A mammogram requires a doctor’s order.  Therefore, the decisions of when to have your baseline and screening mammograms must be negotiated with your doctor.
     A mammogram is a low-dose x-ray of the breast which produces a film image of the breast structure.  There are two distinct types of mammography exams, screening mammography for women with no signs or symptoms of breast cancer and diagnostic mammography when there are physical findings and symptoms present.3
     Screening mammography is accomplished by taking two mammogram x-rays, from different angles, of each breast.  First, the breast is gently yet firmly compressed between two plastic plates to flatten the tissue.  Then the x-ray is taken and the breast is released.14  Since breast tenderness may intensify compression discomfort, it is best to schedule your screening mammogram 5-7 days after the first day of menstrual flow, when breast tissue is least tender and most normal.9
     Diagnostic mammograms (also called consultative or problem-solving mammograms) are used when there is an unusual circumstance, or know physical signs and symptoms, such as a lump, dimpling, spontaneous breast discharge, or abnormal screening mammogram.3,9 These generally take more time as more views are taken to better define the abnormality and rule out the possibility of other physical signs within the breast that have not shown up elsewhere.3  Simply put, the diagnostic mammogram is one way of taking a closer look.
     Research reveals (and authorities generally agree) that annual screening mammograms starting at age 50 save lives.9,12,14  You see, by age 50 most women have reached menopause and have less hormones circulating in their bodies.  Therefore, the dense glandular tissue which reacts to hormonal surges has diminished, leaving only the fatty tissue.  Mammography can see through fatty tissue and this makes cancers stand out vividly in the over 50 age group.12  Nevertheless, new studies suggest that the use of hormones (hormone replacement therapy) by women 50 and over may lower the sensitivity of mammography.EThus, the use of hormone replacement therapy is now associated with a decrease in The accuracy of mammograms.F Nevertheless, the false negative rate for mammography in the 50 and over age group is only 10%.G
     The statistics for the under 50 age group is not as concrete.  Because these women are often still having menstrual cycles, their hormone levels may still be high.  This means that the glandular tissue of the breasts may still be dense and we have already learned that mammography is restricted by dense glandular tissue.12 The false negative rate for mammography in women age 40-49 is 25% and women 30-39 have an amazing 40% false negative rate.G
     Therein lies the controversy.  Some experts feel that a standard recommendation for mammography every 1-2 years in the 40-49 age group is unfounded, while others believe it is the best possible plan of action.9,10,12,13  This is where you are your health care professional need to have an open discussion.  By weighing your personal risk factors and the density and amount of glandular tissue remaining in your breast, you and your doctor can design a screening mammography plan tailored just for you.

“Breast-Mapping”® was designed as an educational tool and it should not be used in place of appropriate medical care.  Every effort has been made to ensure that the information presented herein is accurate at the time of publication.  New research is ongoing however, and therefore it is possible that the data and recommendations presented herein may be invalidated by new findings.

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