Advanced Digital Mammography and Breast Screening
About This Imaging Test
Mammograms and other breast imaging services are used to detect and diagnose breast cancer or conditions and can often identify breast abnormalities at their earliest stages. Early detection of breast cancer can reduce treatment time and lead to more successful outcomes.
How the Test is Performed
You will be asked to undress from the waist up. You will be given a gown to wear. Depending on the type of equipment used, you will sit or stand.
One breast at a time is rested on a flat surface that contains the x-ray plate. A device called a compressor will be pressed firmly against the breast. This helps flatten the breast tissue.
The x-ray pictures are taken from several angles. You may be asked to hold your breath as each picture is taken.
You may be asked to come back at a later date for more mammogram images. This does not always mean you have breast cancer. Your health care provider may simply need to recheck an area that could not be clearly seen on the first test.
Types of Mammography
Traditional mammography uses film, similar to routine x-rays.
Digital mammography is a newer technique:
- It is now used in many breast screening centers.
- It allows the x-ray image of the breast to be viewed and manipulated on a computer screen.
- It may be more accurate in younger women with dense breasts. It has not yet been proven to help reduce a woman’s risk of dying of breast cancer compared to film mammography.
Three-dimensional (3D) mammography is a type of digital mammography. Researchers do not yet know whether 3D mammography is more or less accurate than standard mammogram.
How to Prepare for the Test
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.
Tell your provider and the x-ray technologist if you are pregnant or breastfeeding, or if you’ve had a breast biopsy.
How the Test will Feel
The compressor surfaces may feel cold. When the breast is pressed down, you may have some pain. This needs to be done to get good quality images.
Why the Test is Performed
When and how often to have a screening mammogram is a choice you must make. Different expert groups do not fully agree on the best timing for this test.
Before having a mammogram, talk to your provider about the pros and cons of having the test. Ask about:
- Your risk for breast cancer
- Whether screening decreases your chance of dying from breast cancer
- Whether there is any harm from breast cancer screening, such as side effects from testing or overtreatment of cancer when it’s discovered
Mammography is performed to screen women to detect early breast cancer when it is more likely to be cured. Mammography is generally recommended for:
- Women starting at age 40, repeated every 1 to 2 years. (This is not recommended by all expert organizations.)
- All women starting at age 50, repeated every 1 to 2 years.
- Women with a mother or sister who had breast cancer at a younger age should consider yearly mammograms. They should begin earlier than the age at which their youngest family member was diagnosed.
Mammography is also used to:
- Follow a woman who has had an abnormal mammogram.
- Evaluate a woman who has symptoms of a breast disease. These symptoms may include a lump, nipple discharge, breast pain, dimpling of the skin on the breast, changes of the nipple, or other findings.
Normal Results
Breast tissue that shows no signs of a mass or calcifications is considered normal.
What Abnormal Results Mean
Most abnormal findings on a screening mammogram turn out to be benign (not cancer) or nothing to worry about. New findings or changes must be further evaluated.
A radiology doctor (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 (less commonly done)
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. Types of biopsies include:
- Stereotactic
- Ultrasound
- Open
Risks
The level of radiation is low and any risk from mammography is very low. If you are pregnant and need to have an abnormality checked, your belly area will be covered and protected by a lead apron.
Routine screening mammography is not done during pregnancy or while breastfeeding.
Screening and Diagnostic Mammograms
We provide digital mammography using the latest breast imaging technology and expertise. A digital mammogram uses a low-dose X-ray that passes through your breast tissue to create a high-contrast, high-resolution image of the inner structures of the breast. These images can reveal any potential tumors or abnormalities even before they can be felt.
Depending on your needs, your physician may recommend either a screening mammogram or a diagnostic mammogram.
Screening mammograms are the most common type of breast imaging. These preventive tests check for changes in the breast tissue of women who do not have any abnormal signs or symptoms. A screening mammogram typically consists of two images of each breast.
Lee Health follows The American Cancer Society and the National Cancer Institute’s recommendation to begin annual screening mammograms for women starting at age 40 and continuing as long as they are in good health. Your physician may suggest routine screenings at a younger age if you have known breast cancer risk factors, such as a mother or sister with a breast cancer diagnosis.
Diagnostic mammograms are performed to examine breast changes such as abnormal findings in a screening mammogram, lumps felt during a physical exam or visual changes to the breast and nipple. The technologist takes breast X-rays from several angles, and the suspicious area is magnified for accurate diagnosis. A diagnostic mammogram may find that an area that looked suspicious on a screening mammogram is actually normal, or may result in a recommendation for further testing such as a biopsy.
3-D mammography (tomosynthesis)
A select number of Lee Health breast imaging locations offer a new type of screening option called 3-D mammography or tomosynthesis. This FDA-approved form of breast imaging creates a three-dimensional image of the breast tissue, enabling the radiologist to examine the breast tissue one layer at a time. Breast tomosynthesis is especially helpful in examining dense breast tissue and is associated with a higher cancer detection rate.
Dense breast tissue mammograms
Women who have dense breasts have less fat tissue than glandular and connective tissue in their breasts. This may make it more difficult to evaluate mammogram results. Dense breast tissue is the primary reason a mammogram fails to detect cancer.
Though research estimates that about 40 percent of women who get a mammogram have dense breasts, most women don’t know if their breast tissue is dense or not. A new California state law now requires that facilities performing mammography screenings to notify women if they are found to have dense breast tissue based on their mammogram reading.
The law also requires screeners to tell women that dense breast tissue can make it harder to evaluate the results of a mammogram and may be associated with an increased risk of breast cancer. Screeners can also offer alternative screening options that may be available.
Dense breast tissue is not the same as breast cancer. It simply means that additional screening may be helpful. If you are told you have dense breasts, talk to your physician about the need for additional screening. A number of imaging options are available for dense breast tissue, such as breast ultrasound and breast magnetic resonance imaging (MRI).
Mammograms with breast implants
If you have breast implants, always tell the technologist before your mammogram. Because the X-ray technology cannot pass through silicone or saline implants, the area of breast tissue covered by the implant will not appear on the mammogram.
Women who have breast implants may need to have additional images taken in order to view as much of the breast tissue as possible. Two extra images, called implant displacement (ID) views, are taken of each breast. In these images, the implant is moved aside and the breast tissue is pulled over it. In some cases, a mammogram may reveal that an implant has ruptured; in others, the ruptured implant will look normal, so a mammogram is not used to diagnose burst or leaking implants.
Women with breast implants should follow the same screening mammogram guidelines as women who do not have them.
Similar imaging scans: