A mammogram is the best screening tool we have today to find breast cancer early, when the chances of survival are highest. This X-ray of the breast can find breast cancer when it is very small, even too small to feel. In order to screen for breast cancer, women should have a mammogram every year beginning at age 40. Talk to your doctor about which type of mammography listed below is right for you.
Screening Digital Mammography
A screening mammogram is a low dose x-ray of the breast used to detect abnormal changes in the breast tissue. This type of routine mammogram is for women who have no signs or symptoms of an abnormality. Screening mammography should be used in conjunction with a clinical breast exam performed by your physician and monthly self-breast exams.
The exam is performed in an upright position, usually standing. The mammography technologist will instruct you while they place your breast tissue in the best position to achieve maximum results for your exam, and typically two views of each breast will be obtained. The breast tissue is compressed between two plates on the machine. Compression spreads apart the tissue to give the radiologist better visualization of the anatomical structures within the breast. The applied compression will be held in place only a few seconds during the exposure, and then automatically released.
Mammograms make it possible to detect tumors that cannot yet be felt, and also microcalcifications (tiny calcium deposits) that can sometimes indicate the presence of cancer. To reduce discomfort if you have sensitive breasts, schedule your mammogram in the first two weeks following your menstrual cycle when your breasts are less tender.
Upon completion of your screening exam, the mammography technologist will review the images for quality. The radiologist will interpret your exam and send the results to your referring physician or provider, and we will notify you of the outcome as well. If there is an area that raises any question for the radiologist that needs further clarification, they may recommend you return for a diagnostic mammogram.
Diagnostic Digital Mammography
A diagnostic mammogram is also a low dose x-ray examination of the breasts, but used to evaluate potential problems within the breast. If you have one or more of the qualifying symptoms, you may need a diagnostic mammogram, instead of a screening:
- Personal history of breast cancer
- New lump or mass
- New breast pain that is focal (localized to a specific point or area in the breast)
- New nipple inversion
- Bloody discharge from the nipple
- Short-term follow up recommended by a radiologist from a previous mammography examination
- Screening mammogram revealed a finding that needs further investigation or clarification
With a diagnostic evaluation, the technologist usually obtains the same images as with a screening exam, but also performs special customized views under the direction of the radiologist. This may include the use of special, smaller compression paddles, the use of magnification techniques, and/or breast ultrasound to focus on the area of interest or concern.
Because this exam is more customized, it often requires more images be taken (as compared to a screening study), and also means that diagnostic exams from patient to patient may not be exactly the same. Also, diagnostic mammography is not considered a preventive care service by most insurance companies, and may be subject to deductibles and co-insurance. Please contact your insurance provider with questions concerning your coverage.
Three-dimensional (3D) mammography is a revolutionary new screening and diagnostic tool designed for early breast cancer detection. It is performed in conjunction with a traditional 2D digital mammogram. More about our 3D Mammography services.
How to Prepare for a Mammogram
Do not use deodorant, perfume, powders, or ointments under your arms or on your breasts on the day of the mammogram. These substances may hide the images. Remove all jewelry from your neck and chest area. Two-piece clothing is recommended, since you will be asked to undress from the waist up for the exam.
Tell your provider and the x-ray technologist if you are pregnant or breastfeeding, or if you've had a breast biopsy. If you have any moles or scars on your breast, please point them out to the mammographer before the exam begins.
How the Test Will Feel
All high quality mammography requires the mammographer to adequately position and firmly compress the breast so all tissues deep in the breast can be imaged. You may expect this compression to be uncomfortable especially if you have sensitive breast tissue, but it should not be painful and does not harm the breast tissue.
Be sure to inform the mammographer if you are experiencing great pain and discomfort during the exam and less compression will be used if possible.
Breast compression is necessary in order to:
- Even out 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
What Do Abnormal Mammogram Results Mean?
Most abnormal findings on a screening mammogram turn out to be benign (non-cancerous) or nothing to worry about. New findings or changes must be further evaluated.
A radiologist may see the following types of findings on a mammogram:
- A well-outlined, regular, clear spot (this is more likely to be a noncancerous condition, such as a cyst)
- Masses or lumps
- Dense areas in the breast that can be breast cancer or hide breast cancer
- Calcifications, which are caused by tiny deposits of calcium in the breast tissue (most calcifications are not a sign of cancer)
At times, the following tests are also needed to further examine mammogram findings:
- Additional mammogram views, called magnification or compression views
- Breast ultrasound
- Breast MRI exam
Comparing your current mammogram to your past mammograms helps the radiologist tell whether you had an abnormal finding in the past and whether it has changed.
When mammogram or ultrasound results look suspicious, a biopsy is done to test the tissue and see if it is cancerous.
All of our equipment is maintained by highly trained service engineers and meets or exceeds the operating specifications set forth by the manufacturers and the federal government. Special care is taken during the exam to use the lowest radiation dose possible while producing the best images for evaluation. If you are pregnant and are having breast problems, please notify the staff mammographer.