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Overview
Mammography: Treatment, Procedure, Cost And Side Effects
What is Mammography?
In easy words it is a X-ray of breast which is to detect and diagnose breast cancer by screening use of this screening tool known as mammogram also called mammography. It is a key element in early detection of breast cancer. In case of lump or any other symptoms, doctor will recommend diagnostic mammograms, which is more extensive than screening mammograms. This procedure requires more x-rays to get breast view from multiple positions.
Are mammograms painful?
People who gone through mammograms have different experiences. During the procedure some may feel pain while others may not at all. Most number of women feel discomfort during x-ray. Pressure that comes on breast from the process causes pain and discomfort for few minutes. Apart from that, pain vary from one woman to another, which depends upon breast size, timing of test (relation to menstrual cycle), x-ray technician skills.
What is the procedure of mammography?
At the beginning of the process, a technician will give you a gown to wear. Depending upon test facility, you may either stand or sit during mammogram. In that procedure, the technician fits each breast onto a flat X-ray plate.
Then a compressor will push the breast down to flatten the tissue. This provides a clearer picture of the breast. You might have to hold your breath for each picture. You may feel a small amount of pressure or discomfort, but it’s usually brief.
How do I prepare for my mammogram?
Since mammograms are an important procedure in the prevention of breast cancer by helping to detect them at an early stage, it is important for the patient to adhere to the given rules so that no problem is encountered and the process can be done without interruptions. Since mammograms detect lumps and microcalcifications in the breasts, it is important the patient does not apply anything that might look like a blocking mass of calcium during the x-ray screening. Deodorants, powders, perfumes, ointment and/or any cream should be neglected during the day of the screening so that the results are clear and valid, and if necessary, the situation can be handled with utmost care.
In the case of pregnancy and/or breastfeeding stages, the physician generally recommends an ultrasound for the detection of early breast cancer.
How is mammogram test done?
In easy words, Mammogram is a process to diagnose problems in the breast. In this process, X-ray pictures of the breast are taken. The doctor used to analyze these x-ray pictures to detect the problems. Whenever you go for this test, the technician will ask you to stand or sit (depends upon the facility) facing mammography, which had a flat surface to place one breast at a time. That flat surface is known as compression paddle.
- It is necessary to put the breast on the flat surface on which compression is necessary to spread out the breast tissue. It also helps to eliminate motion, compression is uncomfortable for few seconds.
- During compression, the machine detects breast tissues and record them in the machine. In the case of cancer, breast tissue appears white and bright in x-rays, while non cancerous tissues appear gray or dark.
What are the steps Mammography?
Mammography is done to diagnose the early stage of breast cancer or any kind of cysts in the breast. These are low energy x -rays which help to detect tiny lump or clusters in the breasts even before a human can feel it.
Two x-rays of each breast are usually done in it.
The first one, screening mammography, is done to detect early stage of breast cancer or complication in a human body which a human can take up to 2 years to feel. It is advisable to do yearly screening mammography for all the women above 40 years of age.
Diagnostic mammography is done after an abnormal health behavior is detected in a human breast. It can be any kind of lump, cyst, tumor or any other discomfort which needs to treated further. It is done after the advice of a doctor or can also be done if some complication is found in a particular area of the breast after the screening x-ray.
What should you not do before a mammogram?
Here are few things which should not be done before going for a mammogram are -
- In case of menstrual period, its been better to avoid mammography. Even before or after one week of menstrual periods it been better, not to go for this test, during this time there are chances of breast being tender.
- Avoid deodorants, perfumes, powder on armpits or on your breast at the day of mammography. Metallic particles present in these cosmetics may interfere in result.
- Not to wear any ornament or any jewelry at the time of mammography. Technician will day ask you to remove all the ornaments and upper wear.
Popular Health Tips
Breast cancer(स्तन कैंसर) is on the rise in india. Surveys show that every 4 out of 5 Indian women who have breast cancer, suffer from an advanced stage of the disease by the time they reach the doctor. Urban women are at two times more risk of being diagnosed with breast cancer than rural women. Being overweight, eating unhealthy food, and consuming excessive alcohol or tobacco are some of causes that can make you susceptible to this disease.
How you can avoid breast cancer?
- Every woman should do a self-breast examination every month after the periods. You should check for any abnormal lump, change in skin texture or any abnormal discharge from the nipples. Any abnormality above aspects should be promptly investigated by a doctor's appointment, and an ultrasound or Mammography, as required.
- Apart from self-examining your breasts every month for a lump, going for a mammography (an X-Ray of the breast) is vital for early detection of the problem.
- Consult a gynaecologist before going for the test as its frequency depends on your age and risk factor. About 80-90% of tumours can be traced through this screening.
Breast cancer may run in family. If there is no family history of breast cancer, you start doing mammogram at 40 yrs of age but if there is a family history you start even earlier as advised by your gynaecologist.
Breast cancer is a disease in which malignant (cancer) cells form in the tissues of the breast. It occurs in both women and men, although breast cancer in men is rare.
Risk factors:
- Lack of physical activity
- Alcohol consumption
- Advancing age
- No childbirth or no breastfeeding
- Family history of breast cancer
- Early menarche (< 12 years of age) or late menopause ( > 55 years of age)
- History of ovarian cancer or endometrial cancer
- History of benign breast conditions (e.g. atypical hyperplasia) or lobular carcinoma in situ
- Receiving hormonal replacement therapy (HRT)
- History of receiving radiation therapy to the chest before age of 30
More importantly, you can lower your risk of having breast cancer by the following measures:
- Have regular physical activities, do at least 150 minutes of moderate-intensity aerobic physical activities per week (e.g. climbing stairs or brisk walking)
- Avoid alcohol drinking;
- Maintain a healthy body weight and waist circumference - aim for a body mass index (BMI) between 18.5 and 22.9, and a waist circumference of not more than 80cm for women; and
- Have childbirth at an earlier age and breastfeed each child for longer duration factors include:
What are the common symptoms of breast cancer?
The symptoms of breast cancer may not be easily noticed at an early stage. Any of the following changes in the breast can be a symptom of breast cancer:
• Breast lump;
• A change in the size or shape of the breast;
• A change in skin texture of the breast or nipple (e.g. red, scaly, thickened or “orange-skin” appearance);
• Rash around the nipple;
• In-drawing of the nipple;
• Discharge from one or both nipples;
• New and persistent discomfort or pain in the breast or armpit; and
• A new lump or thickening in the armpit
What is breast cancer screening? Should I screen for breast cancer if I do not have any symptom?
Screening means examining people without symptoms in order to detect disease or fi nd people at increased risk of disease. It is often the fi rst step in making a defi nitive diagnosis. For breast cancer screening, its purpose is to fi nd women who have breast cancer, before they have any symptom, in order to offer them earlier treatment.
Mammography is widely used as a screening tool. It is an X-ray examination of the breasts. During mammography, the breast is pressed between 2 plates to flatten and spread the breast tissue, in order to obtain a clear image. Some women may find it uncomfortable or painful but the discomfort is usually short lasting. Mammography screening is safe in general and only a very small dose of radiation is used in the procedure. One in 5 female breast cancer patients may be missed by mammography.
With the modernization of all economies around the world, one health hazard that has become one of the largest perils within both developed and developing nations is the incidence of cancers of the female reproductive system, especially cervical and breast cancer.
Breast cancer
Breast cancer is the formation of malignant tumors within the breast tissues of a woman. Usually, breast cancer affects women in the age range of 40 to 50, but there have been many reports of it occurring earlier. About 48 % percent of the Indian women having breast cancer have been reported to be under 50. This is an almost 17 percent jump compared to figures 25 years earlier.
Alarming Signs of Breast Cancer:
- The most common symptom of breast cancer is a new lump or mass. A painless, hard mass that has irregular edges is more likely to be cancerous, but breast cancers can be tender, soft, or rounded.
- Swelling of all or part of a breast (even if no distinct lump is felt)
- Skin irritation or dimpling
- Breast or nipple pain
- Nipple retraction (turning inward)
- Redness, scaliness, or thickening of the nipple or breast skin
- Nipple discharge (other than breast milk)
Screening Guidelines for Breast cancer:
- Mammography: US Preventive Services Task Force (USPSTF) recommends mammography once in every 2 year for females between age group 50-75 years. Women with a family history has a benefit of starting at age 40 years. After 75 years there are insufficient evidence of benefit of screening mammography.
- Breast Self Examination and annual Clinical examination: breast self examination is easy to learn and and any abnormality should be reported to the oncologist.
- For High Risk/ Genetic risk factors: screening should start by age 25 or 10 years earlier of youngest relative affected. Annual mammogram and MRI or Doppler ultrasound alternating at 6 month interval can be considered.
Treatment Options:
Some of the common treatment options for breast cancers are:
- Breast conservation surgery - This is where the tumors are removed without cutting out too much of the surrounding breast tissue.
- Mastectomy - If the cancer has spread too far then large amounts of breast tissue has to be removed along with the tumor to stop its spread any further.
- Sentinel lymph node Biopsy - it's part of both surgical procedures, it decreases morbidities of lymph node dissection first draining lymph nodes only are removed in patients with clinically negative axilla. If negative on frozen section further axillary dissection is avoided. It avoids the morbidity of complete axillary clearance.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Popular Questions & Answers
Table of Content
What is Mammography?
Are mammograms painful?
What is the procedure of mammography?
How do I prepare for my mammogram?
How is mammogram test done?
What are the steps Mammography?
What should you not do before a mammogram?
Hi I m doctor Asthta Dayal and I m a consultant gynecologist. And I practice in Gurgaon. I have completed my graduation and post-graduation from Maulana Azad Medical College and I have done my MRCOG from London. I have practiced in hospitals like MediCity and Artemis and now I m privately practicing in Gurgaon so I would like to discuss about preventive screening. Unfortunately preventive screening is something that is highly ignored by women in India and in fact the only time when a woman visits the gynecologist is when she s actually pregnant now the kind of diseases that we re having these days like PCOD, thyroid cancers. It is very important that we detect them at an early stage and treat them and unfortunately they don t produce any symptoms still at very late stage. So that is why a preventive screening is the need of the hour.
So all women should get an annual preventive health check from a gynecologist. Now what happens in the gynea-check that when you count all the gynecologist, we first take your history in which try illicit factors which will put out a higher-than-usual risk of getting a certain disease like PCOD or cancer if you have a family history and then we go on to an examination which includes a breast examination. You can actually learn the examination from your gynecologist which you should be doing yourself once every month and now. This is important because breast cancer is the most common cancer in women in cities in India and India we have a 50-percent of vitality of breast cancer and main reason for this is because it is detected a very late stage.
So this besides the self-examination we mentioned also go for mammography once every other year, once there is about the age of 40. Besides this we also do an abdominal examination and an internal gynea examination. Now an internal check is something which women really are apprehensive about and that s the reason they don t want to visit a gynecologist but believe me it s not painful. At the most it is a little uncomfortable or a little weird and it does not even take a minute during the internal check. We take you for any infection, sexually transmitted diseases, any cervical polyps and any conditions of the uterus like a fibroid or ovarian cyst and you can also take a pap tests at the same time. Now what is a pap smear? Pap Smear is a test which in which we just take cells from the mouth of the uterus, which is the cervix and we send it for testing. It is a screening test for cervical cancer which actually detects the cancer 15 years before the cancer develops.
Now cervical cancer is the second most important cancer in women in India. In fact, one woman is dying every eight minutes because of cervical cancer in India and this is such a distressing statistic because this cancer is highly preventable and treatable in fact there is a vaccine for cervical cancer. Vaccine which can be given to women in the age group of 19 to 27 and this actually prevents the occurrence of cancer. It is given routinely in US and UK in schools but in India we are highly unaware about it. So it is a good practice to get your routine screening for the PAP smear once every three years and an ultrasound annually to detect problems like PCOD and thyroid and other fibroids and so I would highly recommend that women do get an annual health check. And because the health of the woman and reflect only health the family.
So in case you want to get in touch with me you can do that through the Lybrate through a chat or a call or you would consult me in my clinic in Gurgaon.
Symptoms and preventions for Menopause
Hi Good morning! I am doctor Aparna Jain, senior consultant obstetrics and gynaecology. Today we are discussing problems related to menopause. Average age of menopause in an average Indian woman is 48 years. 2/3 years beyond that and before that is the period of perimenopause. Lot of women suffer from problems related to menopause first of which is hot flashes, another is urinary problem and sometimes menstrual disorder. Then there can be joint pains as well.
1. Hot Flashes. In hot flashes women usually feel lot of sweating and nervousness. Deficiency of hormones lead to hot flashes, for that we need to supplement the woman with hormones and usually we ask to avoid taking hot drinks and advice to take natural isoflavones to avoid hot flashes.
2. Menstrual Disorder. Menstrual disorder usually happens in the form of either irregular periods or heavy menses and irregular period usually occur in the initial six months to one year time then the period usually stops. If the period continues to be irregular then we need to do investigation to find out whether this woman is having any benign disorder in the uterus or malignant disorder in uterus. For that we need to do an ultrasound of lower abdomen and if required a D&C Hysteroscopy to find out whether there is any growth inside the uterus and we send this tissue for histopathology to rule out malignancy. If the bleeding till persists then the woman may need hysterectomy in that age.
3. Urinary Problem. It is quite common. Usually women do not come out with this problem because they feel shy about disclosing it. The most common problems are either frequency or dysuria which means burning during urination. Another is stress incontinence. Whenever they sneeze or cough they pass small amount of urine. It is all because of hormonal deficiency. Because of which the lining of the urinary bladder as well as the lining of the vagina becomes thin so there is chances of recurrent infection and women suffer from this problem. For this we need to supplement the women with hormones as well as ask them to take natural sources of oestrogens like soya isoflavones.
4. Joint Pain. Usually this is because of the deficiency of Vitamin D and Calcium. For this we need to address and tell them to do lot of exercises and to take Calcium as well as Vitamin D
Usually we subject every woman with health package during menopausal period in which we include a pap smear, and ultrasound routine, blood test like CBC, blood count, as well as lipid profile and kidney function test, sugar, urine routine culture, ultrasound of lower abdomen and if required mammography and if we find any problem one can go for a cardiac check up also. And, usually we tell every post menopausal woman to do some amount of exercise and take calcium and vitamin d and plenty of liquids to avoid any problem related to postmenopausal.
Thank you very much. If you have any problem related to this you can consult me either on Lybrate or you can come down to my clinic.
Today we just want to give a message on breast cancer treatment is as of today in India. So breast cancer is one of the most common cancer amongst women. All over the world it is a number one can amongst Indian all over the world and even in India initially 10 years back it used to be survival cancer. But nowadays we have a lot of breast cancer is coming up and it has replaced cervical cancer to take the number one position in the above sentence even in the rural centres.
For an exception of few sentences for cervical cancer does more than the rest of the centre breast cancer has topped the charts as of 2018. The recent WHO on ICMR surveys that have come up the state that breast cancers the most common one and one of the square 25 to 30 women in India are at risk of developing breast cancer in the west such as US the numbers of Huge it's about 1 and 8 women are at risk of developing breast cancer. But that does not that should not make us more satisfactory or complacent because a population is huge so for a population as huge as Indian population number of breast cancer 8 March 5 so per year we see about 1.5 Lakh cases of new cases of breast cancer.
What is more worrisome is that is one population is large second is the population of people with breast cancer come at an advanced stage as compared to be used in the West president stage 1 and stage 2 where is in India breast cancer stage 3 and 4 in which it is less advanced. Second thing women in India the great of for tomorrow's find the Biology is not so good and much more aggressive treatment so that makes it different the scenario is different as of the west.
The second thing because of the highest age of presentation to cure rates of survival rates also slightly lower when compared to the west that means out of 1.5 Lakh woman who been duly diagnose breast cancer every year only 50% of the episode 75000 make it be cure in five years of diagnosis only one and two women diagnosed with breast cancer come to the come to Healthcare get proper treatment and get cured. So what we have to understand this we need to know the symptoms of breast cancer treatment of breast cancer to cast an early to make effect cost-effective treatment and to improve the survival rates the second message that I want to pass whatever treatment.
Whatever standard of care of breast cancer treatment is available all over the world is very much available in India is very much available in Delhi and it is very much available in the affordable cost and acceptable for everyone 10 years back treatment for breast cancer would be the removal of entire breast to mastectomy but now mastectomy is for very old people one simple surgery could take care of the rest of it 12 simple surgery to take care of the rest of its population surgery to take care of the rest of us even less population reconstruction plastic breast surgery cost of breast cancer treatment we come along way and with the recent advances in technology parsley second major advancements in interprocess of breast cancer management.
In the West a number of people are picked up even before they have the lump that is because of the screening mammography their lesion are picked up lump is leas than 1cm in India we also have a section of people who come very early they get picked up in a Mammogram even before patient is able to feel the lump in the asymptomatic face pedicure rates are very high the second major advance is genetic testing all of you and Angelina Jolie story and so we do have about 10% of people of hereditary breast cancer in home the bracket genes are involved and Bracket genetic testing is very much available in India at an affordable rate and if it is present then prophylactic surgeries may be option which certain people might opt for so the message for today's breast cancer is one of the very much curable cancers of all most of the cancers and of all the character of amongst women so the message for today is breast.
Mai Dr. Arun Kumar Goel, Max Super Speciality Hospital, Vaishali, Ghaziabad mein Cancer Surgery department ka head hoon, aur breast oncology unit ka director bhi hoon.
Mere main area of interest me breast cancer ka management ek pramukh area hai, breast cancer mahilaon ka sabse common cancer hai jo major cities hai metropolitan Delhi- NCR, Bombay aur aisi cities mein. Aur iska jo incidence hai woh badhta ja raha hai jiske kai karan hai, isme breast cancer ke ilaj mein pichle 30-40 saalon mein bahut tarakki hui hai aur aaj ke din hum dekhte hain ki breast cancer ke marijoo ka survival rate hai woh 90% se upar hai, lekin itna achha survival achieve karne ke liye hame jo hai uski diagnosis bahut jaldi karni padti hai. Toh yeh ek bahut sabse important baat hai, jo sabse common symptom hai breast cancer ka woh hai breast mein ek lump ya ganth ka hona.
Ab breast ki ganthe kuch cancerous hoti hai kuch non-cancerous hoti hai, lekin jab bhi koi ganth ho toh yeh possibility zaroor sochna chahiye ki kahi cancer to nahi hai aur turant ek cancer specialist ya breast surgeon se opinion lena chahiye. Cancer ki diagnosis banane ke liye usme kuch janche hoti hai jisme mammography ya ultrasound hota hai, fine needle aspiration cytology ya biopsy hoti hai aur kabhi kabhi breast ka MRI bhi kiya jata hai. Toh agar cancer confirm hota hai toh phir uske baad kuch staging test karte hain yeh dekhne ke liye ki bimari sharir mein kahin faili toh nahi hai, jyadatar cases me bimari localised hoti hai aur uska ilaj jo hai sabse pehle operation ya surgery ke dwara kiya jata hai jo meri main feild hai. Jyadatar logo ko breast cancer surgery mein jo pareshani hoti hai ki pehle ilaj hota tha usme purye breast ko remove kiya jata tha jise hum log mastectomy kehte thye, lekin agar mareez early stage mein aata hai ganth bahut badi nahi hai to pura breast nikalna zaroori nahi hai, hum log breast conservation surgery ke dwara breast ko bchaa sakte hain.
Isme aage aur kafi advances huye hai aur aaj kal hum log jo approach follow karte hain jis bolte hain oncoplastic breast conservation surgery, jisme jo cosmetic results pehle se bhi bheter hai. Agar kuch marijoo mein pura breast nikalna zaroori bhi hota hai toh reconstruction bhi kiya ja sakta hai. Aur ek nai approach jo surgery mein aaj kal hum log use kar rahe hai jise kehte hain Sentinel lymph Node Biopsy, yeh armpit ki jo ganthe hoti hain nodes unke management ke liye ek latest approach hai aur iss approach ka istemal karne se jo hathon mein sujan aane ka risk hai Lymphedema wo kafi kam ho jati hai. Toh surgery basically jo ho jati hai uske baad kuch marijoo mein additional treatment ki zaroorat ho sakti hai jaise chemotherapy hai, radiotherapy hai, ya kuch dawaiya hai jo hormonal intervention karti hain. Toh surgery ke baad kafi marijoo mein jo pehela ilaj hoga woh chemotherapy hota hai, jo 4 se 8 cycle tak diya ja sakta hai. Radiotherapy jin marijoo mein hoti hai woh bhi again aaj kal karib 3 hafte mein puri ho jati hai jo ki pehle usme 6 se 7 hafte lagte thye, aur nahi radiation technology ke through jo side effects hai radiation ke wo kafi kam ho gaye hain. Isi prakar hormonal therapy jo hai woh yeh radiation or chemo khatam hone ke baad di jati hai jis mein sirf ek tablet hoti hai jo marijoo ko ghar pe regular istemal karna padta hai aur wo 5 se 10 saal tak use ki ja sakti hai.
Ek aur important cheez yeh hai ki jo bhi cancer ke marij hote hain unko ek regular follow up pe chalna padta hai, toh ilaj pura hone ke baad har 3 mahine baad unhe apne surgeon ke pass follow up ke liye jana chahiye, jisme examination jo hai woh ek bahut important part hai. Phir uske baad kuch testing ho sakti hai jaise chhati ka x-ray hai, ultrasound hai, mammography hai, aur agar koi aur takleef hoti hai tu Bol Scan, MRI, CT ya Pet Scan bhi kiya ja sakta hai. Iske alawa breast cancer ke marijoo mein jo ek aur cheez hoti hai hum log ek jo usko promote karte hain woh hai support group ka concept, jisme breast cancer ke survival aapas mein milte hain, ek doosre se cheeze discuss karte hain aur support bhi provide kar sakte hain aur isse unki jo future life hai wo kafi better rehti hai. Toh mein yahi kahunga ke cancer se aapko waise bhi nahi darna chahiye aur breast cancer ke jo aaj ke din success rate hai wo bahut hi acchi hai toh bina darre janch karaye aur apna ilaj pura kare.
Dhanyavad, Thank you.