How to Get The Best Mammogram Possible

By Jane Farrell

Editor’s Note: Mammograms are one of the most commonly performed procedures for women, and there is little argument about their value in detecting breast cancer. But not all mammograms are equal, and you owe it to yourself to get the best one available. Here, from the federal Food and Drug Administration (FDA), is an explanation of how the test works, the difference in types of mammograms, and what kinds of federal protections are in place to guard your health and safety.

How Does The Test Work—and Is It Painful?

A mammogram is a low-dose X-ray picture of the breast. Getting a mammogram is the best way to find breast cancer early, because it can show breast lumps when they are too small for you or your health care provider to feel them.

Thermograms and nipple aspirate tests are not substitutes for mammograms. You should ask your health care provider when and how often you should schedule a mammogram, says Helen J. Barr, M.D., director of the Division of Mammography Quality Standards in FDA’s Center for Devices and Radiological Health (CDRH). ”Regular screening mammograms are important,” she adds.

To get a mammogram, you will need to take off your shirt and bra. While standing in front of the machine, a technologist will position your breast on a small platform. A clear plastic plate will press down on your breast while the mammogram is acquired.

If you’re worried about how the procedure feels, you should know that most women do not find it painful. Some women may find the pressure on the breast uncomfortable, but it lasts for only a few seconds. “Compression of the breast is important because it helps spread out the breast tissue so it doesn’t overlap, allowing better visualization,” explains Barr.

FDA regulations require that you (the patient) receive a summary of the mammography report within 30 days after your mammogram, and that reasonable attempts to communicate the results are made sooner if the results are suspicious or highly suggestive of malignancy. If you do not receive the mammography report summary, call your provider to get your results.

As a rule, you should also call your health care provider if you notice any change in either of your breasts. A lump, thickening or nipple leakage, or changes in how the nipple looks can signal a potential problem.

Why Is Facility Certification Important?               

FDA, or an FDA-approved state certifying agency, certifies mammogram facilities in the United States under a law called the Mammography Quality Standards Act (MQSA). The Act’s purpose is to ensure that facilities and their staff are producing quality mammograms.

“Certification is important because it indicates that a facility has met the MQSA requirements for practicing quality mammography. And a high-quality mammogram can help detect breast cancer in its earliest, most treatable stages,” says Barr.

Each mammography facility is inspected every year. During the inspection, a trained evaluator checks the facility’s equipment, staff training, and staff qualifications. Each facility also undergoes an in-depth accreditation process every three years.

To legally perform mammography, facilities must be certified. “There is a certificate that shows that the facility has been certified,” notes Barr. “Consumers should look for that certificate, which should be prominently displayed.”

What Is The Difference Between 3D and 2D Mammograms?

In recent years, FDA has approved advanced mammography devices that perform 3D digital breast tomosynthesis, a technology that creates cross-sectional (3D) images of the breast from X-rays taken from multiple angles. These devices provide informative images of the breast tissue and are helpful in evaluating dense breast tissue. “Dense breast tissue can make cancers more difficult to find on a mammogram,” says Barr.

After conducting premarket reviews, FDA determined that there was a reasonable assurance that the new 3D devices were safe and effective for their intended use. New breast-imaging equipment must receive an FDA approval or clearance before being marketed, says Robert Ochs, Ph.D., chief of FDA’s Mammography, Ultrasound, and Imaging Software Branch at CDRH.

“FDA’s approval of 3D mammography devices was based on a review of clinical studies involving multiple radiologists and hundreds of cases,” says Ochs. “FDA also sought input on the safety and effectiveness of the devices from a panel of non-FDA clinical and technical experts.”

You can ask your doctor if 3D mammography or additional 3D imaging methods, such as ultrasound or MRI, are options for you. Ochs adds: “The results from multiple studies show that the combination of 3D and 2D imaging can improve breast cancer screening for all women.”

Where Is The Closest Certified Facility?

About 8,600 certified facilities are now in operation across the country. To find a mammography facility in your area, you can search the list on FDA’s website by your zip code. The list is updated weekly. See it here: http://www.fda.gov/Radiation-EmittingProducts/MammographyQualityStandardsActandProgram/ConsumerInformation/ucm113962.htm.

Reprinted with the permission of the FDA. For more information on consumer issues, visit the agency’s Consumer Updates page: http://www.fda.gov/ForConsumers/ConsumerUpdates/.