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WHAT SHOULD I EXPECT WHEN I HAVE A MAMMOGRAM?

The first time you go for any kind of medical test, you may feel a bit anxious because you don’t know what to expect. The following information is given to help you understand what to expect when you have a mammogramMammogram (also called mammography):
A low-dose X-ray of the breast. It is used to take images of the breasts and is an important screening tool for the earlier detection of breast cancer.
and how to prepare for it.

For the best care possible and the highest quality screeningScreening:
The search for diseases such as breast cancer in people without symptoms. Mammography is an important tool for breast cancer screening and earlier detection.
, Canadian Breast Cancer Foundation encourages women to have a mammogram with their provincial or territorial organized breast screening program or if this is not possible, then at a clinic accredited by the Canadian Association of Radiologists. Accreditation is your assurance that you are receiving high quality imaging. When you book your appointment ask if the clinic is accredited.

Digital mammographyDigital mammography:
A low-dose X-ray similar to screen-film mammography, equipped with a digital receptor and a computer instead of film.
has largely replaced screen-film mammography in most parts of Canada. This is because it is better at detecting breast cancer in women in their 40s, women 50+ who have not gone through menopauseMenopause:
A natural part of a woman's aging process, when the ovaries start to make less estrogen and progesterone and the menstrual periods stop. This change typically occurs between the late 40s and mid-to-late 50s.
, and women with clinically diagnosed dense breastsDense breasts (breast density):
Dense breasts have less fat and more glandular and connective tissue. A woman’s breast density depends on her age and genetic factors. Breast density is a risk factor for breast cancer. Having “dense breasts” is a clinical diagnosis that can only be assessed by mammography.
. Wherever it is available, Canadian Breast Cancer Foundation encourages women to be screened with digital mammography.

Preparing for your mammogram

On the day of your appointment:

  • Do not use deodorant, body lotion or talcum powder on your breasts or underarms that day. These products may show up on the mammogram and could lead to an inaccurate result.

  • Wear a two-piece outfit so that you only have to remove your top when you have the mammogram.

  • If you’d like the support, ask a friend to go to your appointment with you.

At the clinic

Having a mammogram can feel uncomfortable or awkward, especially the first time. Before your mammogram, the technologist should explain what is going to happen. If you have any questions or concerns, ask the technologist before the screening begins.

  • You will be asked to remove all clothing from your upper body and stand in front of an X-ray machine designed for mammograms.

  • The technologist will place one of your breasts on a plate. A second plate will slowly come down on top of your breast to spread out your breast tissue. This helps to get a clear image of your breast tissue with the lowest dose of radiation.

  • You will feel a few seconds of pressure on your breast while two images (mammograms) of the breast are taken. This pressure may feel uncomfortable but it will not harm your breast. If you feel pain, let the technologist know. The two of you can work together to try to make sure you are as comfortable as possible.

  • The same process is repeated with your other breast. In total four X-ray pictures will be taken, two of each breast.  Occasionally, the technologist will need to take an extra picture.

What happens next?

Breast Imaging Reporting and Data System (BI-RADS)

There are different systems that radiologists can use for reporting breast cancer screening results. Some breast screening centres in Canada report the results of a mammogram using a system known as the Breast Imaging Reporting and Data System, or BI-RADS. Other breast centres may report mammogram results using a system that is based on BI-RADS. When a radiologist reads a mammogram to look for any changes or abnormalities, they will assign the results to one of six categories (from 0-5) to communicate to your health care provider about your results. The BI-RADS category is included in the report sent to your health care provider.

 

The following table outlines the BI-RADS categories and what they mean:

​BI-RADS Category

​Meaning of Category

Category 0
Assessment is incomplete
​Additional mammogram images are needed, such as spot compression or ultrasound, or the images from an earlier mammogram are needed for comparison.
Category 1
Negative
​The mammogram is normal. There are no areas of concern found on the mammogram. Continue with regular screening mammograms.
​Category 2
Benign findings
​The mammogram is normal, but there are abnormal areas that are benignBenign:
Not cancerous. This is also referred to as non-malignant.
based on their appearance on the mammogram. Continue with regular screening mammograms.
Category 3
Probably benign
​The mammogram shows an area that is probably benign, but a follow-up mammogram needs to be done in 6 months to watch for any changes to the area. Mammograms in this category mean that the abnormality has a less than 2% risk of being cancer.
Category 4
Suspicious abnormality
​The mammogram shows an area of concern. There is a 23%–34% chance that the abnormality is cancer. A biopsy is needed to make a diagnosis.
​Category 5
Highly suggestive of malignancyMalignant:
Cancerous.
​The mammogram shows an abnormality that is very likely (greater than 95% chance) to be cancer. A biopsy is needed to make a diagnosis.

 

Sources:

Canadian Cancer Society. Mammography. Accessed March 16, 2014.