Home DiseasesBreast cancer Mammography – procedure and risks

Mammography – procedure and risks

by Josephine Andrews
Published: Last Updated on 253 views

Mammography is an X -ray examination of the breast (lat. mamma). They can be used to identify changes in breast tissue (such as lumps) that could indicate breast cancer. In addition, women in Germany between the ages of 50 and 69 routinely invited to mammography (mammography screening) from the age of Read here how the examination is carried out, when mammography makes sense and what risks it entails.

ICD codes for this disease:

ICD codes are internationally valid codes for medical diagnoses. They can be found, for example, in doctor’s letters or on certificates of incapacity for work.

D05 C50

What is mammography?

Mammography is an X-ray examination of the breast for the early detection of breast cancer (mammary carcinoma) or its precursors. These include small calcifications (microcalcifications), lumps, thickening, asymmetries or other disorders in the tissue architecture of the breast.

In analog mammography , the X-ray image is created on an exposed film sheet. The more recent digital mammography allows the image to be stored electronically on a computer so that certain areas can be enlarged and reworked if necessary. Even a three-dimensional image of the breast can be made. This can help the doctor better assess some tissue areas.

Mammography: (From) when is it useful?

(From) when a mammography makes sense is still being discussed critically by many experts. It is important to weigh the benefits of the test – its high accuracy rate in detecting breast cancer – against the risks and disadvantages (see below). In Germany the current situation is as follows:

Mammography is usually only performed on women under the age of 50 if there is a concrete suspicion of breast cancer – for example because a suspicious lump in the breast can be felt. In women with an increased risk of breast cancer, however, it may be useful to have routine breast X-rays (see below).

Routine mammography is recommended for women in Germany over the age of 50. Breast cancer is particularly common during this period of life. That is why women in this age group are invited to mammography every two years as a precaution. The costs are covered by health insurance companies (statutory cancer screening program).

For women over the age of 70, the recommendations for early breast cancer detection tests (such as mammography) are based on several factors: the individual cancer risk, the general state of health and the individual life expectancy of the woman are taken into account.

Women at increased risk of breast cancer

Some women have an increased risk of breast cancer, for example because their mother or sister already has breast cancer or because breast cancer risk genes have already been definitively detected in the woman’s genome. Then it can make sense to routinely perform a mammography before the age of 50 – often supplemented by magnetic resonance imaging (magnetic resonance imaging, MRI) of the breast. Such intensified early cancer detection is based on the individual risk profile of a woman with an increased risk of breast cancer.

How is the mammography done?

Mammography is an outpatient examination . During the first visit, you have to fill out a questionnaire in which personal data, previous illnesses and, above all, breast cancer in the family are recorded. The doctor will also personally talk to you about important background information (anamnesis discussion).

You should not apply deodorant before the mammography, as this can impair the validity of the X-ray image.

For the mammography itself, you must completely bare your torso and remove any jewelry that might obscure the breast tissue (necklaces, breast piercings, etc.). Then your breasts are carefully stretched and pressed together as flat as possible between two Plexiglas plates. This step of mammography can be painful. Then the breast tissue is X-rayed. Two X-ray images are usually taken from different directions : from top to bottom (cranio-caudal) and diagonally from the middle to the side (mediolateral oblique).

In good radiological practices, the four-eyes principle applies when evaluating X-ray images . This means that two X-ray specialists (radiologists) examine the images independently of one another. If the findings differ, another mammogram or another examination such as magnetic resonance imaging (MRI) or galactography (mammography in which the milk ducts are visualized with a contrast medium) is carried out.

These examination methods are also used when the mammography X-ray image provides suspicious findings or the breast is difficult to assess using the mammography. This can be the case, for example, with dense breast tissue, especially in younger women, silicone pads, pronounced mastopathy (benign changes in the mammary gland tissue) or after radiation therapy . MRI mammography then provides more accurate results than X-ray mammography.

After mammography

The results of the mammography are available after a few days. If suspicious tissue changes are discovered, further examinations are necessary for clarification, such as a new mammography, ultrasound examinations, MRI mammography or tissue removal ( biopsy ). 

Mammography: yes or no?

Mammography is a quick and easy examination that can be used to detect abnormal changes in the breast. Even tumors that are only three to five millimeters in size and not yet palpable can be detected using a chest X-ray. This means: This examination method has a high sensitivity .

However, mammography also has disadvantages and risks:

  • As with any X-ray examination, the radiation dose from a mammogram can damage the genetic material in the cells Under certain circumstances, this can lead to the cells degenerating and turning into cancer cells. However, according to experts, the risk of developing breast cancer as a result of a mammogram is very low.
  • Squeezing (compression) of the breast can, in rare cases , cause bruising (but not cancer).
  • Mammography screening has a low specificity : Tissue changes that are actually harmless (misdiagnoses) are also discovered and classified as (possible) breast cancer. The affected women must undergo further examinations and possible interventions (such as tissue removal), which ultimately prove to be unnecessary. In addition, the misdiagnoses put the women in unfounded concern.
  • The most serious damage from mammography is the so-called overdiagnosis . This means that a breast carcinoma would never have been found without mammography, but would not have caused any symptoms either. The usual procedure with surgery, radiation and chemotherapy is of no use in the case of an overdiagnosis, but unnecessarily restricts the patient’s quality of life.

Experts took these advantages and disadvantages of mammography into account when developing mammography screening: In the age group of 50 to 69 year olds, the benefit of routine breast X-rays outweighs this. For all other women, it depends on individual factors (concrete suspicion of breast cancer, genetic predisposition for breast cancer, etc.) whether a mammogram makes sense.

You may also like

Leave a Comment