Mammography

What is a mammogram?

A mammogram is a specialized imaging test that uses X-rays to provide a detailed evaluation of breast tissue. It is one of the most effective methods for identifying changes that may be invisible or undetectable during breast self-examinations. Mammographic examinations are non-invasive and relatively quick, making them a commonly used tool in breast disease prevention and diagnosis.

What can a mammogram detect?

Mammograms are highly effective in detecting various changes in breast tissue, including:

• tumors: both benign and malignant;
• microcalcifications: small calcium deposits that may be an early sign of breast cancer;
• structural changes: such as cysts, fibromas, or other abnormalities in breast structure;
• inflammatory changes: which may indicate infections or other inflammatory conditions.

Mammography allows for the early detection of breast cancer, significantly increasing the chances of effective treatment and full recovery.

When should a mammogram be performed?

Women aged 50-69 should have a mammogram every 2 years as part of routine screenings. Women at higher risk should start regular exams earlier, typically from age 40. For those with genetic predispositions, annual mammograms are recommended regardless of age. In case of concerning symptoms or breast changes, the test should be performed immediately, regardless of age.

How is a mammographic examination conducted?

The first step is preparation for the exam. The patient is asked to undress from the waist up and remove jewelry, especially necklaces, which could interfere with the image. Next, a radiology technician will invite the patient to the room with the mammogram machine—a specialized device for taking X-ray images of the breasts.

The key part of the exam is properly positioning the breast in the mammogram machine. The breast is placed between two plates of the device. The plates are then brought together, applying pressure. This step may feel uncomfortable or slightly painful but lasts only a few seconds and is necessary to obtain a clear image.

Typically, two images of each breast are taken—one from top to bottom and one at an angle. In some cases, the doctor may decide to take additional images. During the imaging, the patient is asked to hold their breath for a short moment to prevent blurring of the image.

After all necessary images are taken, the patient can get dressed and resume their daily activities.

How long does a mammographic exam take?

A mammographic breast exam is a relatively quick procedure. The entire exam usually takes about 15-20 minutes.

Mammographic Breast Exam – Preparation

Mammography does not require special preparation. However, keep in mind a few important points:

1.      It is best to schedule the exam during the first half of your menstrual cycle (days 5-10) when the breasts are least sensitive.

2.      On the day of the exam, do not use deodorants, antiperspirants, talcum powder, lotions, or creams around the breast and underarm area. They can affect the quality of the image.

3.      Wear two-piece clothing to make undressing easier. Avoid wearing necklaces.

4.      If possible, bring results of previous mammograms for comparison.

FAQ – Frequently Asked Questions

At what age should the first mammogram be done?

In Poland, the first mammogram under the screening program can be performed at age 45.

However, it is worth noting that in some cases, a doctor may recommend performing a mammogram earlier, especially if there are risk factors, such as:

• presence of BRCA1 and BRCA2 gene mutations;
• long-term use of hormone replacement therapy (at least 10 years);
• family history of breast cancer;
• abnormalities found during a breast ultrasound or physical exam.
   

For women at higher risk, the first mammogram is recommended from age 40 or even earlier, depending on the individual health situation.

How long does it take to get mammogram results?

The waiting time for results may vary depending on the facility performing the mammogram. Typically, it takes from a few days to about two weeks.

Does a mammogram hurt?

A mammogram can cause some discomfort but is generally not considered a painful procedure. During a mammogram, the breast must be compressed between two plates, which may cause a feeling of pressure. For some women, this pressure can be quite uncomfortable or even painful, but it is an individual experience.

Which is better, a breast ultrasound or a mammogram?

The choice between an ultrasound and a mammogram often depends on individual factors such as the patient's age, breast tissue density, medical history, and the presence of specific symptoms. A breast ultrasound is more suitable for younger women with denser glandular tissue. It is a safe test that can also be performed on pregnant and breastfeeding women.

When should a mammogram not be performed?

Mammograms are not performed on pregnant women. In such cases, doctors usually recommend alternative breast examination methods, such as an ultrasound. Mammograms are also not recommended during breastfeeding. Breast tissue is altered due to hormones and milk production, making it difficult to interpret results correctly. It is recommended to wait several months after breastfeeding ends for the tissue to return to its normal state.

Women who have recently undergone breast surgery or a biopsy should also wait before having a mammogram. In such cases, doctors usually recommend waiting a few months for the tissue to fully heal.

For active breast infections, such as mastitis, a mammogram is not advised either. The exam may be painful for the patient, and the inflammation can affect the radiological image.

Can a mammogram be done without a referral?

Yes, a mammogram can be performed without a referral, but the patient will need to pay for the exam. In Poland, from November 1, 2023, women aged 45 to 74 can access free mammograms under the breast cancer prevention program, without needing a referral.