Mammography
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Overview
Mammography is a specialised X-ray that examines breast tissue. It is the standard test for breast cancer screening — and the first investigation when a lump, change, or pain in the breast needs assessment.
Early detection saves lives. Breast cancers found on screening are usually smaller, less spread, and more treatable than those found later. At St. Stephen’s Hospital, mammography is performed using a modern digital machine and reported by senior radiologists.
What is this test?
Each breast is gently positioned between two plates on the mammography machine. The plates briefly compress the breast — flattening the tissue so that smaller features can be seen. A low-dose X-ray is taken from two angles per breast.
Digital mammography produces images that can be magnified and reviewed in detail. In some cases, additional views or an ultrasound may be done in the same session for a clearer picture.
When is this test recommended?
- Routine screening every 1 to 2 years from age 40 to 50 (depending on guidelines and risk) n or suspected coronary artery disease
- Earlier or more frequent screening if there is a strong family history of breast or ovarian cancer
- Any new breast lump or unexplained change in the breast — at any age
- Nipple discharge, particularly if blood-stained
- New skin changes (dimpling, retraction, persistent rash)
- Follow-up of previous breast biopsy or surgery
Why your doctor may order it
- Screening for breast cancer in women with no symptoms
- Assessment of a new lump or breast change
- Investigation of nipple discharge or skin change
- Follow-up after breast surgery or known breast condition
- Family or genetic risk assessment
How long does it take?
The mammogram itself takes about 15 to 20 minutes. With registration, undressing, and discussion afterwards, plan to be at the hospital for about 45 to 60 minutes.
How to prepare
- If possible, schedule the test 7 to 10 days after your period — breast tissue is less tender then.
- Do not apply deodorant, talc, perfume, or lotion to the breast or underarm area on the day of the test — they can show up on the images.
- Wear a two-piece outfit so that you can change only your upper clothing.
- Bring previous mammograms and breast ultrasound reports — comparison is one of the most valuable parts of mammography.
- Tell the team about any breast implants, previous breast surgery, or current pregnancy.
- Bring your prescription and ID.
What to expect during the test
You will undress from the waist up and put on a gown. The radiographer will position you so that each breast in turn is between the two plates of the machine. Compression lasts only a few seconds per view.
Two views per breast are standard. The compression can be uncomfortable — particularly if you have tender breasts — but it is not usually painful and only lasts seconds. Tell the radiographer if it is genuinely too painful; positioning can sometimes be adjusted.
If additional views are needed (or an ultrasound is added), this is normal and does not necessarily mean something is wrong.
After the test
- You can resume normal activities immediately.
- Some women have mild breast tenderness for a few hours — paracetamol helps if needed.
- The report is usually available the same day or within 24 hours.
- Discuss the report with your doctor. Most mammograms come back as "normal" or with benign findings — but a clear picture allows confident next steps either way.
Do's and Don'ts
- Schedule the test for the week after your period if possible.
- Bring previous mammograms — they help the radiologist compare and pick up subtle change.
- Tell us about any breast surgery, implants, or family history.
- Wear easy-to-remove upper clothing.
- Take paracetamol an hour before if your breasts are usually tender.
- Don't apply deodorant, talc, perfume, or lotion to the breasts or underarms on the day of the test.
- Don't avoid screening because of fear of pain — the discomfort is brief and the benefits are real.
- Don't ignore a new breast lump because you had a normal mammogram a few months ago — see your doctor.
- Don't have a mammogram in early pregnancy unless your doctor confirms it is essential.
- Don't skip the recommended interval just because the last mammogram was normal.
Understanding your results
Mammograms are reported using a standardised category called BI-RADS (Breast Imaging Reporting and Data System), from 0 (incomplete — more imaging needed) through 1 (normal), 2 (benign), 3 (probably benign — short interval follow-up), 4 (suspicious — biopsy recommended), to 5 (highly suspicious for cancer).
Most mammograms are BI-RADS 1 or 2 — normal or benign. A BI-RADS 3 typically means a 6-month repeat. A BI RADS 4 or 5 needs further work-up, usually starting with biopsy. The vast majority of women called back for further tests do not have cancer.
Frequently asked questions
Most international guidelines recommend regular screening from age 40 to 50, depending on individual risk. Indian women often develop breast cancer at slightly younger ages than Western populations, and earlier screening is reasonable in those with family history or other risk factors. Your doctor will guide you.
It is uncomfortable for most women but not usually painful, and the compression only lasts seconds. If you have very tender breasts, schedule the test for after your period and take paracetamol an hour before.
The radiation dose from a single mammogram is very small — far less than the lifetime risk of missing an early cancer. Modern digital mammography uses even lower doses than older film systems.
Should I have an ultrasound instead of a mammogram?
Rarely. Male breast cancer exists but is uncommon. Men with a clear breast lump, family history, or BRCA gene mutation may need a mammogram or ultrasound — and should not ignore breast changes.