Services:
Mammography
What
is Mammography?
What
are some common uses of the procedure?
How
should I prepare for the procedure?
What
does the equipment look like?
How
does the procedure work?
How
is the procedure performed?
What
will I experience during the procedure?
Who
interprets the results and how do I get them?
What
are the benefits vs. risks?
What
are the limitations of Mammography?
What
is Mammography?
(Back
to Top)
Mammography
is a specific type of imaging that uses a low-dose x-ray
system and high-contrast, high-resolution film for examination
of the breasts. 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 U.S. Department of Health and Human
Services (HHS), the American Cancer Society (ACS), the
American Medical Association (AMA) and the American College of
Radiology (ACR) recommend screening mammography every one to
two years for women, beginning at age 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
are some common uses of the procedure?
(Back
to Top)
Mammography
is used to diagnose breast diseases in women.
Screening mammography can assist your physician in the
detection of disease even if you have no complaints or
symptoms.
Initial
mammographic images themselves are not always enough to
determine the existence of a benign or malignant disease with
certainty. If a finding or spot seems suspicious, our
radiologist may recommend further diagnostic studies.
How
should I prepare for the procedure?
(Back
to Top)
Before
scheduling a mammogram, the ACS and other specialty
organizations recommend that you discuss any new findings or
problems in your breasts with your doctor. 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 period if
your breasts are usually tender during this time. The best
time is one week following your period. 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 on the day of the exam. These can appear on the x-ray
film as calcium spots.
- Describe
any breast symptoms or problems to the technologist
performing the exam.
- If
possible, obtain prior mammograms and make them available
to Carvel Imaging Center at the time of the current exam.
In
addition, before the examination, 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
does the equipment look like?
(Back
to Top)
A
mammography unit is a rectangular box that houses the tube in
which x-rays are produced. The unit is dedicated equipment,
because it is used exclusively for x-ray exam of the breast
with special accessories that allow only the breast to be
exposed to the x-rays. Attached to the unit is a device that
holds and compresses the breast and positions it so images can
be obtained at different angles.
How
does the procedure work? (Back
to Top)
The
breast is exposed to a small dose of radiation to produce an
image of internal breast tissue. The image of the breast is
produced as a result of some of the x-rays being absorbed
(attenuation) while others pass through the breast to expose
the film. The exposed film is either placed in a developing
machine, producing images much like the negatives from a 35-mm
camera, or images are digitally stored on computer.
How
is the procedure performed?
(Back
to Top)
During
mammography, 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 a lower x-ray dose since a thinner amount of
breast tissue is being imaged
-
Hold
the breast still in order to eliminate blurring of the
image caused by motion
-
Reduce
x-ray scatter which also leads to poor image quality
The
technologist will go to behind a glass shield while making the
x-ray exposure, which will send a beam of x-rays through the
breast to the film behind the plate, thus exposing the film.
You
will be asked to change positions slightly between images. The
routine views are a top-to-bottom view and a side view. The
process is repeated for the other breast.
The
examination process should 15 minutes. When the mammography is
completed you will be asked to wait until the technologist
examines the images to determine if more are needed.
What
will I experience during the procedure?
(Back
to Top)
You
will feel pressure on the breast as it is squeezed by the
compressor. Some women with sensitive breasts may experience
discomfort. If this is the case, schedule the procedure when
your breasts are least tender. The technologist will apply
compression in gradations. Be sure to inform the technologist
if pain occurs as compression is increased. If discomfort is
significant, less compression will be used.
Who
interprets the results and how do I get them?
(Back
to Top)
Our
radiologist, who is a physician experienced in mammography and
other x-ray examinations, will analyze the images, describe
any abnormalities, and suggest a likely diagnosis. The report
will be dictated by the our radiologist, and then faxed to
your referring physician. You will also be notified of the
results by Carvel Imaging Center. This notification is usually
sent a few days after the official report goes to your doctor.
What
are the benefits vs. risks?
(Back
to Top)
Benefits
- Imaging
of the breast improves a physician's ability to detect
small tumors. When tumors are small, effective treatment
and cure are more likely.
- The
use of screening mammagrophy increases the detection of
small abnormal tissue growths confined to the milk ducts
in the breast, called ductal carcinoma in situ (DCIS).
These early tumors cannot harm patients if they are
removed at this stage and mammography is the only proven
method to reliably detect these tumors.
Risks
- The
effective radiation dose from a mammogram is about 0.7 mSv,
which is about the same as the average person receives
from background radiation in three months. The Federal
mammography guidelines require that each unit be checked
by a medical physicist each year to insure that the unit
operates correctly.
- Women
should always inform their doctor or x-ray technologist if
there is any possibility that they are pregnant.
- False
Positive Mammograms. Between 5 and 10 percent of mammogram
results are abnormal and require more testing (more
mammograms, fine needle aspiration, ultrasound, or
biopsy), and most of the follow-up tests confirm that no
cancer was present. It is estimated that a woman who has
yearly mammograms between ages 40 and 49 would have about
a 30 percent chance of having a false-positive mammogram
at some point in that decade, and about a 7 to 8 percent
chance of having a breast biopsy within the 10-year
period. The estimate for false-positive mammograms is
about 25 percent for women ages 50 or older.
What
are the limitations of Mammography?
(Back
to Top)
Interpretations
of mammograms can be difficult because a normal breast can
appear differently for each woman. Also, the appearance of an
image may be compromised if there is powder or salve on the
breasts or if you have undergone breast surgery. Because some
breast cancers are hard to visualize, our radiologists may
want to compare the image to views from previous examinations.
Not all cancers of the breast can be seen on mammography.
Breast
implants can also impede accurate mammogram readings because
silicone implants are not transparent on x-rays and can block
a clear view of the tissues behind them, especially if the
implant has been placed in front of, rather than beneath, the
chest muscles. We have experienced technologists that know how
to carefully compress the breasts to improve the view without
rupturing the implant.
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