Mammogram Screening in Singapore

What Is a Mammogram?

A mammogram is a low-dose X-ray of the breast used to detect early signs of breast cancer and other breast conditions. It is one of the most widely used screening tools for breast cancer, capable of identifying changes in breast tissue before they can be felt during a physical examination.

In Singapore, breast cancer is the most common cancer among women from 2019 to 2023, accounting for 29.9% of all female cancer cases. Mammogram screening is recommended as part of the Healthier SG screening programme, alongside screening for HPV, cervical cancer, colorectal cancer, and chronic diseases.

Besides screening mammograms done as routine checks, a diagnostic mammogram may also be performed, which is a more detailed examination done when a specific concern has been identified, such as a breast lump, nipple discharge, or an abnormal screening result.

How Does a Mammogram Work?

A mammogram works by passing a small amount of ionising radiation through the breast to produce an image of the internal tissue. The breast is positioned on a flat surface and gently compressed by a paddle to spread the tissue evenly, which helps produce clearer images while using the lowest possible radiation dose.

The resulting image can reveal abnormal areas such as calcifications, masses, or areas of distortion that may stand out against the surrounding tissue. This is because different types of tissue absorb radiation at different rates: dense tissue such as glands and connective tissue appears white on the image, while fatty tissue appears darker.

Types of Mammograms

Mammograms are commonly performed using 2D or 3D digital mammography:

• 2D mammography captures flat images of each breast from two angles.
• 3D mammography (digital breast tomosynthesis) takes multiple thin images from different angles and reconstructs them into a three-dimensional picture, which can be particularly helpful for women with dense breast tissue.

How Do I Prepare for a Mammogram?

Mammograms require minimal preparation. Here are some guidelines to help you get the most accurate results:

• Avoid applying deodorant, antiperspirant, powder, lotion, or perfume to the underarm or breast area on the day of the scan, as these can appear as white spots on the images.
• Wear a two-piece outfit so you only need to remove your top.
• Bring any previous mammogram images or reports if they were done at a different facility, so results can be compared.
• If you have breast implants, inform the clinic when booking as the radiographer may need to use a modified technique.

Mammogram vs Breast Ultrasound

Mammograms and breast ultrasounds are complementary imaging methods. Mammograms are primarily used to screen for early signs of breast cancer, while ultrasounds are often used to further evaluate abnormalities or examine dense breast tissue.

Here is how they compare:

How Accurate Are Mammograms: Understanding Your Results

Mammogram results are usually categorised using the BI-RADS (Breast Imaging Reporting and Data System) scale, which ranges from normal findings to results that require further investigation:

• BI-RADS 0 — Additional imaging needed (e.g. ultrasound or magnification views)
• BI-RADS 1 — Normal; no significant findings
• BI-RADS 2 — Benign findings (e.g. cysts or calcifications that are not concerning)
• BI-RADS 3 — Probably benign; short-term follow-up recommended
• BI-RADS 4 — Suspicious; biopsy may be recommended
• BI-RADS 5 — Highly suggestive of cancer; biopsy strongly recommended

An abnormal result does not necessarily mean cancer. Depending on the findings, your doctor may recommend follow-up tests such as an ultrasound, MRI, or biopsy for a more complete assessment.

How Do I Book a Mammogram Appointment?

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