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Mammography

Mammography — detailed evaluation of breast tissue and breast cancer screening using low-dose X-rays.

An imaging method in which breast tissue is evaluated using low-dose X-rays. Used in breast cancer screening and in further evaluation of suspicious findings.

Indication

  • Regular check-ups under the breast cancer screening program for women over 40
  • Evaluation of palpable breast mass, pain, asymmetry or shape changes
  • Nipple discharge, bleeding or skin changes (peau d'orange appearance, retraction)
  • Early screening in women with a family history of breast/ovarian cancer or BRCA gene mutation
  • Follow-up of previously identified benign lesions (fibroadenoma, microcalcifications)
  • Follow-up of recurrence and the contralateral breast in patients after breast cancer treatment
  • Further evaluation when suspicious findings are detected on ultrasound or examination

Preparation

  • The scan is more comfortable when scheduled in the first week after menstruation, when sensitivity is lower
  • Before the procedure, deodorant, perfume, powder or cream should not be applied to the underarm and chest area (they may cause artifacts on the image)
  • Clothing that can be easily removed from the waist up should be worn; jewelry is removed
  • Previous mammography, breast ultrasound, MRI or biopsy reports must be brought; comparison is very valuable
  • Pregnancy or suspected pregnancy must be reported in advance

How it's performed

  1. The patient stands in front of the device; the breast is positioned between the lower and upper plates
  2. For image quality and lower dose, the breast is briefly compressed evenly; a sensation of pressure is felt
  3. In standard screening, two views are taken from each breast (top-down and lateral)
  4. If suspicious findings are present, additional focused images or tomosynthesis (3D mammography) may be added
  5. The entire scan is generally completed within 10-20 minutes
  6. Images are reported by a radiologist by comparison with previous examinations

Post-procedure

  • There are no special restrictions after the procedure; daily activities can resume immediately
  • If the screening result is normal, annual or biennial screening is recommended depending on age and risk
  • In case of suspicious findings, breast ultrasound, MRI and biopsy when necessary may be planned
  • Results are usually evaluated within 1-3 business days; follow-up decisions are made by breast surgery/general surgery
  • Storing previous scans is important for future comparisons

Risks

  • Mammography involves low-dose X-rays; the screening benefit clearly outweighs the very low radiation risk
  • Brief, short-lasting pressure or mild discomfort may be felt during compression
  • There is a possibility that lesions may be missed in dense breast tissue; therefore, evaluation along with ultrasound may be performed
  • False positive (unnecessary anxiety and additional tests) or false negative results may rarely occur
  • Routine screening mammography is not performed during known or suspected pregnancy; ultrasound is the preferred method

FAQ

Is mammography painful?

Pressure or temporary discomfort may be felt during the brief compression of the breast. Pain threshold varies between individuals; scheduling outside painful menstrual periods, in the first week after menstruation, makes the procedure easier for most patients.

Can mammography be performed during pregnancy?

Routine screening mammography is not preferred during known or suspected pregnancy. During this period, breast ultrasound is the primary method; in cases of clear medical necessity, performing it with protective measures depends on the physician's decision.

Is the radiation in mammography harmful?

The X-ray dose used in modern digital mammography is very low and considered safe by international guidelines. The benefit of early cancer detection through screening is many times greater than the very low risk.

How often should breast cancer screening be done?

In the general population, annual or biennial mammography is recommended for women aged 40 and over. Different protocols may be required for those with a family history, gene mutations or dense breast tissue; the decision is made individually by the physician.