What is Mammography?

Mammography is a form of diagnostic radiation that is used in the detection of breast cancer. Breast cancer can affect any person (both males and females can be diagnosed with breast cancer) and it can affect any person at any age. Most often, older women are the most likely to have breast cancer, which is why early screenings are recommended to start at age 40-50. The age at which a woman should begin early mammographic screenings depends on a few factors. Often doctors will suggest an earlier age for screening due to a family history of breast cancer. Since breast cancer is hereditary, if family members have had the disease, other women in next generations are going to be more likely to also be diagnosed with the disease. Another factor involved in early screening age-determination is a past history of previous breast cancer. If a person has previously been diagnosed with breast cancer, it is very likely the doctor will recommend continued screenings to ensure the cancer has not reappeared. [1]

 

What does diagnostic radiation mean?

There are several types of modalities in medicine today that use radiation to diagnose pathologic conditions. Some of these modalities include: standard radiography (more commonly known as x-rays), Computed Tomography (CT), and of course Mammography, etc.

Ok, so what is radiation exactly?

Radiation is a form of electromagnetic radiation, or more simply, radiation is the transfer of energy. When an radiograph (x-ray) is performed, the radiograph machines emit ionizing radiation. Ionizing radiation is a specialized type of radiation that has the potential to remove an orbital electron from an atom. [2] To sum it up, any type of energy that has the ability to ionize, is referred to as ionizing radiation.

So, is radiation dangerous? Will it harm me?

As I discussed in my previous post, the main form of radiation used in diagnostic radiography (mammography included), is ionizing. Since ionizing radiation holds the potential to remove orbital electrons from atoms, this does make them dangerous, but fear not, I will inform you of how dangerous and if preventative mammography screenings are really worth getting.

When an orbital electron is removed from an atom, the atom becomes unstable. If you remember learning about atoms in high school, you will recall that when an atom becomes unstable due to an unpaired electron, it creates free radicals. Free radicals are molecules that are extremely reactive and they dramatically increase biologic damage to cells. Free radicals can produce unwanted chemical reactions in the cells and due to their lack of an electron, they continuously rip electrons from other atoms, which inevitably creates a chain reaction of free radicals. When these cells with an unpaired electron duplicate, they can create cells with mutations, which potentially cause cancer. Cancer occurs when a mutated cell continues to duplicate, which causes many more mutated cells to arise, at an unstoppable rate. [3]

So, let's put this all together: radiographic procedures, such as mammography, use ionizing radiation to produce the diagnostic images that doctors require to assist in diagnosing illness and disease. Ionizing radiation holds the potential to cause free radicals, which in turn, hold the potential to cause cancers.

At this point in time, it is known that ANY amount of ionizing radiation can cause cancer because it only takes one cell to mutate to start cancer. There are certain amounts of radiation that are known to cause specific problems, for example: a single dose of 200 rads to the gonads will cause temporary sterility for 12 months. [4] Do not let this scare you, as there are means of protecting yourself if you have to receive a radiographic procedure, and most doses you receive from a radiographic procedure, will come nowhere close to that dose. Example: for a typical mammogram, the patient receives only 300 mrad (milli-rad--a milli rad is 1000 times smaller than a rad).[5]

Means of Radiation Protection

Since we now know that radiographic exams, including mammography, use ionizing radiation, which holds the potential to cause cancer, let's discuss ways of protecting ourselves.

The most common type of radiation protection used today is shielding. These shields are made of lead, which stops radiation from passing through. There are several different types of shields that will be available at any doctors office that performs radiographic procedures. Keep in mind, that only areas that ARE NOT being examined can be shielded, because the lead stops the radiation from penetrating, which is necessary to produce an x-ray image. Shields available today include, aprons, gloves, glasses, and thyroid shields, to name a few. You may see your radiologic technologist wearing these items when performing your exam. You may also see them standing behind a lead-lined wall when they take the exams. This is to protect them from the unwanted radiation and since they are exposed everyday to radiation per their job requirements, it is ESSENTIAL that they use all means necessary to protect themselves. The patient should also be protected, as well. If a radiologic technologist fails to offer you a shielding device, do not be afraid to ask for one, if the procedure allows for it, and ALWAYS ALWAYS ALWAYS inform your doctor of pregnancy, or potential pregnancy, as radiation is even more dangerous to a fetus and can cause birth defects or even miscarriage. In the event that you are pregnant, and your doctor still requires you to have a procedure done, it is likely because the benefits outweigh the risks involved. Most cases like this would be life or death (trauma) situations.

Another way to protect yourself from radiation is by using distance. (This of course does not apply if you are the one receiving the procedure) but let's say your small child is having an exam done, and you have to be in the room. If you are able to, take a few steps back when the exam is done and this will reduce your dose dramatically.

So I'm sure you're wondering why you should take a step back if you are not the one getting the x-ray. Radiation does not simply travel in one direction and then stop. It holds the potential to interact with several different electrons in different atoms, which means it can potentially shoot out 180 degrees from where it originated. This is why distance is our friend!

Early Mammogram Screenings: Helpful or harmful?

Now that we all know of the dangers of radiation, and that it holds the potential to cause cancer, why should we electively receive mammograms? Doctors are aware of the risks involved in receiving radiographic procedures (as you are now also, I hope) but often, the benefits outweigh the risks. The low doses received by a mammogram are not known to cause any specific problems (unlike the 200 rads will cause temporary sterility). [6] The reason older women are recommended to have these procedures is because as we age, our cells become more sensitive to radiation. I will mention now, that radiation exists all around us, naturally in our environment, which means we are receiving low doses of this stuff everyday. This means you never have to receive a radiographic procedure and you may still get cancer. This is also why we are not able to conclude when someone gets cancer from a procedure, or if it was caused by naturally occurring radiation. Older women may get breast cancer because they are more sensitive to radiation that they are receiving everyday, just from living day to day on earth, or it may be hereditary, or even from a medical procedure they have received--we just don't know. To me, the benefits absolutely outweigh the risks involved. I have personal experiences in my own family, including a death from breast cancer, a survivor of breast cancer, and another who is losing her battle as we speak at the tender age of 38. Catching breast cancer in its early stages is the BEST way to have a chance at beating it. Knowing that I have a history of breast cancer in both sides of my family, I will absolutely opt in for early (probably earlier due to my family history) breast cancer screenings by way of mammography.

Please do not confuse early screenings of mammography with full body scans they offer at the mall. Full body scans expose ALL of your body to radiation, and for no reason. You should NEVER opt to expose yourself, just in the fear that somewhere in your body you have a problem. More times than not, your body will present itself with signs and symptoms of a problem and a full body scan will likely do nothing more than expose you and potentially give you cancer, and for NOTHING. This is why mammograms aren't recommended for women under the age of 40 (keep in mind hereditary cases may be cause for exception).

My verdict: HELPFUL (:

Who are you and do you know what you're talking about?

I am currently a student in the Radiologic Technology program at the College of Southern Idaho. All of this information is fresh in my mind, and I used information from all up-to-date text books. My teachers are former technologists and are credited teachers, but I have listed sources at the bottom that you can check out for yourself.

Most people do not know what myself and others in this industry know about radiation and its dangers. Dentists, chiropractors, and even surgical technologists do not have a clue. Do yourself and your family a favor and refuse to believe what ill-informed people believe. You do no need to live in a bubble, but knowledge is power!

My Sources

Bushong, S. C. (2013). Radiologic Science for Technologists: Physics, Biology, and Protection. St. Louis: Elsevier Mosby. [2]

Sherer, M. A., Visconti, P. J., & Riteour, E. R. (2011). Radiation Protection in Medical Radiography. Maryland Heights: Mosby Elsevier. [1], [3], [4], [5], [6].