Mammography (also called mastography; DICOM modality: MG) is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast for diagnosis and screening.

In 2023, the U.S. Preventive Services Task Force issued a draft recommendation statement that all women should receive a screening mammography every two years from age 40 to 74.

[4][5] These task force reports point out that in addition to unnecessary surgery and anxiety, the risks of more frequent mammograms include a small but significant increase in breast cancer induced by radiation.

While radiologists[12] had hoped for more marked improvement, the effectiveness of digital mammography was found comparable to traditional X-ray methods in 2004, though there may be reduced radiation with the technique and it may lead to fewer retests.

[19] Photon-counting mammography was introduced commercially in 2003 and was shown to reduce the X-ray dose to the patient by approximately 40% compared to conventional methods while maintaining image quality at an equal or higher level.

[24] In European countries like Denmark and Sweden, where mammography screening programs are more organized, the breast cancer death rate has been cut almost in half over the last 20 years.

[44] Furthermore, research has found that standardised compression levels can help to reduce patients' pain while still allowing for optimal diagnostic images to be produced.

This is despite multiple trials showing increased accuracy of detection and improved patient outcomes for both morbidity and mortality when double reading is employed.

The use of language with BI-RADS is extremely precise, with a limited set of permissible adjectives for lesion margins, shape and internal density, each of which carries a different prognostic significance.

Each of these agreed upon adjectives is referred to as a "descriptor" in the BI-RADS lexicon, with specific positive and negative predictive values for breast cancer with each word.

The latter is a more detailed mammogram that allows dedicated attention to the abnormal finding with additional maneuvers such as magnification, rolling of breast tissue or exaggerated positioning.

In 1913, German surgeon Albert Salomon performed a mammography study on 3,000 mastectomies, comparing X-rays of the breasts to the actual removed tissue, observing specifically microcalcifications.

[62] As early as 1937, Jacob Gershon-Cohen developed a form a mammography for a diagnostic of breast cancer at earlier stages to improve survival rates.

[64] In 1949, Raul Leborgne sparked renewed enthusiasm for mammography by emphasizing the importance of technical proficiency in patient positioning and the adoption of specific radiological parameters.

[65] In the early 1950s, Uruguayan radiologist Raul Leborgne developed the breast compression technique to produce better quality images, and described the differences between benign and malign microcalcifications.

[66] In 1956, Gershon-Cohen conducted clinical trails on over 1,000 asymptomatic women at the Albert Einstein Medical Center on his screening technique,[64] and the same year, Robert Egan at the University of Texas M.D.

Anderson Cancer Center combined a technique of low kVp with high mA and single emulsion films developed by Kodak to devise a method of screening mammography.

Use of mammography as a screening technique spread clinically after a 1966 study demonstrating the impact of mammograms on mortality and treatment led by Philip Strax.

[76] Newman posits that screening mammography does not reduce death overall, but causes significant harm by inflicting cancer scare and unnecessary surgical interventions.

[4] Women whose breast cancer was detected by screening mammography before the appearance of a lump or other symptoms commonly assume that the mammogram "saved their lives".

[83] The USPSTF made their review based on data from randomized controlled trials (RCT) studying breast cancer in women between the ages of 40-49.

Dr. H. Gilbert Welch, a researcher at Dartmouth College, states that "screen-detected breast and prostate cancer survivors are more likely to have been over-diagnosed than actually helped by the test.

[85] In 2009, Peter C. Gotzsche and Karsten Juhl Jørgensen reviewed the literature and found that 1 in 3 cases of breast cancer detected in a population offered mammographic screening is over-diagnosed.

Research on a closely related situation has shown that small cancers that are not acted upon immediately, but are observed over periods of several years, will have good outcomes.

A recent systematic review of three studies held in Spain, Denmark, and the United States from 2000-2019 found that digital mammography is not cost-beneficial for the healthcare system when compared to other screening methods.

[94] Instead, the USPSTF used statistical models to estimate what would happen if the starting age were lowered, assuming that screening mammography reduces breast cancer mortality by 25%.

For example, a study showed that British-Pakistani women faced cultural and language barriers and were not aware that breast screening takes place in a female-only environment.

Facilities found deficient during the inspection or accreditation process can be barred from performing mammograms until corrective action has been verified or, in extreme cases, can be required to notify past patients that their exams were sub-standard and should not be relied upon.

[107][108] Recently, artificial intelligence (AI) programs have been developed to utilize features from screening mammography images to predict breast cancer risk.

[109] Another study of 32 published papers involving 23,804 mammograms and various machine learning methods (CNN, ANN, and SVM) found promising results in the ability to assist clinicians in large-scale population-based breast cancer screening programs.