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Many women, particularly those with
small breasts, are worried that a mammogram will be painful
and may not accurately detect breast cancer. While
mammography does involve breast compression, which
may be temporarily uncomfortable for some women, the procedure should not be significantly
painful for any patient. No two mammogram patients have identical breasts, and therefore,
each patient provides a unique set of challenges for the mammogram technologist. However,
a good technologist is skilled at imaging all breast sizes and shapes, from large,
pendulous breasts to small, dense ones.
The following are common questions
about mammography on small breasts:
Q: Do all women have enough breast
tissue to have a mammogram?
A: A good mammography technologist should be able to image all breast sizes and
shapes, including very small breasts. Women with small breasts should have enough breast
tissue for a mammogram. In fact, most men have just enough
breast tissue to cover the first photocell of a mammography machine. If there is not
enough breast tissue, the technologist may have to time the mammogram manually, though it
is still possible to obtain an image. Men are often referred for mammograms if a breast
abnormality is detected by their physician.
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Mediolateral
oblique (MLO)
view
mammogram
showing the
pectoral
muscle,breast,
nipple and
breast ducts |
Q: Will portions of breast tissue
not be imaged on women with small breasts because the tissue does not protrude very much?
A: There is always a small amount of breast tissue that cannot be imaged with
mammography regardless of breast size: the area between the edge of the film cassette and
the chest wall. This area is typically the same in all patients, regardless of breast
size.
Q: Is mammography less accurate on
women with small breasts?
A: Mammography is approximately 85% to 90% accurate in detecting breast cancers in
women, regardless of breast size. Mammography is not typically less accurate at revealing
breast cancer in women with smaller breasts; however, it may be more difficult to detect
cancer in dense breasts as opposed to breasts made up of more fat content. In general,
smaller-breasted women tend to have dense breasts and larger-breasted women tend to have
more fat in their breasts. Fat appears as a black area on a mammogram film, making it
fairly easy to detect any abnormalities while dense breast tissue appears as a white area,
sometimes obscuring abnormalities (which also appear as white areas). For these reasons, breast self-exams and physician performed clinical breast exams should also be performed to help
detect breast cancer in its earliest stages. The majority of
cancers are found in the upper, outer quadrant of the breast, which is approximately the
same size in most women. The mediolateral oblique
(MLO) mammography view helps image this portion of the breast.
 |
41% of breast cancers are found in
the upper, outer quadrant of the breast and 34% are found in the area behind the nipple.
Image courtesy of the American
Medical Association |
Q: Is a mammogram more painful for women with small breasts? |
A: A mammogram requires that the
breasts be compressed briefly, which may be
uncomfortable for some women regardless of breast size. However, mammograms should not be
significantly painful. Breast compression is necessary to flatten the breast so that the
maximum amount of tissue can be imaged and examined. Patients should feel firm pressure
due to compression but no significant pain. Patients who feel pain should inform the
technologist so that the breast may be repositioned. Women who have sensitive breasts
may wish to schedule their mammograms at times of the month when the breasts are less
tender. In general, the week before and during menstruation is when breasts are most
tender, and the week after a period is when breasts are the least tender. Click here for more tips for a successful mammogram.
|
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Breast compression is
necessary to flatten the breast so that the maximum amount of tissue can be imaged and
examined. |
Q: Are small-breasted women less likely to get breast cancer because they have
less breast tissue? |
| A: The amount of breast tissue a woman
has does not affect her risk of developing breast cancer. Click here
to learn about the risk factors for breast cancer. |
Q: What are some alternative breast cancer screening exams for women with small
breasts? |
| A: Currently, mammography is the only
screening exam approved by the FDA to help screen for breast cancer in asymptomatic women
(women with no signs or symptoms of the disease). All women 40 years of age
should have a screening mammogram every one or two years. Women 50 years of age and older should receive screening mammograms every year. Mammography has been shown to detect 85% to 90%
of breast cancers. If a mammogram reveals a breast abnormality, the concern may then be
further assessed with other imaging tests (such as ultrasound)
or a biopsy may be performed. In addition, if a mammogram does not
reveal any breast abnormalities but the patient’s physician is still concerned,
further imaging tests may be ordered.
|
Additional Resources and
References
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Updated: September 12, 2007
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