Mammography is a specific type of imaging that uses a low-dose x-ray system for examination of the breasts. The images of the breasts can be viewed on film at a view box or as a digital image on a high-resolution computer monitor. Mammography is used to aid in the diagnosis of breast diseases in women. Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Successful treatment of breast cancer often is linked to early diagnosis. Studies have shown that digital mammography can be more effective than conventional mammography in women with dense breasts and women under 50 years of age.

The Digital Mammography Exam

Digital mammography is a new technology which shows great promise in the fight against breast cancer. It uses computers and specially-designed digital detectors to produce an image that can be displayed on a high-resolution computer monitor. From a patient's point of view, having a digital mammogram is very much like having a conventional film mammogram. During mammography, a specially qualified radiologic technologist will position you to image your breast. The breast is placed on a special platform and compressed with a paddle (often made of clear Plexiglas or other plastic).

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 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.

The technologist will be in the examination room at all times. You will be asked to change positions slightly between images. The routine views are a top-to-bottom view and a side view. The process is repeated for the other breast. The screening mammography process should take about 15 minutes. The images are immediately available for the radiologist to review.

Screening vs. Diagnostic Mammography

Screening Digital Mammography can assist your physician in the detection of disease even if you have no complaints or symptoms. Initial mammographic images themselves are not always enough to determine the existence of benign or malignant disease with certainty. If a finding or spot seems suspicious, our radiologist may recommend further diagnostic studies. Diagnostic Digital Mammography is used to evaluate a patient with abnormal clinical findings, such as a breast lump, pain or a history of breast cancer. Diagnostic Digital Mammography may also be done after an abnormal sening mammography in order to determine the cause of the area of concern on the screening exam. Not all cancers of the breast can be seen on mammography. Interpretations of mammograms can be difficult because a normal breast can appear differently for each woman. With the assistance of our CADX system, a computer-aided detection system, the radiologist gets a "second look" at your mammogram. It is a routine part of the mammography reading process at the Women’s Imaging Center.

Preparation and Special Instructions

Before scheduling a mammogram, the American Cancer Society 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. Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time. The best time is one week following your menstrual cycle. Always inform your doctor or radiologic technologist if there is any possibility that you are pregnant.

The Women's Imaging Center also recommends that 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 digital image as calcium spots.
• Please describe any breast symptoms or problems to the technologist performing the exam.
• Before the examination, you will be asked to remove all jewelry and clothing above the waist and you will be given a gown or loose-fitting material that opens in the front.
• If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam. The radiologists may want to compare the new images to views from previous examinations.
• Results will be available to your doctor within just a few working days.

Breast Implants

At the ACR-accredited Women’s Imaging Center, our technologists are experienced in performing Digital Mammography on patients with breast implants. Breast implants can also impede accurate mammogram readings because both silicone and saline implants are not transparent on x-rays and can block a clear view of the tissues behind them, especially if the implant has been placed in front of, rather than beneath, the chest muscles. Our technologists and radiologists use special techniques that are designed to carefully compress the breasts to improve the view without rupturing the implant. Please inform the technologist and/or radiologist if you have breast implants prior to your exam.