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MAMMOGRAPHY-MAMMOGRAMS
X-ray examination of the breast in the diagnosis of the cause of breast lumps; it is used
as a screening test for BREAST CANCER.
A picture is obtained of the soft tissues of the breast in which any potentially cancerous
areas may be seen. Mammography can detect cysts and tumors in the breast tissue while they
are still too small to be readily palpated by a nurse or physician, so that it provides a
means for the detection of early cancer.
Like any screening test, its cost has to be weighed against its accuracy, any potential
dangers, and the value of detection. Tumors detected by mammography may be either benign
or cancerous; further tests and often removal of the tumor may be needed before a firm
diagnosis can be made. Breast cancer screening by mammography carries a very small risk
since repeated x-ray examinations may themselves induce cancer. For that reason, current
policy in the United States is for mammography to be used in screening only for women aged
over 50 and for women in high-risk groups, such as those related to women who have had
breast cancer. Studies have shown, however, that in these high-risk groups and in women
over the age of 50 mammography can improve the detection rate and lower mortality from
breast cancer.
This x-ray examination of the female breasts still remains somewhat controversial.
Malignant tumors of the breast is not a rare disease; since recovery appears to be related
to early diagnosis and treatment, the concept of periodic x-ray examination to detect any
malignant change at the earliest possible time has great appeal. On the other hand, the
test has been challenged on the basis of its accuracy (sensitivity vs. specificity), cost
and the relatively high doses of radiation which could accumulate if the test were
performed repeatedly.
Critics contend that regular self-examination of the breasts, coupled with periodic checks
by the physician, will provide as much information as mammographic screening. Improvements
in technology which lower the cost of the test and decrease the level of radiation
required to perform the test may blunt some of the arguments against regular use of
mammography - at least for those women who are at higher risk for the development of
BREAST CANCER due to family history or other factors.
Statistically, the risk of developing breast cancer or any kind of cancer as the result of
exposure to x-rays is incredibly low and the dosages currently being used is comparable to
that used in common dental x-ray exams. The benefits of early detection far and away
outweigh the statistical risks of x-ray exposure considering that these risks are almost
mathematically irrelevant.
To the Question, are mammograms safe?
The Answer is Yes. Experts tend to agree that the amount of radiation exposure received
during mammography is minimal and about the same as the amount received during a dental
x-ray. It has been estimated that if 10,000 women had yearly mammograms for ten years, the
radiation from mammograms would cause 1 additional breast cancer death.
Ultimately, personal vigilance and early detection remain a woman's best weapons in the war against cancer.
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References:
National Institutes of Health Consensus Development Panel. National Institutes of Health
Consensus Development Conference Statement: Breast Cancer Screening for Women ages 40-49,
January 21-21, 1997 J Natl Cancer Inst 1997;89:1015-26.
Feig SA. Assessment of radiation risk from screening mammography. Cancer 1996;77:818-822.