Mammograms are quick and easy. You undress from the waist up, covering your upper body with a wrap provided by the facility. You stand in front of an X-ray machine and a technician will help you position your breast on the X-ray plates, flattening it to enable to X-ray machine to get a clear picture of the breast tissue. You may feel a little uncomfortable, but it usually lasts for only 1 to 2 minutes. The entire process of taking the X-ray images lasts about 20 minutes.
The best time to go for a mammogram is to schedule it about a week after your period. To ensure that the mammogram which you are going to get is clear,
- do not wear deodorant or body powder on the day of your mammogram as these can show up as dark spots on the X-rays and interfere with the radiologist’s ability to assess the condition of your breasts.
- stand perfectly still during the mammogram.
- bring a list of the dates and locations where past mammograms and/or biopsies were done, past mammograms and biopsy reports if you have them, to help the physician who is assessing your mammogram to compare the X-ray to old information.
When a radiologist examines a mammogram, he or she would be looking for shadows, masses, distortions, special patterns of tissue density, calcifications, and differences between the two breasts. If none of these findings are reported, the mammogram is considered normal. If one or more of these findings occur, you will likely be required to do a follow-up mammogram.
To eliminate the possibility of misunderstanding or oversight, mammogram results have been codified by the American College of Radiology (ACR) so radiologists can measure what they see against a standard to decide whether the abnormality is something to be concerned about. This system is called the Breast Imaging Reporting And Data System (BIRADS). The numbers help radiologists and physicians to determine whether a follow-up mammogram or a biopsy might be needed.
Assessment is incomplete and additional imaging evaluation is needed. You only need to schedule a follow-up mammogram. When the subcategory “/Level 4” is added to the Category 0 classification, it means that a possible abnormality may not be completely seen or defined and will need additional evaluation including the use of spot compression, magnification views, special mammographic views or ultrasound. A new mammogram appointment should be scheduled as soon as possible.
There is no significant abnormality to report. The breasts are normal and healthy in appearance.
A Category 3 finding means that there is an area in the breast that is probably benign but is unusual enough that the physician feels it should be watched. Follow-up with repeat imaging is usually done every 6 months for 1 year and then every year for 2 years. This allows the doctor to keep an eye out for changes that could indicate cancer without subjecting the patient to what is probably an unnecessary biopsy.
With this categorization, the radiologist is recommending a biopsy. There is sufficient possibility of malignancy from the presence of microcalcification clustering, enough to warrant further investigation.
This means that there are findings such as irregular or star shaped masses on the X-ray that are characteristic of cancers and have a high probability of malignancy. The radiologist is strongly recommending a biopsy and is sending a message to the primary care physician that immediate investigation and treatment of the lump or mass are necessary. The pictures below show what breast cancer looks like on mammogram: