Mammograms are a vital tool in the early detection of breast cancer. This simple yet effective procedure can help identify abnormalities in the breast tissue before any physical signs or symptoms appear. Early detection significantly increases the chances of successful treatment, which is why mammograms are a cornerstone of preventive healthcare for women. In this article, we'll explore what a mammogram involves, how the technology works, and why regular screenings should be a part of every woman’s health routine.

What is a mammogram?^1,2

A mammogram is an X-ray imaging method of the breast, primarily used to detect early signs of breast cancer or other abnormalities. It is one of the most effective methods for screening women who have no symptoms of breast cancer. During a mammogram, the breast is placed between two plates, which compress the tissue to obtain a clear image. The procedure is quick, typically lasting about 15-20 minutes, but it can be slightly uncomfortable due to the pressure applied to the breast.

To minimise discomfort and ease any fear, there are several strategies women can consider.

While the procedure may feel uncomfortable for a short time, it is important to remember that mammograms are essential for women over 40 or those with a family history of breast cancer. Regular screening can help detect cancer at an earlier, more treatable stage, often before lumps can be felt by hand.

The mammogram process: step by step³

While the mammogram process may sound intimidating, it is usually straightforward and performed in a calm, controlled environment. Here’s a breakdown of what to expect:

	Preparation before the procedure Before your mammogram, you’ll be asked to avoid using deodorants, lotions, or powders on your breasts or underarms. These products can appear as white spots on the X-ray, which may make it harder to interpret the results. It’s also a good idea to wear a two-piece outfit, as you will need to remove your top and bra during the procedure.
	Positioning and imaging Once you’re in the exam room, the radiographer will ask you to stand in front of the mammogram machine. You’ll be instructed to place one breast at a time on a flat plate. A second plate will then compress the breast to ensure the tissue is evenly spread and that clear images can be captured. The compression may feel uncomfortable, but it is necessary to get the best possible images. Standard views: The most common views are the top-down and side-angle views. Each breast is imaged from these angles to ensure that no part of the breast tissue is missed. Compression: The compression lasts only a few seconds, but it may cause some temporary discomfort. The purpose of compression is twofold: to spread out the tissue for clearer imaging and to reduce the radiation dose needed for a high-quality image.
	Repeat process for both breasts The process is repeated for the second breast. Each breast is compressed individually, and images are taken from multiple angles to provide a detailed view of the tissue. The radiographer will ask you to remain still and hold your breath momentarily during each exposure.
	After the procedure Once the images are taken, they will be sent to a radiologist for analysis. In most cases, the procedure is quick, and you can resume your daily activities immediately. It’s important to remember that the mammogram is just one part of breast cancer detection, and any abnormalities found will likely require follow-up testing, such as additional imaging or biopsy.

Technological aspects of mammography

Mammography has evolved over the years, with advances in technology significantly improving the accuracy and comfort of the procedure. Here’s a look at the technological developments that have shaped modern mammograms:

1. Digital mammography
One of the biggest improvements in recent years is the transition from traditional film mammography to digital mammography. Instead of using film, digital mammograms use a sensor to capture the X-ray images, which are then displayed on a computer screen.

• Advantages: Digital mammograms provide clearer images with better contrast and resolution, which can help detect small abnormalities that may have been missed on traditional film. They also allow for easier storage and sharing of images, which can be helpful for second opinions or monitoring changes over time.

2. 3D mammography (Tomosynthesis)
A more recent technological advancement is 3D mammography, also known as tomosynthesis. This technique allows for a more detailed, three-dimensional view of the breast tissue.

• How it works: The 3D mammogram takes multiple X-ray images from different angles, creating a series of thin "slices" of the breast tissue. This method reduces the chances of overlapping tissue obscuring potential issues, making it particularly useful for women with dense breast tissue, which can make it more difficult to spot abnormalities.
• Benefits: Research shows that 3D mammograms improve cancer detection rates and reduce the need for additional follow-up tests compared to traditional 2D mammograms.

3. Artificial intelligence (AI) in mammography
AI is starting to play an important role in mammography interpretation. Software can assist radiologists by highlighting areas that may require closer inspection. These AI tools help to speed up the process and ensure no potential issues are overlooked.

• How AI helps: AI systems analyse mammogram images, looking for patterns and anomalies that may indicate the presence of cancer. While AI doesn't replace human radiologists, it acts as a valuable tool to improve diagnostic accuracy.

Why regular mammograms matter

Mammograms are essential for breast cancer prevention and early detection. Breast cancer is the most common cancer in women worldwide, but when caught early, it is often treatable. Regular screenings can identify potential issues in the breast tissue before any symptoms appear. The earlier the detection, the more treatment options are available, and the better the outcome is likely to be.

Key benefits of mammograms

	Early detection Identifying cancer early can significantly improve the chances of successful treatment and recovery.
	Peace of mind Regular screenings can help reduce anxiety about your breast health, knowing that you are actively monitoring for any potential issues.
	Prevention Although a mammogram can't prevent cancer, it can help detect abnormal growths that could develop into cancer, allowing for earlier intervention.

When should you start getting mammograms?

The general recommendation is for women to begin regular mammograms at age 40, though those with a family history of breast cancer or other risk factors may be advised to start earlier. It's essential to consult with your healthcare provider to determine the appropriate schedule based on your health history.

Conclusion

Mammograms are an essential part of a woman’s healthcare routine, especially as they age. The procedure has become more comfortable and accurate over the years, thanks to technological advancements like digital mammography, 3D imaging, and AI-enhanced analysis. Regular screening can detect breast cancer early, when it is most treatable, and may even help reduce the need for more invasive procedures later on. Don’t wait for symptoms—take proactive steps for your health and schedule your mammogram today.

References

1. American Cancer Society Recommendations for the Early Detection of Breast Cancer. American Cancer Society. Available at: https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html.
2. Mammogram. Singapore Cancer Society. Available at: https://www.singaporecancersociety.org.sg/get-screened/breast-cancer/mammogram.html.
3. About Mammograms. U.S. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/breast-cancer/about/mammograms.html.