Mammography is an X-ray examination of the breasts that can detect cysts or

tumors unpalpable during a physical examination. A biopsy of an area of suspicion

may be needed to confirm malignancy. Mammography may follow
screening procedures, such as ultrasonography or thermography.

There are two uses of mammogram (screening and diagnostic). A screening

mammogram is used to screen for unsuspected breast cancer in women with no
signs or symptoms. It usually involves two x-ray images of each breast to detect
tumors or small calcifications within the breast tissue. While a diagnostic
mammogram is used to diagnose breast cancer in a patient with a suspicious lump
or other signs such as breast pain, nipple discharge, thickening of breast skin, or
sudden change in breast shape or size. It is also utilized to examine breast
abnormalities found during a screening mammogram and in such cases for
patients with breast implants since it provides a more detailed x-ray of the breast
than using a screening mammogram.

Although mammography can detect 90-95 % of breast cancers, this test produces
many false-positive results. The American College of Radiologist, American Cancer
Society, and the National Cancer Institue suggests that women should begin
screening mammogram at age 40 annually for women with average risk while
higher-risk women should start earlier and may benefit from supplemental
screening modalities.

Nurses have important responsibilities in assisting patients during mammography

by providing information about breast disease and breast examination, providing
emotional support, and coordinating with other healthcare specialists for further
diagnostic and laboratory test.

This study guide can help nurses understand their tasks and responsibilities during
mammography.

Mammography is generally indicated to:

 Differentiate between benign breast disease and breast cancer

 Investigate breast pain, nipple retraction, nipple discharge

 Evaluate palpable and unpalpable breast masses

 Screen for malignant breast tumors

  Monitor effectiveness of breast radiation therapy

 Evaluate opposite breast following mastectomy

These are the contraindications for the procedure:

 Pregnant women, unless the potential benefits of a procedure using radiation

outweigh the risks of maternal and fetal damage

 Patients younger than age 25 or patients with very dense breast tissue

mammography is performed on an outpatient basis and the step-by-step procedure is as

follows:

1. Prepare the patient.

The patient stands and is asked to rest one breast on a table above an X-
ray cassette.

2. Technician places breast onto compression plate.

The compression plate is placed on the breast and the patient is told to
hold her breath. A radiograph is taken of the craniocaudal view. The
machine is rotated, the breast is compressed again, and a radiograph of
the lateral view is taken.

3. Repeat procedure on other breast.

The procedure is repeated on the opposite breast.

4. Review if films are reliable

After the films are developed, they are checked to make sure they’re
reliable.

Nursing Responsibility 

The following are the nursing interventions and nursing care considerations for a
patient indicated for mammography:
Before the procedure
The following are the nursing interventions prior to mammography:

 Explain the procedure and what to expect after. Tell the patient who will
perform the test and where it will take place. Inform the patient that although
the test takes only about 15 minutes to perform, she may be asked to wait while
the films are checked to make sure they are readable. Advise her that there’s a
high rate of false-positive results.

 Allow the patient to express concerns and fears about the

procedure. Assess the patient’s understanding of the procedure, answer any
questions, and correct any misconceptions.

 Remove interfering factors. Instruct the patient to avoid using underarm

deodorant or powder on the day of the examination.

 Schedule a senior technologist on a patient with breast implants. If the

patient has breast implants, notify him/her to inform the staff when he/she
schedules the mammogram so that a technologist familiar with imaging implants
is on duty.

 Prepare the patient. Just before the test, give the patient a gown to wear that
opens in the front, and ask her to remove all jewelry and clothing above the
waist.

During the procedure 

The following are the nursing interventions during mammography:

 Assist with patient positioning. Place patient in a standing or sitting position in

front of the X-ray machine, which is adjusted to the level of the breast. Place the
patient’s arms out of the range of the area to be imaged.

 Tell the patient that some discomfort may be felt. Pain/discomfort may be

caused by the pressure required to compress the breast tissue against the X-ray
plate.

 Advise the patient to cooperate completely and follow directions. Instruct

patient to remain still throughout the procedure since movement produces
unreliable results. Ask the patient to hold breath while the x-ray films are being
taken.
After the procedure
The nurse should note of the following nursing interventions after:

 Provide information about the availability of the results. Inform the patient a
report of the findings will be given to the requesting physician, who will discuss
the results with the patient.

 Reinforce the information given by the patient’s HCP. Assist the patient in

arranging an additional test, therapy, or referral to another HCP if an
abnormality is found.

Normal findings in mammography will show:

 Normal breast tissue, with an absence of cysts, tumors, or calcification

Abnormal Results
Abnormalities in mammography will reveal:

 Breast abscesses or cysts

 Breast tumors

 Breast calcifications

 Hematoma resulting from trauma

 Mastitis (inflammation of breast tissue)

 Soft tissue masses

 Vascular calcification (small calcium deposit within breast tissue)