Mammography

Mammography is a specific type of imaging that uses a low-dose x-ray system for the examination of breasts. A mammography exam is used as a screening tool to detect early breast cancer in women experiencing no symptoms (screening mammography) and to detect and diagnose breast disease in women experiencing symptoms such as a lump, pain or nipple discharge (diagnostic mammography).

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 year for women, beginning at age 40. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available. While mammography is the best screening tool for breast cancer available today, mammograms do not detect all breast cancers.

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.

Advanced Medical Imaging is committed to providing our patients with the best mammography options available. We are proud to offer digital mammography, the latest technology in breast cancer detection. Studies have shown that digital mammography is more accurate for women under 50 years of age, pre-menopausal women, and all women with dense breast tissue. There is no change in efficacy in women over fifty or women with less dense breast tissue.

At Advanced Medical Imaging, we utilize the latest in Computer-aided detection (CAD) systems. This technology searches for abnormal areas of density, mass, or calcification that may indicate the presence of cancer. The CAD system highlights these areas on the images, alerting the radiologist to the need for further analysis.

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, your radiologist may recommend further diagnostic studies. Also, diagnostic mammography is used to evaluate a patient with abnormal clinical findings (such as a breast lump or lumps) that have been found by the woman or her doctor.

Benefits

  • Imaging of the breast improves a physician’s ability to detect small tumors. When cancers are small, the woman has more treatment.
  • The use of screening mammography increases the detection of small abnormal tissue growths confined to the milk ducts in the breast, called ductal carcinoma in situ (DCIS). Mammography is the only proven method to reliably detect these lesions.

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. Federal mammography guidelines require that each unit be checked by a medical physicist every year to ensure 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. Five percent to 15 percent of screening mammograms require more testing such as additional mammograms or ultrasound. Most of these tests turn out to be normal. If there is an abnormal finding a follow-up or biopsy may have to be performed. Most of the biopsies confirm that no cancer was present. It is estimated that a woman who has yearly mammograms between ages 40 and 49 has about a 30 percent chance of having a false-positive mammogram at some point in that decade and about a 7 percent 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.

 

How should I prepare for a mammogram?

  • Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time. The best time for a mammogram is one week following your period.
  • To reduce tenderness, have a caffeine-free diet for several days before the exam. During
  • Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium spots.
  • Describe any breast symptoms or problems to the technologist performing the exam.
  • Obtain prior mammograms and make them available to the radiologist at the time of the current exam.
  • Always inform your doctor or x-ray technologist if there is a possibility that you may be pregnant.

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 or loose-fitting material that opens in the front.

How is the procedure performed?

Please allow up to 1 hour for your exam. During mammography, a specially qualified radiologic technologist will position your breast in the mammography unit. Your breast will be placed on a special platform and compressed with a paddle, often made of clear Plexiglas.

Most often, multiple views will be taken of your breasts. During each x-ray, the technologist will carefully position your breast so that it fits firmly between the compression paddles on the mammogram unit. This will last only a few seconds. It should not be painful, but may be uncomfortable if your breasts are very sensitive, or you are having a problem with tenderness or swelling. To reduce tenderness, have a caffeine-free diet for several days before the exam. The compression will not harm your breast in any way and is important in obtaining a good image for evaluation. You must hold very still while the x-ray picture is taken to reduce the possibility of a blurred image. When the exam is complete, the technologist will determine that the images are of high enough quality for the radiologist to read, and she will escort you back to your dressing room.

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 to increase sharpness of picture.

When will I receive results?

A written results report will be sent to you and your physician in one to two weeks. It is extremely important for the radiologist to have your prior films for comparison, as it enhances the doctor’s ability to detect a subtle change or small abnormality on your current mammogram. Availability of prior films also decreases the length of time it takes for you to get your results.

What are the limitations of Mammography?

Interpretations of mammograms can be difficult because a normal breast can appear differently for each woman. The appearance of an image may be compromised if there is powder or salve on the breasts or if you have undergone breast surgery. Not all cancers of the breast can be seen on mammography. Breast implants can impede accurate mammogram readings because both silicone and saline implants are not transparent on x-rays and can block a clear view of the tissues behind them. When scheduling your mammogram study, please advise our scheduling department that you have breast implants so that the appropriate scheduling arrangements can be accommodated.

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