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By Hakan Ilaslan, MD, Associate Professor of Radiology; Staff Radiologist, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University; Imaging Institute, Diagnostic Radiology

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Patient Education

Mammograms are breast x-rays, which usually include ≥ 2 views of each breast taken at different angles. The breasts are compressed with plastic paddles to optimize visualization of breast tissue and abnormalities.

Screening mammograms are used to check for breast cancer in asymptomatic women (see also Breast Cancer : Screening).

Diagnostic mammograms are used to diagnose breast disorders in women who have

  • Breast symptoms

  • Palpable breast masses

  • Abnormal results on screening mammograms that require further investigation

Diagnostic mammograms can include standard and specialized views.

Typically, mammography exposes the breasts to about 0.4 mSv of radiation. This dose is relatively low compared with other imaging tests that use radiation (see Table: Typical Radiation Doses*). However, radiation exposure is a concern with mammography because breast tissue is sensitive to radiation (see Risks of Medical Radiation). Mammography is sometimes recommended only for women > 40 partly because breast tissue in older women is less sensitive to the adverse effects of radiation. Specialized mammography units and digital imaging techniques are used to minimize radiation exposure.

Variations of mammography

Tomosynthesis, a 3-dimensional technique, can be used in mammography. In tomosynthesis, an x-ray source moves over an arc of excursion, providing thin, tomographic slices, which are reconstructed into 3-dimensional images. This technique minimizes the effect of overlapping structures in the breast. Thus, abnormalities can be better separated from the background. As a result, the need for repeat mammograms may be reduced, and clinicians may be able to detect cancers more accurately, especially in patients with dense breasts.

The total radiation dose used in 3-dimensional mammography (1.0 mSv) is higher than that used in conventional mammography (0.5 mSv). although it is relatively low, compared with some other imaging tests.