- What is a mammogram?
- Types of mammograms
- How is a mammogram done?
- Help with mammogram costs
- Regulation of mammography
- What does the doctor look for on a mammogram?
- Breast biopsy
- Mammogram reports – BI-RADS
- Mammograms in special circumstances
- Improving mammograms
- Other breast imaging tests
- Experimental and other breast imaging methods
- To learn more
Regulation of mammography
In the United States, mammography is highly regulated. Although the overall quality of mammography has improved since its introduction in the late 1960s, studies done in the mid-1980s showed that quality varied greatly from place to place.
In an attempt to educate those working with mammograms, improve quality, and lower the dose of radiation, the American Cancer Society approached the American College of Radiology (ACR) and requested that it establish standards and criteria that would help women and doctors find those facilities that provided high-quality screening services. In 1986, the ACR started the first national Mammography Accreditation Program (MAP). This voluntary program raised standards nationwide and led to better mammogram services at those sites that took part in the program.
In 1992, Congress passed the Mammography Quality Standards Act (MQSA) to ensure that radiology facilities offering mammography would be required to meet minimum quality standards. Today, the US Food and Drug Administration (FDA) certifies every facility offering mammography (except those of the Department of Veterans Affairs). In order to be certified, the equipment, personnel, and practice of the facility must be reviewed by an FDA-approved accreditation body, have an on-site inspection, and meet the following criteria:
- Each mammography unit has to be accredited.
- Certain staff members must meet strict standards including:
- Typical x-rays are reviewed for quality and information on radiation dose, which is required to be very low.
- Radiologists (the doctors who interpret or read the mammograms)
- Radiologic technologists (those who actually position women for the mammogram and take the pictures)
- Medical physicists (professionals who specialize in medical equipment and image production)
If the facility meets all of the required standards, the FDA gives its certification. These standards are outlined in the MQSA, which has been in effect since 1994. It is unlawful to do mammograms in the United States without an FDA certificate.
The FDA has a list of all of its certified mammography facilities by state and zip code. This list is available at the FDA’s Web site: www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMQSA/mqsa.cfm.
Mammogram clinics must notify women in writing about the results of their mammograms. The Mammography Quality Standards Act (MQSA) requires this. Mammography clinics still report mammogram results to the woman’s doctor, too, who is responsible for ordering more tests or treatments, if needed.
As of 1999 the MQSA requires clinics to mail women a separate, easy-to-understand report of their mammogram results within 30 days—or “as quickly as possible” if the results suggest cancer is present. This means that the woman may know the results even if her doctor has not yet called to tell her.
Radiation exposure from mammography
The modern mammography machine uses low radiation doses to produce breast x-rays that are high in image quality. (It usually uses about 0.1 to 0.2 rads per picture; a rad is a measure of radiation dose). Older mammography units delivered higher doses, and led to concerns about radiation risks. These older machines are no longer used.
Strict guidelines ensure that mammography equipment is safe and uses the lowest dose of radiation possible. Many people are concerned about the exposure to x-rays, but the level of radiation from a mammogram today does not significantly increase the breast cancer risk for a woman who gets regular mammograms.
To put dose into perspective, if a woman with breast cancer is treated with radiation, she will likely get a total of several thousand rads. If she has yearly mammograms starting at age 40 and continues until she is 90, she will get a total of 20 to 40 rads. To put it another way, flying from New York to California on a commercial jet exposes a woman to roughly the same amount of radiation as one mammogram.
Last Medical Review: 12/17/2012
Last Revised: 02/07/2013