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What Is a Mammogram X-Ray?

By Rebecca Harkin
Updated May 17, 2024
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A mammogram x-ray uses low radiation to produce images of the internal structure of the breast and reveal possible tumors. The black and white pictures created are based on the density of the internal structures imaged. A mammogram x-ray machine consists of an x-ray tube and a compression paddle to uniformly squeeze the breast onto the recording plate below the breast. Mammogram x-rays are performed by x-ray technicians, take about 30 minutes, and the then images are reviewed by a radiologist.

During a mammogram, low radiation x-rays are aimed precisely at the tissue of one breast. These x-rays are absorbed differentially by the various types of tissue in or near the breast. The shoulder bone will absorb the most radiation and appear the densest or whitest on the recorded image, and muscle, fat, and any existing tumors will be less dense or grayish. A black and white image of what is inside the breast results from the different densities and are recorded either on an x-ray film or as a digital image. All of the images will be carefully examined by a radiologist or a medical doctor specially trained to evaluate x-rays, and a summary will be sent to the patient’s referring doctor.

The mammogram x-ray machine looks like a tower. At the top pointing straight down is the x-ray tube where the x-rays are generated and focused onto the breast. Below the x-ray tube is a vertically adjustable compression paddle. Underneath the paddle is another vertically adjustable plate which records the image. The breasts are rested one at a time on the recording plate, and the compression paddle is brought down to squeeze and spread out the breast tissue.

A mammogram x-ray is typically performed by an x-ray technician, and it takes about 30 minutes to image both breasts. The patient will be asked to remove her shirt and bra, place on a robe, stand directly in front of mammogram x-ray machine, place one breast in the machine, and stay as still as possible while the breast is compressed for the image. Breast compression is necessary in order to even out the thickness of the breast to provide the best possible image, allow for lower doses of x-rays, and to help keep the tissue still. Following the exam, the technician typically meets with the radiologist for a few minutes to make sure all the images are clear and the entire breast has been captured before dismissing the patient.

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