A mammogram is a special type of X-ray image of the breast. In order to achieve the best possible image at the lowest possible radiation dose, images are obtained with mild to moderate compression of the breast tissue to achieve a more uniform thickness for imaging. The actual compression only lasts long enough for the x-ray exposure, which is just several seconds, before compression is automatically released. This may be uncomfortable for a very short time, but is extremely important to diagnose, and will not permanently harm your breast in any way. Your registered technologist is highly trained and will work closely with you, monitoring for any discomfort and tailoring the examination to your needs. You will be acting together as a team to obtain the best quality exam we can offer.
Why digital mammography?
Community Health Network uses digital mammography to provide the highest quality image for both routine and diagnostic procedures. Digital mammography uses a lower dose of radiation and takes less than half the time of traditional film-based exams. Studies have shown that digital mammography is superior to film-based mammography for patients who are:
- Under age 50
- At any age with dense breast tissue
- Premenopausal or have had their last menstrual cycle within the last 12 months
- Receiving hormone replacement therapy
Types of mammograms: baseline, screening and diagnostic
You may have heard of several different "types" of mammograms such as baseline, screening, and diagnostic. Your baseline mammogram is your first mammogram, which will serve as a basis for future comparison to detect subtle changes. Screening mammograms are routine examinations performed to detect breast disease in women having no symptoms of a lump, discharge, pain or other clinical findings. In this standard screening examination, two images of each breast are taken, one from the top (called a cranio-caudal view) and one from the side (called a mediolateral oblique view). This allows the images to display as much breast tissue as possible in only two views. Diagnostic mammograms are performed when the patient does have a symptom; these studies often require extra tailored images to fully evaluate the clinical problem.
Some situations in which you will need a diagnostic mammogram
- You feel an abnormality on breast self-examination.
- Your doctor felt an abnormality when he or she examined you.
- You have a new area of focal persistent breast tenderness or pain.
- You have one-sided nipple discharge that is clear, bloody or red-tinged.
- You had a previous finding on mammography that needs short-term follow-up mammography to verify that it has remained stable.
- You have had a recent biopsy and your surgeon wants follow-up images.
Age recommendations for screening mammography
- Baseline screening mammogram between age 35-39.
- All women over 40 should have annual mammography examinations.
Age recommendations for higher-risk patients
- Baseline screening mammogram when you are 10 years younger than the age at which your mother or sister was diagnosed with pre-menopausal cancer.
- Annual mammograms thereafter.
- Contact us about any other recommendations that might apply to your individual high risk status.
What if I am called back after my screening mammogram?
If there is a question of an abnormality on your screening mammogram, this may require additional imaging to fully evaluate the findings. Nationwide, approximately 1 in 10 women who have a screening mammogram will need additional mammogram views, and possibly breast ultrasound. Often, the possible abnormality can be from superimposed or overlapping normal glandular tissue caused by a non-uniform pattern in the normal breast tissue. The questioned abnormality often resolves when the breast is positioned in a slightly different way. If any area remains abnormal on additional mammography work-up, a breast ultrasound may be necessary as another means of evaluation. Ultimately, any suspicious or new finding may need either short-term follow up imaging to verify its stability, or occasionally a biopsy to find out the type of tissue present. Again, most of these findings are due to benign causes, but only a thorough work-up can exclude a serious lesion.
Although mammography is still the most sensitive test for identifying early breast cancer, it does not identify all breast cancers. As many as 10 to 15 percent of breast cancers cannot be seen with mammograms. All cancers affect the normal breast tissues, however some of these changes do not show up on mammograms. This problem is somewhat greater in younger women when the breast contains more fibrous and glandular tissue. However, mammography is still very useful.
Therefore, breast self-examination is important. A lump, particularly a new lump or fullness, can be significant even if both your mammogram and breast ultrasound have not revealed an explanation. In this case, surgical evaluation may still be necessary to determine the reason for the new lump.
Scheduling your appointment
Scheduling an appointment at one of our breast centers is easy. You or your referring physician may call to speak to one of our schedulers. She will help you find a day and time that fits best with your schedule. Be prepared to give her some background information, such as your name, type of exam needed (screening or diagnostic mammogram), date of birth, referring physician's name, location of previous mammogram films and insurance information.
It is extremely important that we have your previous mammograms for comparison at the time of your appointment. This significantly increases the sensitivity of your current examination, because we can look for even subtle changes. It also can reduce the amount of additional evaluation necessary because old films can confirm stability of your present breast pattern.
Please check with your insurance company about your benefits or limitations of coverage. We will file your insurance claim at the time of your visit.
What happens during my visit?
- You will report to the receptionist to complete the necessary insurance information and paperwork.
- You will be escorted to a private changing area, given a comfortable gown, and asked to undress from the waist up. You will also be asked to remove any deodorant before your examination, because it can create an artifact on your mammogram. Spray deodorant is provided for you to reapply after your exam is complete.
- You will be assisted by a specially trained mammography technologist who will explain each procedure and answer your questions.
- Final written results will be sent to you and your referring physician.