Mammogram Screening Forms

Breast cancer as well know is the most common type of cancer in females and is responsible for most number of deaths in females every year.

Breast cancer spreads very rapidly because of its extensive blood supply and a rich network of lymphatics. This is the very reason why a cancer of one breast spreads so quickly to other that it becomes necessary to do intervention before it invades other side of the body.

Just like that and because of the same reason, breast cancer metastasis to other organs of the body more rapidly than cancers of other organs.


So this makes it necessary to diagnose the disease at very initial stages because if diagnosed in time, breast cancer is hundred percent treatable.

Simple ways to screen for breast cancer

  1. Breast self-examination on monthly basis
  2. And if found any signs, undergoing a simple mammogram are the most important and effective ways to screen for breast carcinoma.

What is a mammogram???

Mammogram or Mammography is basically an x-ray for the breast in which low-intensity x-rays are used to examine the breast tissue. It is also called as a mammogram.

Ideally mammogram is to be done every two years after the female reaches 50 years. But, if there is any strong family history of breast cancer, it is recommended that one should undergo a screening mammography after even 30 years of age.

How is a mammogram form filled?

A mammogram form has to be filled to get information of the patient and know any risk factors present in the lady. For example, we all know that x-rays cannot be done in a pregnant lady so we have to know first if she pregnant at the time of mammography.

Similarly, she past medical and surgical history and especially family history of any kind of malignancy is inquired.

  1. Starting from the basic introduction of the patient, a mammogram form is filled. Name of the patient, her age and date of birth is also asked along with her contact number and email address.
  2. We also want to know if her Medicaid is active or any other health insurance is active or not for later purposes in case she is found positive for breast cancer.
  3. Now we want to know the reason for her visit. Is it a regular annual checkup or she found something suspicious in self-examination?
  4. If she have had any previous mammogram, the report is required for further reference.
  5. Next, we ask and fill if the lady is currently pregnant or not, or if she is taking any birth control pills or hormonal replacement therapy for any reason. The hormonal replacement therapy has a very known effect and we want to know the drug history of this patient otherwise.
  6. In the medical history section, we are mainly interested in the family history of cancer. Any history of breast cancer in the father’s and especially mother’s family is important know as it has strong genetic association.
  7. In the end, we inquire about her own history of cancer or if she underwent any procedure for this in the past.
Mammogram Screening form
Mammogram Screening form

Simi Karton

Simi Karton is a regular contributor to National Science Quarterly and an enthusiastic Lakers fan. She recently collaborated on a manuscript with friends and colleagues. Dr. Simi Karton, entitled Parkinsons and the Genetic Response to Eastern Medicine, in which she and Dr. Inshal presented research compiled during a summer spent in United States. She currently resides in Los Angeles with her husband. This website is a voluntary work of Dr. Karton to provide people with useful health related information stuff at an easy approach. The information has been collected from different sources at one place.

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