People with an increased risk of breast cancer, especially for those with an inherited increased risk, need to be diligent in watching for changes in their breasts. However, they should be cautious about and avoid early and frequent mammography exposure. Many times, though, in order to find and treat breast cancer early, this is exactly what is recommended. Alternative examination methods such as MRI or ultrasound testing can be considered in these cases. There is growing controversy regarding the safety and efficacy of mammography. The risks and limitation of mammography include:
Mammograms aren’t always accurate. The accuracy of the procedure
depends in part on the technique used and the experience and skill of the radiologist. Other factors – such as your age and breast density – may result in false-negative or false-positive mammograms. False positives usually result in additional diagnostic tests, which can include an additional x-ray or biopsy. Tell your doctor if you’ve noticed a change in one of your breasts, especially if your mammogram is interpreted as normal. If you’ve had a change in your breast, your doctor may order a diagnostic mammogram so that the suspicious area is looked at more closely than can be done with a screening mammogram.
Mammograms expose you to low-dose radiation. The low doses of radiation associated with annual screening mammography could be placing high-risk women in even more jeopardy of developing breast cancer, particularly if they start screening at a young age or have frequent exposure. The dose is very low, though, and for most women the benefits of regular mammograms outweigh the risks posed by this amount of radiation.
Mammograms in younger women can be difficult to interpret. The breasts of younger women contain more glands and ligaments than do those of older women, resulting in dense breast tissue that can make it difficult to pick up the signs of cancer. As we age, breast tissue becomes fattier and has fewer glands, making it easier to detect changes on mammograms.
Screening mammography can’t detect all cancers. Some cancers detected by physical examination may not be seen on the mammogram. A cancer may be too small or may be in an area that is difficult to view by mammography, such as your armpit. Mammograms can miss 1 in 5 cancers in women.
Some studies have shown that severe compression of the breast can lead to microscopic tissue ruptures