Imaging study · Low dose

Mammography

Also known as: mammogram, breast screening, breast X-ray, tomosynthesis

A low-dose X-ray of the compressed breast that can detect cancers years before they can be felt, used for screening programmes and for investigating breast symptoms.

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How it works

A low-dose X-ray of each breast, compressed between two plates for a few seconds to spread the tissue thin and hold it still. Two views are taken of each side. Digital tomosynthesis takes a sweep of images to reconstruct thin slices, reducing overlap. Cancers show as masses, distortions or clusters of tiny calcifications, often years before they can be felt.

What it shows

  • Breast cancer, including ductal carcinoma in situ (calcifications)
  • Benign lumps: cysts, fibroadenomas (with ultrasound to tell them apart)
  • Breast density, which affects both risk and how easily cancers are seen

Best for

  • Population screening of women aged roughly 50-70, every 2-3 years depending on country
  • Investigating a new lump, nipple change or skin change in women over 40
  • Follow-up after breast cancer treatment

Not the right tool for

  • Younger women with dense breasts, where ultrasound and MRI see more
  • Assessing implants (MRI)
  • Ruling out cancer completely: about 1 in 8 cancers is missed, so a new lump is always investigated even after a normal screen

What to expect

Modality
Mammography
Preparation
No deodorant or talc on the day (they mimic calcifications); book after a period if breasts are tender.
Duration
About 10-15 minutes, with each compression lasting a few seconds.
Radiation
About 0.4 mSv for two views of both breasts, similar to seven weeks of natural background radiation.
Contrast
Contrast-enhanced mammography with iodine is an emerging alternative to breast MRI.
Risks
Discomfort from compression; a small radiation dose; false alarms leading to recalls and biopsies; overdiagnosis of cancers that would never have caused harm.

Common uses

RegionTypical question
ScreeningAsymptomatic women in the screening age range
SymptomaticLump, discharge, dimpling, in a one-stop clinic with examination, ultrasound and needle biopsy
High riskEarlier and yearly screening for BRCA carriers, usually with MRI

Studies this page covers

Named studies of the master test taxonomy that this modality page covers; each links to its test category.