A mammogram is a black-and-white x-ray image of your breast used to screen for breast cancer. Mammograms play a key role in early breast cancer detection and help decrease breast cancer deaths.
Floyd Memorial Hospital is proud to provide digital mammography that utilizes the Siemens MAMMOMAT Novation DR, the most advanced two-dimensional digital mammography system available. Mammopad, a patented, FDA approved soft foam cushion, ensures a warm, relaxed and comfortable experience.
During a mammogram, your breasts are compressed between two firm surfaces in order to spread out the breast tissue. Then, an X-ray captures images of your breasts that a doctor uses to detect changes and cancer. A mammogram can be used either for screening or for diagnostic purposes. How often you should have a mammogram depends on your age and your risk of breast cancer.
Mammography is X-ray imaging of your breasts designed to detect tumors and other abnormalities. Mammography can be used either for screening or for diagnostic purposes in evaluating a breast lump:
- Screening mammography. Screening mammography is used to detect breast changes in women who have no signs or symptoms or observable breast abnormalities. The goal is to detect cancer before any clinical signs are noticeable. This usually requires at least two mammograms from different angles of each breast. Self-referral mammograms at Floyd Memorial are permitted by the FDA and the Indiana State Board of Health. This is for preventative screening mammograms for women 40 and over who do not show symptoms, and is allowed whether the patient has a primary care physician or not. The main focus will be getting the results back to either the primary care physician or the patient. In the case that the patient doesn’t have a primary care physician, the hospital will make every effort to assist them in finding one. Floyd Memorial will also assist the patient in finding a physician for any follow-up care needed.
- Diagnostic mammography. Diagnostic mammography is used to investigate suspicious breast changes, such as a breast lump, breast pain, an unusual skin appearance, nipple thickening or nipple discharge. It’s also used to evaluate abnormal findings on a screening mammogram. Additional images can be made from other angles or focus on areas of concern at higher magnification.
- When to begin screening mammography. Experts don’t agree on when women should begin regular mammograms or how often the tests should be performed. Your doctor can recommend a screening mammography schedule for you. Some general guidelines for when to begin screening mammography include:
- If you have an average risk of breast cancer, discuss when to begin mammograms with your doctor. Many women begin mammograms at age 40 and have them every one to two years. Professional groups differ on their recommendations, with most, including the American Cancer Society, advising women with an average risk to begin mammograms at age 40 and the U.S. Preventive Services Task Force recommending women wait until age 50 to begin regular mammograms.
- If you have a high risk of breast cancer, you may benefit by beginning screening mammograms before age 40. Talk to your doctor for an individualized program. Your risk factors and your degree of breast density may lead your doctor to recommend magnetic resonance imaging (MRI) in combination with mammograms.
Mammography isn’t foolproof. It does have some limitations and potential risks:
- Mammography exposes you to low-dose radiation. The dose is very low, though, and for most women the benefits of regular mammography outweigh the risks posed by this amount of radiation.
- Mammograms aren’t always accurate. The accuracy of the procedure depends in part on the quality of the film, the technique used, and the experience and skill of the radiologist. Other factors — such as your age and breast density — may result in false-negative or false-positive mammograms. Always tell your doctor if you’ve noticed a change in one of your breasts, especially if your mammogram is interpreted as normal.
- Mammograms in younger women can be difficult to interpret. The breasts of younger women contain more glands and ligaments than do those of older women, resulting in dense breast tissue that can obscure signs of cancer. With age, breast tissue becomes fattier and has fewer glands, making it easier to detect changes on mammograms.
- Having a mammogram may lead to additional testing. Among women of all ages, about 10 percent of mammograms require additional testing. However, most abnormal findings aren’t cancer. If you’re told that your mammogram is abnormal, make sure that the radiologist has compared your current mammogram with any previous mammograms.
- Screening mammography can’t detect all cancers. Some cancers detected by physical examination may not be seen on the mammogram. A cancer may be too small or may be in an area that is difficult to view by mammography, such as your armpit. Mammograms can miss 1 in 5 cancers in women.
- Not all of the tumors found by mammography can be cured. Certain types of cancers are aggressive, grow rapidly and spread early to other parts of your body.
If your mammogram shows areas of concern that may be cancer, the radiologist may recommend additional mammograms or an ultrasound. A breast biopsy may be recommended if the area continues to appear suspicious. A biopsy is a procedure to remove a piece of tissue or a sample of cells from your body so that it can be analyzed by a pathologist — a doctor who specializes in examining body tissues. If your mammogram or biopsy shows that you have breast cancer, you and your doctor can discuss the best course of treatment.
If the breast biopsy results are normal or reveal a benign breast condition, talk with your doctor to be sure that the radiologist and the pathologist drew the same conclusions from your mammogram and your biopsy. If they have interpreted your test results differently, you may need further testing.
How you Prepare
Schedule the test for a time when your breasts are least likely to be tender. If you haven’t gone through menopause, that’s usually during the week after your menstrual period. Your breasts are most likely to be tender the week before and the week during your period.
Ask whether the mammogram facility is certified by the Food and Drug Administration. This certification will ensure that the facility meets certain standards.
If you’re going to a new facility for your mammogram, gather any prior mammograms and bring them with you to your appointment so that the radiologist can compare them with your new images. It’s important to bring the original mammogram films, not copies, and accompanying reports.
Avoid using deodorants, antiperspirants, powders, lotions, creams or perfumes under your arms or on your breasts. Metallic particles in powders and deodorants could be visible on your mammogram and cause confusion.
Taking an over-the-counter pain medication, such as aspirin, acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others), about an hour before your mammogram might ease the discomfort of the test.
What you can Expect
During the test
At the testing facility, you’re given a gown and asked to remove neck jewelry and clothing from the waist up. It’s a good idea to wear a two-piece outfit that day.
For the procedure itself, you stand in front of an X-ray machine specially designed for mammography. The technician places one of your breasts on a platform that holds the X-ray film and raises or lowers the platform to match your height. The technician helps you position your head, arms and torso to allow an unobstructed view of your breast.
Your breast is gradually pressed against the platform by a clear plastic plate. Pressure is applied for a few seconds to spread out the breast tissue. The pressure isn’t harmful, but you may find it uncomfortable or even painful. If you have too much discomfort, inform the technician.
Your breast must be compressed to even out its thickness and permit the X-rays to penetrate the breast tissue. The pressure also holds your breast still to decrease blurring from movement and minimizes the dose of radiation needed. During the brief X-ray exposure, you’ll be asked to stand still and hold your breath.
After the test
After images are made of both your breasts, you may be asked to wait while the technician checks the quality of the images. If the views are inadequate for technical reasons, you may have to repeat part of the test. The entire procedure usually takes less than 30 minutes. Afterward, you may dress and resume normal activity.
It’s required that the mammogram facility send your results within 30 days, but you can usually expect to receive your results within five business days.
Mammography produces mammograms — black-and-white digital images of your breast tissue. Your mammogram digital images are displayed on a video monitor or are printed off for viewing. A radiologist interprets the images and sends a written report of the findings to your doctor. The radiologist looks for evidence of cancer or noncancerous (benign) conditions that may require further testing, follow-up or treatment. Possible findings include:
- Calcium deposits (calcifications) in ducts and other tissues
- Masses or lumps
- Distorted tissues
- Dense areas appearing in only one breast
- Dense areas that have appeared since your last mammogram
Calcifications can be the result of cell secretions, cell debris, inflammation, trauma, previous radiation or foreign bodies. Tiny, irregular deposits called microcalcifications may be associated with cancer. Larger, coarser deposits called macrocalcifications may be caused by aging or injury or by a benign condition such as fibroadenoma, a common non-cancerous tumor of the female breast. Most breast calcifications are benign, but if calcifications appear worrisome, the radiologist might order additional diagnostic images with magnification.
Dense areas indicate tissue with many glands and can make calcifications and masses more difficult to identify. They could also represent cancer. Distorted areas suggest tumors that may have invaded neighboring tissues.
If the radiologist notes areas of concern on your mammogram, further testing may include additional mammograms known as compression or magnification views, as well as ultrasound imaging or a biopsy. Some situations require the use of diagnostic magnetic resonance imaging (MRI) in areas where the current imaging with mammography or ultrasound is negative.