state capital or your county health department (found in the blue pages of your phone book) for additional information about this important program.
You can find out more about cancer in women by contacting the following organizations:
- National Cancer Institute's Cancer Information Service 1-800-422-6237
- American Cancer Society
- The National Center for Human Genome Research, NIH
Reprinted with permission from American Pregnancy Association.