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What is a Mammogram?
Mammography is an X-ray examination of the breast tissue (mammary glands) used to detect breast cancer and other abnormalities of the breasts.
There are two types of mammographic examinations:
Routine screening, or annual mammography, should be a part of every woman’s annual physical examination past the age of forty. This exam is appropriate for an asymptomatic patient, a woman without current breast concerns or problems. A screening appointment can be made without a physician referral or prescription. During this test several radiographic images of each breast are obtained. The supervising radiologist will review the images after the patient has left the department and issue a report to the primary care physician or OBGYN.
Diagnostic mammography is a more involved examination. This test is warranted when a woman, or her physician, has concerns about her breasts. Palpable abnormalities (lumps), nipple discharge or retraction, and skin dimpling are examples of such concerns. During this test several images will be obtained and immediately reviewed by the radiologist. Any additional images, or perhaps ultrasound, will be performed at that time and the radiologist will give the patient a preliminary report. During this time any additional questions the patient may have will also be addressed. A referring physician’s prescription is necessary before a diagnostic mammogram may be scheduled.
When do I get a Mammogram?
The American College of Radiology recommends annual screening mammograms for all women over age 40.
Many insurance companies want you to wait a full year between screening exams. We are careful to check your records before scheduling an appointment. If you have any coverage concerns, you can always check with your insurance provider.
Why should I have a Mammogram?
Luckily, most breast cancers are easily treatable, if found early. Our goal is to find any suspicious areas before they grow big enough to be noticed by the patient. The best tool we have for early detection is annual mammography.
The Radiologist will look for any changes on the mammogram from year to year. Changes in the breast tissue can have several sources. It is the Radiologists job to determine, sometimes through additional imaging, whether any changes are cause for concern.
What do I do?
In preparation for your mammogram, get comfortable. You should wear a two-piece outfit and do not apply deodorants, powders, or lotion to your chest or underarm areas. Most deodorants are made of chemical elements that may be displayed on you mammogram and mimic breast disease.
As you arrive in our facility, you will check in and the registration process will begin. As part of your screening mammography exam you will complete a brief history of you breast health. The registration staff will ensure all your information is correct in the computer system and you are ready for the exam.
In a few minutes, when you are finished with registration, we will lead you to a dressing room and give you dressing instructions. The technologist will perform a physical breast exam and go over your history sheet with you. She will be happy to answer any questions or concerns you may have.
You will then follow your technologist to the mammography suite. The mammographer will place your breast on the image detector platform and lower the compression paddle. Compression is the key factor is obtaining an optimal image. Breasts are comprised of glandular and adipose tissue, as well as blood vessels. Thinning the breast with compression spreads these different tissues out and away from each other, giving us the best possible end result. All of our technologists work efficiently to ensure any discomfort is minimal and brief in duration. Most of our patients report a painless exam. Your technologist will ask you to hold your breath while she exposes each position. Breathing during image acquisition can cause the image to be blurry.
With digital technology, you will not have to wait for films to be developed. Your exam will appear immediately for the mammographer to critique. Any projections that are not perfect, due to motion or position, will be modified or repeated. When she is satisfied with your examination, the mammographer will show you where to dress, deodorant is provided for your convenience. The radiologist will issue a report to your physician in 24 – 48 hours. We will also send you the results in the mail; expect those within a week if you live in the City. After dressing, you are ready to leave and we trust your visit was professional and pleasant.
What are you saying?
You will hear a lot of medical terms anytime you are in a clinic or hospital setting. Here are some explanations to help you during your visit:
Screening mammogram – Routine, no problems, mammogram appointment.
Diagnostic mammogram – Mammogram appointment requiring physician’s order, for a breast problem or concern.
Spot compression – Part of a diagnostic examination. A small paddle is used to target a specific area of the breast and apply compression to that area only. Useful to assess densities within the breast tissue.
Density – An area within the breast that images differently than the adjacent tissue. A density on mammogram could correlate to a cyst, lymph node, insufficient compression, or tumor.
Magnification – Part of a diagnostic mammogram. Another small paddle is used in tandem with a raised platform to magnify a specific area of the breast. Imagine enlarging a negative or photograph. This projection is used to evaluate calcifications.
Calcifications – Tiny, sometimes microscopic, calcium deposits within breast tissue. The reason for their occurrence is unknown and the majority of calcifications are benign. Dietary routines, vitamins or dairy products, do not contribute to calcification appearance. This can be the earliest form of detectible breast cancer; however, the majority of calcifications are benign.
Breast Ultrasound – Use of sound waves to target a mass or density in the breast and characterize that anomaly as cystic or solid. Ultrasound is not a screening tool as it is unable to ‘see’ calcifications.
Cyst – Fluid filled sac within the breast. Sometimes palpable or painful, depending on size. Cysts are benign and can fluctuate under hormonal influence, as with menstrual cycle or hormone replacement. Small cysts are generally left alone, as cysts will not turn into cancer. Larger cysts, usually painful, can be drained (aspirated) to alleviate symptoms, but may reoccur.
Aspiration – Ultrasound guided procedure to drain a cyst or abscess for comfort or diagnosis.
Mass – A tumor in the breast tissue. Several solid tumors of the breast are benign. A biopsy is the only means to confirm benignancy or cancer.
Needle Biopsy – Breast tissue sampling done in the Mammography department. The radiologist uses mammographic or ultrasound guidance to take pieces of the abnormal tissue. The tissue is sent to the pathology department and analyzed under a microscope to determine whether or not the mass is cancerous.
Needle Localization – The use of a thin wire to guide a surgeon to the anomaly in the breast. Placed under mammographic or ultrasound guidance, the wire is inserted through a small, hollow needle to pinpoint the area of concern. This is usually performed after a tissue diagnosis of cancer has been made from a biopsy or when a patient is not a candidate for needle biopsy.
Malignant – Cancerous.
Benign – Not cancer, will not become cancerous.
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