Guidelines For Mammography

Mammography is another way of detecting breast cancer. This technique, which is performed by a radiological technologist, produces a mammogram or soft-tissue X-ray of the breast that allows the doctor to see tumors that are too small to be detected by physical examination.

A mammogram also reveals the presence of other tumors and helps the doctor tell whether they are cancerous or not.

"According to the National Cancer Institute, mammography has helped detect 45 percent of breast cancers that were missed by the doctor when he examined the breast manually. For earlier cancers, called minimal tumors, which cannot be felt and are only detectable through mammography, cure rates of up to 95 percent are being reported," revealed Marrion Morra, assistant director of the Yale Comprehensive Cancer Center at Yale University School of Medicine in Connecticut, and Eve Potts in “Choices: Realistic Alternatives in Cancer Treatment.”

However, the procedure does have its drawbacks. Like other diagnostic tools, mammography relies on the skills of the technician taking the X-rays and the radiologist who interprets them. Both must be highly experienced to read mammograms and give the right interpretation.

The position of the breast on the X-ray plate can also give distorted results. False readings can likewise be obtained from a mammogram. It may show a tumor when there is none or it may indicate the absence of cancer in one who has the disease. For this reason, mammography should not be used alone but combined with other diagnostic techniques.

There is much controversy regarding the routine use of mammography in detecting breast cancer. This stems from the fear that the procedure could unnecessarily expose women to dangerous levels of radiation, thereby increasing the risk of cancer.

There is some truth in this. Old machines and methods exposed women to as much as 10 rads of radiation which are hazardous if done regularly over a 10- to 20-year period. This was pointed out by Dr. Corazon A. Ngelangel, professor, Clinical Epidemiology Unit, College of Medicine, and a consultant at the Medical Oncology Section of the University of the Philippines - Philippine General Hospital.

"Mammography is like a two-edged sword. It is more sensitive than breast examination in detecting small lesions less than two centimeters but it has a carcinogenic effect. Young women who are exposed to this technique may develop cancer later," Ngelangel said.

For those who require mammography though, they'll be glad to know that newer techniques have eliminated the risk of cancer and have lowered doses of radiation to less than one rad per breast. So if your doctor tells you to have a mammogram check the facility and make sure the machine delivers the lowest dose of radiation possible. (Next: Who needs mammography?)

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