Mammography, everything you need to know
Mammography is the gold standard screening test for breast cancer. It makes it possible to spot small cancers even before symptoms appear. Health Passport answers all the questions you may have about this test.
What is it ?
Mammography is an x-ray of the breast that makes it possible to obtain images of the interior of the breast using x-rays and thus detect tumors of a few millimeters in size, the location of which is impossible to determine on palpation.
It is performed by a radiologist.
During a mammogram, two x-rays are taken of each breast, one anteriorly and one obliquely.
A mammogram may be done either as part of breast cancer screening or when symptoms appear.
Who cares?
Structured breast cancer screening targets women between the ages of 50 and 74, without any specific symptoms or risk factors, because women in this age group are most likely to develop breast cancer.
The examination is also most effective during this period, since earlier hormonal impregnation makes the breasts dense and opaque.
If you are between 50 and 74 years old and do not have a particular risk factor (familial breast cancer), every two years you will receive an invitation to have a mammogram.
Outside this age group and without a risk factor or symptom present, screening mammography is not recommended.
What about men?
Mammography is used to detect breast cancer, and it is very rare in men [1]. In addition, it can be easily detected through a physical examination.
Is a prescription required?
If you are under 50, you need a prescription to be reimbursed.
Before making an appointment with a radiologist, you should go to your GP or gynecologist.
But if you are between the ages of 50 and 74, every two years you will receive an invitation to your home for a mammogram accompanied by a list of radiologists whom you can therefore consult without a prescription.
What should be done before mammography?
No preparation is required prior to the mammogram.
On the day of the examination, it is recommended not to wear cosmetics and not to wear jewelry. These precautions make it possible to obtain high quality images.
If you already have a mammogram, bring the pictures. The radiologist will be able to compare mammograms and identify any changes more quickly.
We recommend that you wear a blouse and a skirt or pants instead of a dress: it will be more comfortable because you can keep the bottom.
Finally, it is best to have a mammogram when you are in the first part of your period. Then the breast examination becomes easier and less painful.
How will it go?
First, you take off your clothes in a single room. The mammogram is performed topless.
The radiologist then explains how to stabilize: you have to remain standing and your chest should be brought forward as far as possible against the device to be able to position your entire breast correctly on a plate. Then a second pad is applied to your breast and compresses it.
The radiologist or radiographer correctly places you on the machine.
Then several shots are taken from different angles.
A mammogram lasts an average of 10 to 15 minutes.
After the mammogram, the radiologist analyzes the images and performs a clinical examination: he checks the appearance of the skin and the nipple and makes sure that everything is normal on palpation.
Does it hurt?
It is a not very pleasant examination, because it is necessary to compress the breast between two plates, but it is not really painful .
The pressure exerted by the two plates pressing on the breast lasts only a few seconds. This pressure is considered safe on your chest and will dissipate once the plates are relaxed.
How will I be informed of the results?
At the end of the examinations, the radiologist gives you the first results. But the final results will be mailed to you, in about two weeks, because the images are sent to the second radiologist who does a second reading.
The results are also sent to your attending physician or gynecologist.
Mammograms are divided into 6 categories:
ACR 0: Additional investigations necessary
ACR 1: normal mammography
ACR 2: There are benign abnormalities that do not require additional monitoring or examination
ACR 3: Possible benign abnormality Short-term monitoring is advised
ACR 4: There is an unspecified or suspicious anomaly
ACR 5: an anomaly suggestive of cancer
Then what happens?
If no abnormalities are detected, the mammograms will be returned to you and a new treatment invitation will be sent to you automatically after two years if you are between 50 and 74 years old.
If an abnormality is detected, the radiologist can prescribe additional examinations. An ultrasound, MRI, or biopsy is necessary, depending on the situation, and a new appointment will be made.
Supplementary examinations are covered by health insurance funds under the usual payment terms.
is he dangerous?
Like any x-ray, a mammogram exposes you to x-rays.
Repeated exposure may, in rare cases, lead to cancer.
However, the risk of developing cancer is very low in the age group for regulated screening. In fact, after the age of 50, breast density decreases and the radiation doses required for mammography are lower.
They are higher in young women whose breasts are denser and require a higher dose of radiation to ensure that the images are easier to read.
On the other hand, if mammography can reduce breast cancer, according to Professor Kirsten McCaffrey of the University of Sydney [1], it can lead to “overdiagnosis” leading to a treatment of breast cancer that poses no risk to the patient. However, this risk is very limited.
Is a mammogram every two years enough?
Repeat screening every two years improves early detection of breast cancer.
But even if you have a mammogram every two years, it's important to stay alert for any changes in your breasts.
In fact, cancer can occur between two mammograms, and this is called interval carcinoma.
Pay attention to the following signs:
A lump or bump in the breast or armpit
Breast shape that looks unnatural to you
Skin or nipple retraction
Redness, edema or the appearance of an orange peel
Discharge from the nipple
Consult a doctor if in doubt.