Screening Mammography
This specific type of breast imaging that uses low-dose x-rays to detect cancer early—before women experience symptoms—when it is most treatable. Mammography plays a central part in the early detection of breast cancers because it can show changes in the breast up to two years before you or your physician can feel them. The American Medical Association (AMA) and the American College of Radiology (ACR) recommend annual mammograms for women starting at age 40. The National Cancer Institute (NCI) adds that women who have a personal or family history of breast cancer should talk to their doctor about when they should begin screening.
Breast tomosynthesis
Three-dimensional (3-D) mammography and digital breast tomosynthesis, is an advanced form of breast imaging where multiple images of the breast from different angles are captured and reconstructed (“synthesized”) into a three-dimensional image set. In this way, 3-D breast imaging is similar to computed tomography (CT) imaging in which a series of thin “slices” are assembled together to create a 3-D reconstruction of the body.
Large population studies have shown that screening with breast tomosynthesis results in improved breast cancer detection rates and fewer “call-backs,” instances where women are called back from screening for additional testing because of a potentially abnormal finding.
Breast tomosynthesis may also result in:
- earlier detection of small breast cancers that may be hidden on a conventional mammogram
- fewer unnecessary biopsies or additional tests
- greater likelihood of detecting multiple breast tumors
- clearer images of abnormalities within dense breast tissue
- greater accuracy in pinpointing the size, shape and location of breast abnormalities
How to prepare for your mammography?
Before scheduling a mammogram, the American Cancer Society (ACS) and other specialty organizations recommend that you discuss any new findings or problems in your breasts with your doctor. In addition, inform your doctor of any prior surgeries, hormone use, and family or personal history of breast cancer.
The best time for a mammogram is one week following your period. Scheduling your mammogram for the week before your menstrual period if your breasts are usually tender during this time. Always inform your doctor or x-ray technologist if there is any possibility that you are pregnant.
The ACS also recommends you:
- 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.
- Let us know if you have prior mammograms so we can make them available to the radiologist if they were done at a different location. This is needed for comparison with your current exam.
What to expect during your mammogram?
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 clear plastic paddle. The technologist will gradually compress your breast.
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 are less likely to be hidden 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 minimize blurring of the image caused by motion.
- Reduce x-ray scatter to increase sharpness of picture.
You will be asked to change positions between images. The routine views are a top-to-bottom view and an angled side view. The process will be repeated for the other breast. Compression is still necessary for tomosynthesis imaging in order to minimize motion, which degrades the images. During screening breast tomosynthesis, two-dimensional images are also obtained or created from the synthesized 3-D images.
You must hold very still and may need to hold your breath for a few seconds while the technologist takes the x-ray. This helps reduce the possibility of a blurred image. The technologist will walk behind a wall to activate the x-ray machine.
How long does the mammogram take?
Your mammogram will take approximately 15-20 minutes.
When should I know the results of my mammogram?
After your mammogram, a radiologist will analyze the images. The radiologist will send a signed report to your ordering healthcare provider within 24 hours of the scan. Your provider will share the results with you. You will also receive a letter with your results. In certain circumstances, you may need further diagnostic evaluation, such as a diagnostic mammogram or an ultrasound. This does not necessarily indicate an abnormality was found or that your mammogram was not properly obtained, but that additional images are needed to ensure all breast tissue is fully evaluated.
