The breast screening tests that can help save your life.
A mammogram is an x-ray of the breast. Although people speak in general terms about mammograms, there are actually two different kind of mammograms: screening mammograms and diagnostic mammograms.
What is a screening mammogram?
Screening mammograms are routine checks used to find early signs of cancer in women who have no apparent breast problems or symptoms. They can find abnormal changes in the breast that are too small to be felt by you or your healthcare provider.
A screening mammogram only takes about 10 minutes to complete. If any abnormal change is found, your healthcare provider will recommend more tests which might include a diagnostic mammogram – a special x-ray that provides more images and allows a closer look at changes in the breasts.
What is a diagnostic mammogram?
If your screening mammogram detects any abnormal changes, your healthcare provider may recommend having a diagnostic mammogram.
Diagnostic mammograms are special x-rays that provide more images than a screening mammogram. They can be used to look more closely at changes found during a screening mammogram. They’re used for women who have had a previous breast cancer diagnosis and/or for women who notice unusual breast changes, such as:
A new lump in the breast or armpit
A nipple that is turned inward, if it isn’t usually
Crusting, bleeding or a rash on your nipple
Dimpling or thickening of the skin in one area of your breast
If you think you need a diagnostic mammogram, speak to your healthcare provider for a referral.
If you don’t have a healthcare provider, here are some resources to help you find one:
Call Health Link Alberta at 1-866-408-LINK (5465)
Visit www.cpsa.ab.ca (to find doctors only)
Computer Aided Detection (CAD)
CAD is a computer software tool that may help radiologists review your screening mammogram and may be helpful in finding breast cancer.
Right now, CAD is only available at some clinics and while your screening mammogram will always be free, there may be a charge for this added tool. So if it’s offered to you, it’s up to you to decide whether or not you’d like to include this as part of your screening mammogram review.
Researchers are currently studying the use of CAD but evidence about the benefits and risks are still unclear. The hope is that CAD will reduce human error. However, studies about CAD have come to different conclusions. Some have found that CAD improves the accuracy of breast cancer screening, but other studies have not.
Should you have a mammogram?
There are two things we know that help us determine who benefits most from getting screened: we know that the risk of breast cancer goes up as women get older and we know that most women with breast cancer have no history of the disease in their family.
So if you’re age 50 to 74 – even if you have no family history – it’s a good idea to start including a screening mammogram as part of your regular health routine.
Follow these guidelines to get the best benefit from screening:
Women under the age of 40: The risk of breast cancer at this age is low. Generally, screening mammograms are not needed before the age of 40. However, if you're concerned about having an increased risk of breast cancer, talk to your healthcare provider.
Women 40 to 49: Although the risk of developing breast cancer increases with age, it is less clear that the benefits of mammograms outweigh the risks for women in this age group. Talk to your healthcare provider about your breast cancer risk and your need for mammograms.
Women 50 to 74: During these years, breast cancer screening has proven to have the most benefit. Plan on having a mammogram every two years or as decided by you and your healthcare provider.
Women 75 or over: You may continue to benefit from regular screening mammograms. Talk to your healthcare provider.
See the Breast Screening Life Plan to know the best way to keep track of changes in your breasts throughout your lifetime.
What if you have breast implants?
If you have breast implants, early detection of breast cancer is still very important. However, because implants can interfere with screening mammograms, you’ll require additional images in order to detect abnormal changes. To book a diagnostic mammogram you will need a referral from your healthcare provider. When booking an appointment for your mammogram, remember to let the clinic know that you have breast implants.
Preparing for your mammogram
On the day of your appointment you should:
Wear a separate top and bottom since you’ll have to remove clothing from the waist up.
Avoid wearing antiperspirant, deodorant or body powder as these can affect the mammogram results.
Think about some ways you can help yourself relax during your mammogram. The appointment shouldn’t take very long and every effort will be made to make it as comfortable as possible.
How is a mammogram done?
You might have a few questions about how a mammogram is done. The process itself should only take about 10 minutes and will be done by a female technologist to help you feel comfortable and at ease.
Once you’re standing in front of the mammography unit:
Your breast will rest on a plastic plate that will be adjusted to your height.
A second plate will press down on your breast for a few seconds to spread out the breast tissue so that small abnormalities can be seen.
For a screening mammogram, two x-rays will be taken of each breast; one from the top and one from the side. Several more x-rays are taken for diagnostic mammograms.
The x-rays will then be looked at by a radiologist for any abnormal changes.
Does a mammogram hurt?
Because your breasts need to be compressed to get the best image possible, it may be uncomfortable or slightly painful (but tolerable). The good news is each compression only lasts a few seconds, so any discomfort will be very brief.
If you normally have tender breasts, you may find it more comfortable to have your mammogram at least a week before or after your period.
Find out why compression is important when having a mammogram. From the BC Cancer Agency Screening Mammography Program.
How do you get your mammogram results?
After you’ve had your screening mammogram, the x-rays will be looked at for abnormal changes. There are a few different ways you may get your results:
You may hear from your healthcare provider.
You can contact your healthcare provider, if you haven’t heard from them already.
You may receive a result letter from the radiology clinic in partnership with the Alberta Breast Cancer Screening Program
There are two types of results:
Your result may be normal. This means no signs of breast cancer were found at this time. About 93% of women have a normal result.
Your result may be abnormal. As scary as this result may be, try to keep in mind that only a small percentage of abnormal results are actually cancer. However, any abnormal changes should be checked as soon as possible. Your healthcare provider or the radiology clinic will arrange for more tests, which may include a diagnostic mammogram, an ultrasound or a biopsy. What to do if your results are abnormal
When to have your next mammogram
Once you’ve had your screening mammogram and the results are normal, you can follow these guidelines for your next test:
If you’re 40 to 49, and your healthcare provider has suggested you have screening mammograms regularly, you’ll probably need one every year. Women of this age who benefit from screening often have dense breast tissue (less fat), so small cancers are not easily seen.
If you’re 50 to 74, plan on having a screening mammogram every 2 years or as decided by you and your healthcare provider.
If you’re 75 or over, talk with your healthcare provider about whether you should continue having screening mammograms and how often to return.
In between mammograms, it’s always a good idea to:
Talk to your healthcare provider about having your breasts examined as part of your regular health check-up. This is not a substitute for your regular mammogram.
Know what looks and feels normal for you. And always tell your healthcare provider if you notice changes or anything unusual.
The benefits and risks of getting screened
Almost any kind of test carries certain risks and benefits – and the same is true for screening mammograms. Being informed will allow you to make decisions that are right for you.
Benefits of being screened
Since screening mammography and improved treatment were introduced in Alberta, the risk of women dying of breast cancer has been dropping steadily. Women across Alberta are living longer, healthier lives.
And although screening mammograms can’t prevent breast cancer, screening mammograms done regularly:
Can find cancer early when treatment is likely to be more successful.
Often find small tumours in the breast before they can be felt.
Let the radiologist compare your current and past mammograms for changes in the breast.
Reduce deaths from breast cancer by up to 30%.
Risks worth knowing about
There are many benefits to being screened for breast cancer. But there are also a few risks you should be aware of:
There’s a chance your mammogram will show no signs of abnormal changes even though breast cancer is present. That’s why it’s important to know your breasts and to let your healthcare provider know right away if you notice any unusual changes, even if your mammogram is normal.
You may have a false alarm which can be stressful. Something abnormal might be seen on your mammogram and, after more tests, no cancer is found. This may take 4 to 6 weeks to sort out and can cause worry. Sometimes, the worry lasts long after the test results are known.
Even though a mammogram found breast cancer, the quality of life or the number of years you live may not change. Some breast cancers found by screening would otherwise cause no problems because women would die of something else first. These breast cancers could be slow growing cancers. So, if the woman had not been screened, she might never have known she had cancer and would not have had treatment.
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|About breast cancer screening|