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Women's Health Breast Pain

Mammogram
(Breast Cancer Screening)

A mammogram is a specialised X-ray imaging technique designed to detect and diagnose breast abnormalities, particularly early signs of breast cancer, by capturing detailed images of the breast tissue.

What is a Mammogram?

A mammogram is a medical screening tool used primarily for breast cancer detection and diagnosis. It involves taking X-ray images of the breast tissue to detect abnormalities, such as tumours, cysts, or calcifications, that may not be palpable during a physical examination. Mammograms play a pivotal role in early breast cancer detection, allowing for the identification of potential issues well before they cause noticeable symptoms. 

 

There are two types of mammograms: screening mammograms, which are recommended for women without any breast symptoms as a routine part of preventive healthcare, and diagnostic mammograms, which are performed when there are specific concerns, like breast pain or lumps, and are used to investigate and evaluate breast abnormalities further. 

 

Regular mammograms are a vital component of breast health, as they can significantly increase the chances of successful treatment when breast cancer is detected at an early, more treatable stage.

What Age Should You Get A Mammogram?

When to start getting a mammogram very much depends on the risk profile of the woman and the population risk. In Singapore, it is recommended that women should start an annual screening mammogram from the age of 40. After the age of 50, women should have a screening mammogram every 2 years.

 

However, it is important to understand that the above recommendations are for the general population. In this day and age, we are looking at screening tailored to the individual risk. For example, women with dense breast tissue (which can only be diagnosed on mammogram), should consider adding a screening ultrasound at the same time as dense breasts lower the screening capabilities of a mammogram. 

 

Furthermore, other risk factors to consider include previous history of breast lumps and a family history. Hence, it is important to speak to your doctor about the screening modalities and frequency best suited for you.

What Are The Risks Of A Mammogram?

Radiation - As mammograms are X-rays of the breast, getting a mammogram does involve exposure to small amounts of radiation. However, the risk of radiation induced problems is very low as the radiation dose is low. In fact, the amount of radiation one is exposed to during a mammogram is the same amount of radiation one is exposed to in a flight from Singapore to Tokyo.  

 

False Positives - Sometimes a mammogram may detect signs of what appears to be breast cancer, which never progresses to be breast cancer. This can lead to further tests and cause unnecessary stress and anxiety. 

 

Undetected Cancer - In some cases, mammograms may not detect signs of cancer, which later become an issue. If a tumour is too small or is located in the armpit or upper chest, or if the breast is too dense, it may be hard for a mammogram to detect.  

 

Mammograms are successful at detecting cancer far more often than they provide false positives or do not detect cancer. For many women, the risks associated with mammograms are too small to deter them from receiving a screening.

How To Prepare For A Mammogram

Usually, there is no preparation necessary to receive a mammogram. However, it is recommended that you don’t wear deodorant or creams on the breast as this can affect the final X-ray images. 

 

If you have received previous surgery on your breasts for cosmetic or health reasons, tell the doctor or nurse conducting the screening beforehand. This is because surgery can often leave scars in the tissue which may appear unusual on X-ray images.

What To Expect During A Mammogram

Getting a mammogram is a relatively quick process, typically taking less than 30 minutes. While it might cause some discomfort, it's generally not painful.

 

Here's what to expect during your mammogram:

 

Step 1: Your doctor will explain the procedure and address any questions you have.

 

Step 2: You'll need to undress from the waist up for the screening. You can change privately or use a gown provided.

 

Step 3: In the X-ray room, the radiographer  will position your breast on a plastic plate and then lower another plate from above to flatten it. You'll need to stay still while they take X-ray images.

 

Step 4: Each image only takes a few seconds. They'll capture one from above and one from the side for each breast.

 

Step 5: After the mammography, you can get dressed.

 

You'll receive your mammogram results in the following days, and if necessary, your doctor will contact you to discuss them.

Results Of A Mammogram

Depending on the results of a mammogram, further testing may be needed, such as: 

  • Ultrasound 

  • MRI 

  • Core Needle Biopsy 

  • Vacuum-Assisted Core Needle Biopsy 

  • Fine Needle Aspiration 

  • Excision Biopsy

  • How painful is a mammogram?
    For many people, getting a mammogram isn’t painful at all. However, if you have tender breasts, the process may be slightly uncomfortable. You should let your radiographer know if you are experiencing pain, and you can ask to stop the screening at any time.
  • How long does a mammogram take?
    Mammograms usually take less than 30 minutes to complete. The screening does not require downtime after so you can return to your activities immediately.
  • Is it better to have a mammogram or ultrasound?
    Comparing mammograms to ultrasound is like comparing apples to oranges. The mammogram allows us to pick up microcalcifications (calcium deposit in the breast tissue) which may indicate pre-invasive cancers before a mass is formed. An ultrasound is good for picking up masses and determining the characteristics of the masses but are not useful for picking up microcalcifications. Hence, these screenings are complementary to each other. One modality does not replace the other.

Dr Jesse Hu: Breast Cancer Specialist in Singapore

Dr Jesse Hu is a breast cancer specialist and experienced breast surgeon in Singapore. With a commitment to excellence and a focus on patient well-being, Dr Jesse Hu brings her expertise to the field of breast health. Whether you're seeking preventive consultations or surgical solutions, trust in Dr Jesse Hu's expertise for compassionate care that prioritises your needs.

Dr Jesse Hu
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