The mammogram is probably one of the most important screening tools in breast cancer. It is used not only for breast cancer screening, but also for breast cancer diagnosis, evaluation and follow-up of breast cancer patients. Mammogram is an x-ray of the breast, which is safe and accurate. In China, it is generally used for women over the age of 35. Mammograms are generally recommended every year to year and a half to detect early signs of breast cancer. Diagnostic mammograms are different from screening mammograms in that the main purpose of the former is to examine suspicious areas to obtain more information – usually because the screening mammogram reveals suspicious findings or after a suspicious mass has been found by other means. Diagnostic mammograms capture more images than screening mammograms. The mammography technologist may need to magnify the suspicious area to obtain a more detailed image to help the doctor make a diagnosis. Mammography: What are the benefits? What are the risks? Mammograms do not prevent breast cancer, but they can prolong life by detecting breast cancer early. One study showed that for women over age 50, mammograms can reduce their risk of dying from breast cancer by 35 percent. For women between the ages of 40 and 50, the risk reduction is relatively low. Early detection of breast cancer using mammography also means that more women with breast cancer have a chance to save their breasts. Early localized lesions may not require a mastectomy. The main risk of mammography is its imperfect nature. Normal breast tissue may mask the breast cancer, resulting in a lesion that will not show up on the mammogram. This condition is called a false negative. In addition, a lesion that appears to be a tumor on the mammogram may come back normal on biopsy. This is called a false positive. False positives can lead to more follow-up examinations and follow-ups, causing unnecessary anxiety for the person being examined. To compensate for these limitations of the mammogram, you will need to perform a breast self-examination, regular breast exams with a specialist, a breast ultrasound, and sometimes other breast exams such as an MRI. Some women may be concerned about the radiation exposure associated with a mammogram. Modern mammograms involve very little radiation – even less than a standard chest x-ray. 5 things to know about mammograms: 1. Mammograms can prolong life. Early detection of breast cancer can reduce your risk of dying from breast cancer by 25-30% or more. Chinese women should have regular mammograms after the age of 35 (every year to year and a half), and high-risk women may need to be screened earlier and more closely (please consult a specialist). 2. Please do not worry about the examination process. The mammogram is a relatively quick test (about 20 minutes), and for most women, they will feel only minor discomfort. The procedure is safe: the amount of radiation involved in each mammogram is minimal. 3. Try to get the highest quality images possible. If you have dense breasts or are young, try to have a digital mammogram. Digital mammograms are recorded on a computer, so your doctor can zoom in locally for a closer look. Mammography is the most powerful screening tool for breast cancer. However, mammograms can still have a nearly 20 percent missed diagnosis rate. Other important tests – breast self-examination, clinical physical examination, ultrasound or MRI – can be used to complement it, but they cannot replace mammography. When a mammogram is abnormal and further testing is needed, it does not mean that you have breast cancer. According to the American College of Oncology, 10% (1 in 10) of women who have had a mammogram will need further testing. Only 8-10% of these women who undergo further testing require a biopsy, and 80% of those who do have a biopsy end up with a non-cancerous result. It is normal to be concerned when your test report asks you to undergo further testing, but it is important that you do not make an unfounded self-imposed death sentence before other test results are available. When should I have a mammogram? There are no clear rules about when to start mammograms or how often to have them. In the United States, it is generally recommended that women have annual mammograms starting at age 40. In China, the average age of breast cancer is younger, so it is generally recommended to start mammograms around the age of 35. For women who are at high risk for breast cancer, mammograms are recommended every year to a year and a half. For women who are at high risk for breast cancer, such as those with a significant family history of breast or ovarian cancer, or those who have received radiation therapy to the chest wall, earlier mammograms may be recommended (this is a question you will need to ask your specialist).