Mammography

See also: Breast cancer screening

Mammography
Woman undergoing mammogram on the right breast. A technologist performs breast compression.
Mammography
Other namesMastography
ICD-10-PCSBH0
ICD-9-CM87.37
MeSHD008327
OPS-301 code3–10
MedlinePlus003380

Mammography (also called mastography; DICOM modality: MG) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening. The goal of mammography is the early detection of breast cancer, typically through detection of characteristic masses or microcalcifications.

As with all X-rays, mammograms use doses of ionizing radiation to create images. These images are then analyzed for abnormal findings. It is usual to employ lower-energy X-rays, typically Mo (K-shell X-ray energies of 17.5 and 19.6 keV) and Rh (20.2 and 22.7 keV) than those used for radiography of bones. Mammography may be 2D or 3D (tomosynthesis), depending on the available equipment or purpose of the examination. Ultrasound, ductography, positron emission mammography (PEM), and magnetic resonance imaging (MRI) are adjuncts to mammography. Ultrasound is typically used for further evaluation of masses found on mammography or palpable masses that may or may not be seen on mammograms. Ductograms are still used in some institutions for evaluation of bloody nipple discharge when the mammogram is non-diagnostic. MRI can be useful for the screening of high-risk patients, for further evaluation of questionable findings or symptoms, as well as for pre-surgical evaluation of patients with known breast cancer, in order to detect additional lesions that might change the surgical approach (for example, from breast-conserving lumpectomy to mastectomy).

In 2023, the U.S. Preventive Services Task Force issued a draft recommendation statement that all women should receive a screening mammography every two years from age 40 to 74.[1][2] The American College of Radiology and American Cancer Society recommend yearly screening mammography starting at age 40.[3] The Canadian Task Force on Preventive Health Care (2012) and the European Cancer Observatory (2011) recommend mammography every 2 to 3 years between ages 50 and 69.[4][5] These task force reports point out that in addition to unnecessary surgery and anxiety, the risks of more frequent mammograms include a small but significant increase in breast cancer induced by radiation.[6][7] Additionally, mammograms should not be performed with increased frequency in patients undergoing breast surgery, including breast enlargement, mastopexy, and breast reduction.[8]

  1. ^ "Draft Recommendation: Breast Cancer: Screening | United States Preventive Services Taskforce". www.uspreventiveservicestaskforce.org. Retrieved 2024-02-01.
  2. ^ US Preventive Services Task Force, Nicholson WK, Silverstein M, Wong JB, Barry MJ, Chelmow D, Coker TR, Davis EM, Jaén CR, Krousel-Wood M, Lee S, Li L, Mangione CM, Rao G, Ruiz JM (2024-04-30). "Screening for Breast Cancer: US Preventive Services Task Force Recommendation Statement". JAMA. doi:10.1001/jama.2024.5534. ISSN 0098-7484.
  3. ^ "Breast Cancer Early Detection". cancer.org. 2013-09-17. Archived from the original on 10 August 2014. Retrieved 29 July 2014.
  4. ^ Tonelli M, Connor Gorber S, Joffres M, Dickinson J, Singh H, Lewin G, et al. (Canadian Task Force on Preventive Health Care) (November 2011). "Recommendations on screening for breast cancer in average-risk women aged 40–74 years". CMAJ. 183 (17): 1991–2001. doi:10.1503/cmaj.110334. PMC 3225421. PMID 22106103.
  5. ^ "Cancer screening: Breast". European Cancer Observatory. Archived from the original on 2012-02-11.
  6. ^ "Final Recommendation Statement: Breast Cancer: Screening". US Preventive Services Task Force. January 2016. Archived from the original on 13 May 2017. Retrieved 31 May 2017.
  7. ^ Friedenson B (March 2000). "Is mammography indicated for women with defective BRCA genes? Implications of recent scientific advances for the diagnosis, treatment, and prevention of hereditary breast cancer". MedGenMed. 2 (1): E9. PMID 11104455. Archived from the original on 2001-11-21.
  8. ^ American Society of Plastic Surgeons (24 April 2014), "Five Things Physicians and Patients Should Question", Choosing Wisely: an initiative of the ABIM Foundation, American Society of Plastic Surgeons, archived from the original on 19 July 2014, retrieved 25 July 2014