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Mammography

What is Mammography?

A mammogram is an examination of the breasts using x-rays. Mammography is considered the single most effective tool for early breast cancer detection. Most medical experts agree that successful treatment of breast cancer is linked to early diagnosis. Mammography plays a central part in early detection of breast cancer because it can show evidence of a cancer months or years before a woman or her doctor can feel a tumor within the breast on physical exam.

Delaney Radiologists Group has converted to Digital Mammography as of April 2008. We use state-of-the-art General Electric Senographe DS and Essential digital mammography units and computer review workstations at our Women’s Imaging Center at Medical Center Drive.

The American College of Radiology has recently concluded a large-scale trial to evaluate the performance of digital mammography versus traditional film mammography (the DMIST trial). There is good evidence that the overall accuracy of digital and film mammography for breast cancer detection is similar, but digital mammography is more accurate in women under the age of 50 years, women with radiographically dense breasts, and in premenopausal women.

Extending our diagnostic capabilities further, computer-aided detection, or CAD, analyzes a mammographic image in search for abnormal areas of density, mass, or calcification that may indicate the presence of cancer. The CAD system highlights these areas of the images, prompting the radiologist for further analysis. This “second-look” at a mammogram has increased the detection rate of early breast cancers by 10-15% in most clinical studies.

What are the advantages of Digital Mammography and CAD?

• Compared to conventional mammography, digital mammography allows for a quicker and more comfortable examination. The technologist can see the images immediately for quality of positioning and exposure. The time-consuming processes of film handling and development in a dark-room are no more. Once the exam is complete, the mammogram is immediately available electronically to the radiologist for review and interpretation.
• The superior contrast resolution of digital mammography and the ability to change the display characteristics of images make for more accurate detection of breast cancers, especially in young women with dense breasts.
• Computer-aided detection, or CAD, is integrated into the mammography review software, and provides instant analysis of the images, highlighting areas of possible abnormal calcification, mass, density or architecture. This “second-look” technology has been shown in clinical studies to increase early cancer detection by as much as 20%.
• Digital mammograms can be securely stored in various ways. At Delaney Radiologists, our computer systems produce multiple copies of images on different storage devices, insuring that your mammograms will always be available when needed (no films to get lost or misplaced). The images can be transferred readily to a CD, or printed on a high-resolution laser printer using transparent film that can be viewed on a lightbox like a conventional film mammogram (some doctors prefer looking at mammograms in this traditional way, without the use of a computer). The digital copy of your mammogram will be immediately available for comparison with your next and subsequent mammograms.

How often should I have a mammogram?

Current guidelines from the American Cancer Society (ACS) and the American College of Radiology (ACR) recommend screening mammography every year for women beginning at age 40. 

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

Isn’t the radiation from a mammogram dangerous?

Current mammographic techniques (including digital) use very low-dose radiation. Our equipment undergoes rigorous daily, weekly, monthly, and annual testing to insure optimal performance. There is no scientific evidence that having regular mammograms increases your risk of developing a breast cancer. The proven and possibly life-saving benefit of early breast cancer detection that mammography provides greatly outweighs any very small theoretical risk from radiation.

When should I schedule my mammogram?

Generally, the best time is the week following your menstrual period. Avoid scheduling your mammogram for the week before your period if your breasts are usually tender during this time. Always inform your x-ray technologist if there is any possibility that you are pregnant. Before scheduling a mammogram, you should discuss any current breast problems with your doctor. In addition, inform your doctor of hormone use, any prior surgeries, and family or personal history of breast cancer.

How should I prepare for a mammogram?

On the day of the exam:

• Do not wear lotion, deodorant, or powder under your arms or on your breasts. These can produce artifacts on the mammograms that may simulate disease.
• Describe any problems you’re experiencing with your breasts with your technologist
• Remove all jewelry and clothing from the waist up. You will be given a gown that opens in the front.

What can I expect during the procedure?

A radiologic technologist (a woman specializing in mammographic imaging) will position you standing near the machine and your breast will be placed on a contoured platform and compressed with contoured translucent plastic plate. 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. 
• Allow use of a lower x-ray dose.
• Hold the breast still to eliminate blurring of the image caused by motion. 
• Reduce x-ray scatter to increase picture sharpness.

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

What will I experience during the procedure?

The exam usually takes about 10 minutes altogether. The technologist will compress the breast only during the brief time immediately before and during x-ray exposure. Our technologists are highly experienced and understand the need to balance patient comfort with optimal image quality. Let the technologist know if you are experiencing more discomfort than you can tolerate. We compress because we care!

Who will read my mammogram?

Your mammogram will be read by one of our highly experienced radiologists. All of our radiologists are certified by the American Board of Radiology, have received special training in mammography and digital mammography, read a large volume of mammograms annually, undergo annual performance audits, and remain at the forefront of breast imaging through continuing medical education specific to breast imaging and disease.

When and how will I find out the results of my mammogram?

Delaney Radiologists will send you a letter written in clear language detailing the results. We also send the radiologist’s comprehensive medical report to your physician. The vast majority of women receive a negative or normal report. You may receive a letter indicating that the radiologist has seen something that is clearly benign, such as a cyst. Sometimes we want to see you back before another year, such as a six-month follow-up mammogram of one breast or an ultrasound exam. It is not unusual to be called back within a few days of your mammogram with a request that you return for additional mammograms or an ultrasound exam of the breast. The great majority of such “call-backs” prove to be negative or confirmatory of benign findings such as cysts, benign calcifications, or lymph nodes, so if you get a call from us, please don’t panic!

If our radiologists see a significant or suspicious finding that will require further analysis with imaging or a biopsy, we follow-up and track your progress to insure that a final diagnosis is established.

For more information on this topic, please visit www.Radiologyinfo.org.

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