Mammografi – engelska

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Mammography is a radiological examination of your breasts by means of a special technique that provides detailed images. This is one of several procedures that a doctor can order to discover the cause of any changes in your breasts.

Mammography is also the method used for the nationwide breast screening programme whereby all women between the ages of 40 and 74 are regularly invited to have their breasts examined . The purpose of screening is to detect breast cancer before the disease has had time to give any symptoms.

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Breast cancer is the most common form of the disease among women. The risk of developing breast cancer increases with age. The prospects for full recovery are good if the disease is detected at an early stage.

How mammography screening works

How mammography screening works

You do not have to make any special preparations.

A nurse will examine you and ask questions

A radiology nurse will perform the examination. The first thing the nurse will ask you is whether your breasts are causing any discomfort and whether you are taking any medications that contain hormones.

Then you will take off your blouse and bra. The nurse will look at your breasts to determine whether you have any visible changes, including large birthmarks or surgical scars. Such changes may show up in X-rays and be erroneously interpreted as cancer tumours.

Two or three X-rays of each breast

You will then stand or sit next to the X-ray machine. The nurse will help you place one of your breasts on the film plate. Another plate will press the breast down and hold it in place for a few seconds.

You will hold your arm up and lean against the machine while the nurse takes two or three X-rays. The procedure is then repeated for your other breast.

It takes 5-10 minutes to take the X-rays and 15-30 minutes to complete the entire examination.

What does a mammography examination feel like?

The nurse will squeeze your breast to ensure as clear an X-ray and as low a dose of radiation as possible. You might experience some discomfort and pain for a short period of time. You are not likely to feel any different from usual once the examination is over. It is possible that you will experience some tenderness but it will go away quickly.

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Results of the screening

Results of the screening

Usually, two radiologists will look at the X-rays, independently of each other. That way, they can come up with a more reliable assessment.

You will receive a letter within two weeks notifying you of the results. Make sure to ask during your visit if you want to know more about the clinic's procedures for informing you of the results.

If you have a follow-up appointment

You may be scheduled for a follow-up appointment after mammography screening. Perhaps the X-rays did not turn out to be as clear as intended. If that is the case, it may be enough for you to repeat the original examination.

Or you might need a follow-up appointment because the X-rays showed a change in one or both of your breasts that requires further assessment.

If the X-rays show a change

During the initial screening session, you will have the same kind of mammogram as everyone else. If the X-rays show that a change has occurred, examinations will be required to find out what caused it in your particular case. In other words, the mammography examination will be adapted to your personal needs. The radiology nurse will take more X-rays from various angles. A radiologist will look at the images right away.

A doctor may also order an ultrasound examination. The doctor might also decide to request that a biopsy or tissue sample be taken from your breast with a needle.

All the examinations will be performed at the same appointment.

A doctor will inform you of the results in person so that you can ask questions and obtain additional information. You will see the doctor as soon as possible, but the waiting time will vary depending on where you live. You are welcome to ask questions when you are at the clinic having the various examinations.

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If you are pregnant or breastfeeding

If you are pregnant or breastfeeding

Mammography screening is possible even if you are pregnant or breastfeeding. It is true that it may be more difficult to detect or rule out cancer by looking at the images of your breasts, given that they are different than usual. But avoiding mammograms while you are pregnant or breastfeeding may stretch out the time between examinations more than is recommended.

The radiation dose is not dangerous to the foetus and does not affect your breast milk. So there is no reason to be afraid of screening if you receive an appointment letter.

If you are breastfeeding, you might want to empty your breasts as much as possible before the examination.

Pregnant women and those breastfeeding are welcome to reschedule the appointment, just like anyone else.

You should immediately call and make an appointment if you notice a change in one of your breasts while you are pregnant or breastfeeding. In that case, you may start with a mammogram and then have an ultrasound examination.

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Advantages and disadvantages of mammography screening

Advantages and disadvantages of mammography screening

The X-rays may reveal breast cancer before you have experienced any symptoms.. The risk that the disease will spread and become fatal is very small at that point, and your treatment will not necessarily have to be very extensive.

Nevertheless, mammography screening is not always totally reliable. The X-rays can miss a tumour. Some types of cancer grow so slowly that they will never cause any problems. It is hard to know in advance which slow-growing cancer tumours fall into this category. To err on the side of caution, all breast cancer is treated as if it were dangerous. As a result, some patients undergo treatment that they don't actually need.

The Swedish National Board of Health and Welfare recommends mammography screening for all women aged 40-74. All the counties and regions follow this recommendation.

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Additional information about mammography screening

Additional information about mammography screening

You will receive an appointment letter

Between the ages of 40 and 74, you will receive an appointment letter every 1½ to 2 years. Your age and where you live will determine exactly how often you are screened.

The letter will say where and when the examination is to be performed, whom you should ask if you have any questions, and how to reschedule if you cannot make the appointment.

Screening is completely voluntary.

You are free to be screened in another county if you prefer. You will be subject to the same conditions as inhabitants of that county.

What to do if you do not receive any appointment letters

Call a mammography clinic or health centre if you are 40-74 years old and have not received an appointment letter.

After the age of 74, you will no longer be scheduled for screening. No studies have been able to demonstrate that screening improves the survival rate of women who are older than 74. But be sure to see a doctor if you notice a change in one of your breasts.

If your identity is protected

If you are living under a protected identity, you will not receive an appointment letter. Contact a mammography clinic for an appointment. Call the clinic afterwards to get the results.

If you do not want to receive a letter

Call the mammography clinic if you have received an appointment letter but do not want to participate in the screening programme or have letters sent to you in the future. The staff at the clinic are likely to request that you write to them and confirm that you are declining any more letters.

If you ever change your mind, simply let the clinic know and they will resume sending you letters until you turn 74.

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Scheduling a mammogram if you detect a change

Scheduling a mammogram if you detect a change

You might be worried if you detect a change in one of your breasts. Usually, the change is not dangerous. For instance, a lump in the breast can be a tissue nodule or a fluid-filled blister, known as a cyst.

But take any change in your breasts seriously, regardless of your age. It could be breast cancer. Make sure to schedule an examination and don't put it off. Call a health centre or gynaecology clinic or a breast clinic at a major hospital.

You can make an appointment at the health centre or outpatient clinic of your choice anywhere in the country. You can also request a regular family doctor at your health centre.

A doctor will examine your breasts thoroughly and decide whether you should have a mammogram. If so, you will be given a referral.

The mammogram examination will be adapted to your particular needs. In addition, the radiologist may want an ultrasound examination to be performed. A biopsy or tissue sample might also be required.

The results of the various examinations will be sent to the doctor who referred you. The doctor will set up an appointment to tell you whether you have breast cancer or whether something else is causing the symptoms.

In order for you to participate actively in the care you receive and make good decisions, it is essential you understand the information you are given. The staff at the clinic are obliged to ensure you do understand. Don't be shy about asking questions. If you prefer, request that they write the information down on a piece of paper so you can read it in the peace and quiet of your own home. You have the right to receive the information in a language other than Swedish through an interpreter or by some other means. An interpreter must also be made available to you if you have hearing or vision loss.

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Can I have a mammogram under the following conditions?

Can I have a mammogram under the following conditions?

I am menstruating.

Yes, mammography works perfectly well during a menstrual period.

I have dense breasts.

You can have dense breast tissue no matter how old you are. There is no way of knowing that before you have a mammogram done. If it turns out that you have dense breasts, more X-rays than normal may be needed.

I am receiving hormone therapy.

Some people receive hormone therapy during or after menopause or are taking oral contraceptives. That kind of treatment increases the density of your breast tissue. That makes it more difficult to assess the mammograms. It's important, therefore, that you inform the clinic if you are taking any medications that contain hormones.

I have breast implants.

Breast implants are not an obstacle to having a mammogram done. There is no danger of breaking the implants but your breasts cannot be squeezed together as much. Depending on what the implants are made of, the X-rays might also be harder to assess.

One of my breasts is inflamed.

Inflammation might make it too painful to squeeze a breast the way that a mammogram requires. An ultrasound examination may be able to identify any pus that needs to be drained. Once the inflammation goes away, you should have a mammography, particularly if you are over 60.

I have had breast cancer before.

Certainly, although screening procedures may vary – ask your doctor for more information. In most places, you will have a special medical check-up the first year following completion of your treatment. During the next ten years, you will receive an annual appointment letter for mammography screening. Once that period has passed, letters will be sent to you at the same interval as women who have never been diagnosed with breast cancer.

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Under what circumstances are mammograms avoided?

Under what circumstances are mammograms avoided?

Breast cancer is rare before the age of 30. If you are very young and need an examination, ultrasound can provide more reliable results. At that age, your breast tissue is too dense for X-rays to be assessed properly. Mammography is not an effective method for young women.

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Editor: Susanna Olzon Schultz och Helena Vogel, 1177 Vårdguiden


Reviewed by: Magnus Rosenborg, bröströntgenläkare, överläkare, mammografikliniken Blekinge.