Definition
Mammography is a specialized medical imaging technique that uses low-dose X-rays to examine breast tissue. It is primarily used for the early detection and diagnosis of breast cancer, as well as other abnormalities in the breast. Mammograms can reveal changes in breast tissue, such as masses, microcalcifications, or distortions, even before symptoms appear.
Types of Mammography
- Screening Mammography:
- Performed on asymptomatic individuals to detect early signs of breast cancer.
- Recommended routinely for women starting at age 40, depending on risk factors.
- Diagnostic Mammography:
- Used to investigate specific symptoms, such as lumps, pain, or nipple discharge.
- Provides more detailed images to evaluate abnormalities found during screening.
Advantages
- Wide Availability: Mammography is accessible in most healthcare facilities.
- Early Detection: Mammograms can identify breast cancer at an early stage, improving survival rates.
- Non-Invasive: The procedure is quick and does not require surgery.
Purposes
- Screening tool to detect early breast cancer in women experiencing no symptoms.
- To detect and diagnose breast disease in women experiencing symptoms, such as a lump, pain, or nipple discharge.
Contraindications
Absolute Contraindications
- Pregnancy:
- Mammography is generally avoided during pregnancy due to the potential risks of radiation exposure to the developing fetus. Alternative imaging methods, such as ultrasound, are preferred.
Relative Contraindications
- Age Under 25:
- Mammograms are less effective in younger women due to the density of breast tissue, which can obscure imaging results.
- Dense Breast Tissue:
- Women with very dense breast tissue may require supplemental imaging, such as ultrasound or MRI, as mammography may not provide sufficient clarity.
- Severe Health Conditions:
- Patients with serious health problems or limited life expectancy may not benefit from mammography, as early detection may not improve outcomes.
Procedure
Procedure is performed in a diagnostic department.
| Nursing action | Rationale | |
| 1. | Inform patient that procedure is carried out on an outpatient basis. The best time for a mammogram is 1 week following menstruation. | Breasts are less tender at this time compared to the period before menstruation. |
| 2. | Inform patient to bring along prior mammograms (if any) at the time of current examination. | Helps make comparison between two mammograms. |
| 3. | Inform patient not to apply deodorant, talcum powder, or lotion on under arms or on breasts. | These can appear on the mammogram as calcium spots. |
| 4. | On the day of examination, explain the procedure and obtain verbal consent of the patient. | Helps minimize patient’s anxiety. |
| 5. | Assist patient to change into hospital clothing. Inform patient to remove brassier and jewelry. | Hinders performance of test. Presence of jewellery produces artifacts on X-ray films. |
| 6. | Inform patient that a specially qualified radiology technologist will position her breast in the mammography unit. The breast will be placed on a special platform, gradually compressed with a paddle (made of clear plexiglass or other plastic material). | Breast compression is necessary to even out the breast thickness so that all of the tissue can be visualized: Spreads out the tissue so that small abnormalities would not be obscured by overlying breast tissue.Allows the use of a lower X-ray dose since a thinner amount of breast tissue is being imaged.Holds the breast still in order to eliminate blurring of the image caused by motion.Reduces X-ray scatter to increase sharpness of picture. |
| 7. | Inform patient that technologist will stand behind a glass shield during the X-ray exposure. Patient will be asked to change positions slightly between images. Inform patient that she must hold very still and may be asked to keep from breathing for a few seconds while the X-ray picture is taken. | Reduces the possibility of blurred images. |
| 8. | Inform patient that she may feel pressure on her breast as it is squeezed by the compressor. If discomfort is significant, less compression will be used. | Patient knows what to expect during the procedure. |
| 9. | The procedure may last for 30 minutes. | |
| 10. | Assist patient to dress up. | |
| 11. | Inform patient that a radiologist will analyze the images and prepare a report of findings. |
Special Consideration
- Mammography may be contraindicated in individuals with conditions that make them highly sensitive to radiation.
- Assist the patient in positioning their breasts correctly on the mammography machine.
- Ensure the patient remains still during the imaging to avoid blurry results.
- Provide clear instructions and reassurance throughout the procedure.
- Address any discomfort promptly and adjust positioning if necessary.
- Inform the patient that they can resume normal activities immediately.
- Advise them to report any unusual symptoms, such as persistent pain or redness.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884.
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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