Mammography and Breast Examinations

Breast cancer is the most prevalent cancer among women. The statistics speak for themselves: while it used to be that one in every nine women would develop breast cancer during her lifetime, today the numbers are approaching one in every seven women. In light of this fact, the importance of early detection has increased significantly. The earlier it is discovered, the greater the chances of a woman's recovery.
Traditionally, there are two main methods for early detection of breast cancer: manual breast examination and mammography.

Manual Breast Examination

The manual breast examination is the most important and effective method for detecting breast cancer. During this examination, a physician assesses the breast through palpation. It is recommended for women to start having this examination from the age of 20, at least once a year. It should be performed by a breast surgeon. During the examination, the physician may also provide instructions on self-examination, a method that allows the woman to check her breasts for lumps.
There are cases in which it is difficult to detect lumps manually, such as during pregnancy. In such cases, the expertise of a physician may be required for lump detection.

Mammography

Mammography is a supplementary tool used to diagnose cases where manual breast examination does not provide conclusive findings. It can detect abnormalities in the breast that are smaller than one centimeter and are not palpable. Mammography is essentially a "screening test," performed on a healthy population, and its results may suggest the need for further investigation. Sometimes, following a manual examination or mammography, an ultrasound may also be used to identify and characterize breast lumps.
Mammography is based on X-ray imaging of the breast tissue. The breast is positioned between two plates and imaged from two angles: from above and from the side. There are several radiographic features specific to breast cancer, and their presence in a mammogram requires further investigation.
Mammography is a sensitive test, but it's important to consider age-related differences. The chance of a finding on mammography being breast cancer is only 20% in women under the age of 50, increasing to 60-80% in women aged 50-69.
False-Positive Results - the main concern associated with mammography is false-positive results. In other words, when a suspicious finding is detected that requires further evaluation, and even surgery, but ultimately turns out to be a benign condition.
Some argue that it is better to be safe at any cost, but one cannot ignore the psychological distress and unnecessary anxiety that a woman may experience due to the results of a mammography and the unnecessary invasive procedures that may follow.

Recommended Frequency for Mammography

The balanced solution lies in recommendations regarding the appropriate age and frequency of mammography.
The majority of the medical community worldwide agrees that there is no medical advantage to performing mammography before the age of 40.
Between the ages of 40-49, opinions are divided. Some argue against the need for mammography at this age, while others recommend it once a year or once every two years.
Leumit health policies dictate that there is no need for mammography in these age groups as a routine screening unless the woman is in a high-risk group.
For women aged 50-74, there is a consensus that mammography should be performed, but opinions differ on whether it should be done annually or biennially. The national health insurance law requires this examination once every two years for this age group. However, the national health policy services agree with this recommendation but make one change for the benefit of women: they do not limit mammography to age 74 but recommend continuing it throughout a woman's life.
Recently, the Ministry of Health also recommended continuing mammography for women over the age of 74.

To access information about eligibility for national gold standard mammography, click here.

When Is Mammography Essential?

The exceptional group is a specific group of women at risk who are recommended to undergo annual mammography after the age of 40. These women can be divided into the following groups:
Women with a family history of breast cancer.
Women who have been exposed to prolonged use of estrogen hormones, such as during fertility treatments.
Women with significantly excessive weight, as their excess fat tissue produces estrogen, increasing the risk of breast cancer.
Carriers of the breast cancer gene, BRCA1 or BRCA2.

Is Early Preparation Required for the Examination?

The recommended time for a mammogram is one week after the end of menstruation. It is not advisable to have the examination one week before menstruation due to breast sensitivity. If there is a chance that you might be pregnant, it is important to inform the technician or doctor.
It is recommended to avoid using deodorant, talcum powder, or cream on your armpits or breasts on the day of the examination, as these substances may appear as calcium deposits in the mammogram image and make interpretation difficult.
If there are previous mammography images, it is important to bring them to the radiologist for proper assessment.

How Is the Examination Conducted?

Before the examination, the patient will be asked to remove clothing and jewelry from the waist up. For the examination, the patient will stand in front of a specialized X-ray machine designed to accommodate her height. During the examination, gentle pressure is applied to the breast, which is compressed between two surfaces. The pressure on the breast does not cause any harm, but many women report discomfort and even pain. If the pain is unbearable, it is important to inform the technician or doctor.

Is There Any Other Important Information Regarding Breast Health?

Genetic Screening for Detecting Common Genetic Changes in the BRCA1 and BRCA2 Genes
In 2020, genetic screening for detecting common genetic changes in the BRCA1 and BRCA2 genes became part of the national health basket for women of Ashkenazi Jewish descent. You can read more about the screening and eligibility by clicking on the link.

Please consult a physician immediately if you notice one or more of the following changes in your breasts:

• Changes in breast size.
• Appearance of a lump or thickening in the breast or under the armpit.
• Contraction or formation of nodules on the skin around the breast area.
• Swelling in the breast or around the collarbone.
• Skin peeling, retraction, thickening, or discharge from the nipple.
• Redness or dimpling on the breast skin.
• Breast discharge.
• Uneven swelling of veins on the breast.
• Nipple discharge.
• Changes in breast color.
• Abnormal warmth sensation in the breast.
• Itching in the breast.
• Pain.
• Cracks or swelling in the areola (the darker area around the nipple).

Where can you get a mammogram?

Mammograms can be performed at one of the nationally-operated mammography clinics located throughout the country. We invite you to schedule a life-saving and worry-free mammogram. To arrange your screening, please contact one of the following clinics:

North

Center

Jerusalem

South