Mammography (Including 3D Tomosynthesis)

Mammography is a low-dose X-ray of the breasts. Each breast is pressed between two plates for a few seconds so that the tissue is spread out and small changes can be seen. Digital breast tomosynthesis, often called 3D mammography, takes a sweep of images that are viewed as thin slices.

Screening mammography finds many cancers before they can be felt, and regular screening lowers deaths from breast cancer in women from about 40 to 50 upwards. It is not perfect: dense breast tissue can hide tumours, and some findings lead to extra tests that turn out to be harmless.

What Mammography (Including 3D Tomosynthesis) shows

A mammogram shows masses, areas of distortion, asymmetry between the breasts and microcalcifications, tiny calcium deposits that can be the only sign of DCIS. Radiologists grade the findings with the BI-RADS scale from 1 (normal) to 5 (highly suspicious), and also report breast density from A to D. It shows that something is there and how worrying it looks. It cannot by itself prove whether a lesion is benign or malignant, which requires ultrasound and usually a needle biopsy.

When Mammography (Including 3D Tomosynthesis) is recommended

• Routine screening, generally every 1 to 2 years from age 40 to 50 depending on national guidance, up to about 74
• Earlier and yearly screening for women at higher risk through family history or gene changes, often together with MRI
• Any new lump, skin dimpling, nipple change or bloodstained discharge in women over about 35 to 40
• Before breast reduction, lift or augmentation surgery in women over 40
• Follow-up after treatment for breast cancer

Limits and situations where another test is better:

• Under about 35 to 40, ultrasound is usually the first test because young breast tissue is dense
• Very dense breasts may need added ultrasound or MRI, since sensitivity falls
• Pregnancy, unless clearly needed, in which case shielding is used
• A normal mammogram does not exclude cancer if you can feel a lump; further imaging is still required

How to prepare

• Book for the week after your period, when breasts are least tender
• Do not use deodorant, talc or lotion on the chest or armpits that day, as they can mimic calcifications
• Wear a two-piece outfit
• Bring previous mammograms or reports, since comparison is one of the most useful parts of the reading
• Tell staff about implants, previous surgery, pregnancy or breastfeeding

What happens during the test

You undress to the waist and stand at the machine. The radiographer positions each breast in turn and the plate compresses it for 5 to 10 seconds per image, with two views of each side. Compression is uncomfortable and sometimes briefly painful, but it lowers the radiation dose and sharpens the picture. The whole visit takes 15 to 20 minutes. With implants, extra displaced views are taken.

Results and next steps

In a diagnostic setting the radiologist often reports the same day and can add an ultrasound straight away. Screening reports may take a few days. BI-RADS 1 and 2 mean routine screening, 3 means a short-interval recheck at about 6 months, and 4 or 5 lead to a core biopsy. About 1 woman in 10 is recalled after a first screen, and most recalls end with a normal result.

• Test time: 15 to 20 minutes
• Results ready: Same day to a few days
• Back to everyday activity: None

Safety and risks

• A very small radiation dose, comparable to a few weeks of natural background exposure
• False positives leading to anxiety, extra imaging and sometimes biopsy
• False negatives, particularly in dense breasts
• Overdiagnosis, meaning detection of slow cancers that might never have caused harm
• Brief pain or bruising from compression

Arranging Mammography (Including 3D Tomosynthesis) in Türkiye

Mammography is not a reason to travel by itself. It fits well within a women's check-up or the work-up before breast surgery, and same-day reporting with ultrasound and biopsy in one centre can be convenient. Take the images home on disc so future screens can be compared.

Send your previous reports and the question you want answered and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions