INTRODUCTION

Screening mammography is the primary imaging modality for early detection of breast cancer because it is the only method of breast imaging that consistently has been found to decrease breast cancer-related mortality [1-3]. Mammography may detect cancer one and a half to four years before a cancer becomes clinically evident [4,5].

Ongoing technologic advancements, to both enhance mammography and develop other breast imaging modalities, seek to provide earlier diagnosis of breast disease; more accurate assessment of disease extent and treatment response; and improve the detection of recurrence.

This topic will review mammography technique, performance capabilities of mammography in particular patient groups, interpretation of a mammogram report, and the use of breast ultrasound as an adjunct to mammography. Issues regarding screening for breast cancer, the role of mammography in women with suspected disease, and surveillance for patients with known breast cancer are discussed separately. (See "Screening for breast cancer" and "Clinical features, diagnosis, and staging of newly diagnosed breast cancer" and "Approach to the long-term survivor of breast cancer".) Other imaging techniques for breast disease are discussed separately. (See "MRI of the breast and emerging technologies".)

MAMMOGRAPHY

The first x-ray of the breast, obtained in 1913 from a mastectomy specimen, showed the presence of primary tumor in the breast specimen as well as spread to the axillary lymph nodes [6]. Calcifications were reported in radiographs of breast cancer in 1949 [6]. Soon after this, patient positioning for radiographs of the breast similar to present day standard views were described.

The prototype of the mammography unit was developed in 1965 [6]. Many technical advances have been made since then to improve the image quality, as well as to reduce the radiation dose to the patient.