Mammography

What is mammography?
Mammography is a specific type of imaging that uses a low-dose x-ray system and film for examination of the breast. Most medical experts agree that successful treatment of breast cancer often is linked to early diagnosis. Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them.

Current guidelines from the American Cancer Society (ACS) recommend screening mammography every one to two years for women beginning at the age of 40.

The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening.

What is the difference between digital and film mammography?
Film mammography has limited sensitivity for the detection of breast cancer in women with radiographically dense breasts.

Digital mammography, which was developed in part to address some of the limitations of film mammography, separates image acquisition and display, allowing the optimization of both. Image processing of digital data allows the degree of contrast in the image to be manipulated, so that contrast can be increased in the dense areas of the breast with the lowest contrast.

The overall diagnostic accuracy of digital and film mammography as a means of screening for breast cancer is similar, but digital mammography is more accurate in women under the age of 50 years, women with radiographically dense breasts, and premenopausal or perimenopausal women. The radiologist has the ability to manipulate (darken/lighten, magnify) the images as he views them.

Digital mammography offers other advantages over film mammography — namely, easier access to images and computer-assisted diagnosis; improved means of transmission, retrieval, and storage of images; and the use of a lower average dose of radiation without a compromise in diagnostic accuracy.

How is the procedure performed?
During the mammogram, a specially qualified radiologic technologist will position you to image your breast. The breast is first placed on a special cassette and compressed with a paddle (often made of clear Plexiglas or other soft plastic).

Breast compression is necessary in order to:

  • Even out the breast thickness so that all of the tissue can be visualized
  • Spread out the tissue so that small abnormalities won’t be obscured by overlying breast tissue
  • Allow the use of lower x-ray dose, since a thinner amount of breast is being imaged
  • Hold the breast still in order to eliminate blurring of the image caused by motion
  • Reduce x-ray scatter, which leads to poor image quality

The technologist will go behind a glass shield while making the x-ray exposure. You will be asked to change positions slightly between images. The routine views are top-to-bottom and a side view. The process is repeated for the other breast.

The examination process should take about 20 minutes. When your mammogram is complete you may be asked to wait until the radiologist reviews the images to determine if more are needed.

How should I prepare for the procedure?
Before a mammogram is scheduled, the ACS and other specialty organizations recommend that you discuss with your doctor any new findings or problems in your breasts. In addition, inform your doctor of any prior surgeries, hormone use and family or personal history of breast cancer.

Do not schedule your mammogram for the week before your menstrual cycle if your breasts are usually tender during this time. The best time is one week following your menstrual cycle. Always inform your doctor or x-ray technologist if there is any possibility that you are pregnant.

The ACS also recommends:

  • Do not wear deodorant, talcum powder or lotion under your arms or on your breast the day of the exam.
  • Describe any breast symptoms or problems to the technologist performing the exam.
  • If possible, obtain prior mammograms and make the available to the radiologist at the time of the current exam.

In addition, before the exam you will be asked to remove all jewelry and clothing above the waist, and you will be given a gown that opens in the front.

What will I experience during the exam?
You will feel pressure on the breast as the mammography machine squeezes it. Some women with sensitive breasts may experience discomfort. If this is the case, schedule your mammogram when your breasts are least tender, decrease your caffeine intake 1-2 weeks prior to your exam.. The technologist will apply compression in gradations. Tell the technologist if pain occurs as compression is increased.

RESULTS:
You will receive a letter in the mail from the mammography department informing you in simple terms your results. Your physician will receive a detailed report.

You will also receive a follow-up letter the following year reminding you it is time for your annual mammogram.

Who interprets the mammogram?
A radiologist, who is a physician experienced in mammography and other imaging examinations, will analyze the images, describe any abnormalities, and suggest a likely diagnosis. The report will be dictated by the radiologist and then sent to your physician. You will also be notified of the results by SWMC Mammography Department.