Diagnostic Tool: Mammogram
A mammogram is an assessment tool used in healthcare to detect early signs of breast cancer. The purpose of a mammogram is to capture images of the breast tissue using low dose x-rays, and to identify any abnormal growths or tumors that may be too small to be felt by a physical examination. Mammograms are typically conducted in a radiology clinic or hospital setting by a radiologic technologist, who will position the patient’s breast on a platform and compress it with a paddle in order to flatten out the breast tissue and improve image quality. The mammogram machine then takes images of the breast tissue from multiple angles, which are reviewed by a radiologist to look for any signs of abnormal growths.
Mammograms are an important tool in breast cancer screening, as they can identify small growths in the breast tissue before they become large enough to cause symptoms or be felt by a physical examination. The American Cancer Society recommends that women at average risk of breast cancer receive annual mammograms starting at age 45, and that women between the ages of 40 and 44 have the option to begin annual mammograms if they choose to do so. Women at higher risk of breast cancer may need to begin screening at an earlier age, or receive additional imaging tests such as breast MRI.
While mammograms are an important tool in breast cancer screening, there are some issues with the test’s sensitivity, reliability, and predictive values. One potential issue is that mammograms may miss some breast cancers, particularly in women with dense breast tissue. According to a study published in the New England Journal of Medicine, mammograms miss approximately 20% of breast cancers in women with dense breasts, compared to only 7% of breast cancers in women with less dense breasts (Lehman et al., 2015). Additionally, mammograms can sometimes detect abnormalities that turn out not to be cancerous, leading to false positive results and unnecessary biopsies or other invasive procedures.
Despite these limitations, mammograms remain an important tool in breast cancer screening, and are recommended by many healthcare organizations for women at average risk of breast cancer. Other screening tools such as breast MRI may be recommended for women at higher risk of breast cancer, but mammograms are generally considered the standard of care for breast cancer screening in most women.
References: American Cancer Society. (2022). American Cancer Society recommendations for early breast cancer detection in women without breast symptoms. Retrieved from https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html
Lehman, C. D., Arao, R. F., Sprague, B. L., Lee, J. M., Buist, D. S., Kerlikowske, K., … & Henderson, L. M. (2015). National performance benchmarks for modern diagnostic digital mammography: update from the Breast Cancer Surveillance Consortium. Radiology, 277(2), 358-367.
National Cancer Institute. (2021). Mammography. Retrieved from https://www.cancer.gov/types/breast/mammograms-fact-sheet
US Preventive Services Task Force. (2016). Breast cancer screening. Retrieved from https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening