Thought by many to be the single most important innovation in the detection and control of breast cancer since the introduction of the radical mastectomy in 1868, mammography is an invaluable aid in the early detection of breast cancer and other abnormalities. For proof of this, you only need to look at the Breast Cancer Detection Demonstration Project (BCDDP) of the mid 70's. This project, which was organized by the American Cancer Society and the National Cancer Institute, followed 280,000 women for five years through a regiment of screenings, physicals, mammograms, and self-examination of the breast. During the course of the project, over 40% of the cancers found and treated were found only with mammography.

The exam itself is fairly simple and straight forward. When you report to the facility where your exam will be performed, it is important that you do not wear deodorant/antiperspirant, powder, or perfume, as all of these may show up on your films. The technologist, or mammographer, who will be doing your study will probably begin by discussing the exam with you to be sure you know what to expect. Some facilities even have a short video on the subject they will have you watch. Following this, you will be escorted to a dressing area where you will be asked to remove everything from the waist up and given a special gown to put on. From there you will be taken to the exam room and positioned on the mammography machine.

Inspite of the fact that many, many companies make mammography equipment, there seems to be three basic styles of machines as far as patient positioning goes. In one type, the patient is seated in front of the machine, another has the patient stand, and the third type has the patient lay on a specially designed table. The one thing they all have in common though is a device designed to compress the patient's breast to a uniform thickness. Some women may feel considerable discomfort when this compression is applied, but it is, unfortunately, necessary if good quality films are to be obtained.

You see, not all the x-rays produced by the machine get to the film. Some are stopped by the body part being x-rayed, just as curtains will stop some daylight from getting into a room. Plus, just as a thicker, heavier curtain will stop more light than a thinner, lighter curtain will, so will a thicker or heavier body part stop more x-rays than a thinner body part. Thus, without adequate compression, the outer edges of your breast will show up too dark on the film, and the part closest to the chest wall will show up way too light, rendering the film useless. By compressing the breast to a uniform thickness, everything can be seen without worrying that the area near the nipple will be "burnt"(too dark) or that the area near the chest wall will be "washed out"(too light).

If you are one of those woman whose breasts are very sensitive, one thing you might consider trying is cutting out all caffeine for about a week before your exam. Some Mammographers I know tell me that this simple trick can make a big difference.

One final thing must be said. While mammography is very good at detecting lesions, fibrous masses, and cysts, it can not tell whether or not they are cancerous. Though annoying, they may be completely benign. Only by testing a small tissue sample in the lab can it be determined whether the object(s) seen on your mammograms is indeed cancerous or not.