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1.
What is Mammography?
2. When should I have schedule my mammogram?
3. How should I prepare for the procedure?
4. Are you accredited by the American College
of Radiology?
5. What does the equipment look like?
6. What can I expect during my mammogram?
7. What are the benefits vs. risks?
8. What are the limitations of Mammography?
1 . What is Mammography?
Mammography is a specific type of imaging
that uses a low-dose x-ray system and high-contrast, high-resolution
film for examination of the breasts. Most medical experts agree
that successful treatment of breast cancer often is linked to
early diagnosis. 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.
Current guidelines from the American Cancer Society (ACS), the
American Medical Association (AMA) and the American College
of Radiology (ACR) recommend screening mammography annually
for women, beginning at age 40. Women who have had breast cancer
and those who are at increased risk due to a genetic history
of breast cancer should seek expert medical advice about whether
they should begin screening before age 40 and about the frequency
of screening.
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2. When should I have schedule my mammogram?
Screening mammograms should be performed
annually for women beginning at age 40. Women with a history
of breast cancer or at increased risk for breast cancer due
to genetic history should consult their physician regarding
when screening should begin and the frequency of screening.
The best time to have your mammogram is one week following your
period. Do not schedule your exam for the week before your period
if your breasts are usually tender during this time. Always
inform your doctor if there is the possibility that you may
be pregnant.
Before scheduling a mammogram, we recommend that you discuss
any new findings or problems in your breasts with your doctor.
In addition, inform your doctor and the radiologist of any prior
surgeries, hormone use, and family or personal history of breast
cancer.
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3. How should I prepare for the procedure?
•
Do not wear deodorant, talcum powder, or lotion under your arms
on the day of the exam. These can appear on the x-ray film as
calcium spots.
•
Describe any breast symptoms or problems to the technologist
performing the exam.
•
If possible, obtain prior mammograms and make them available
to the radiologist at the time of the current exam.
In addition, 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.
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4. Are you accredited by the American College
of Radiology?
All of our imaging centers are accredited
by the American College of Radiology. In order to obtain this
accreditation, examples of images must be submitted to the ACR
for review. Additionally, all radiologists are required to read
a minimum number of mammograms per year and all technologists
buts be certified to perform mammograms.
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5. What does the equipment look like?
A mammography unit is a rectangular box
that houses the tube in which x-rays are produced. The unit
is dedicated equipment because it is used exclusively for x-ray
exam of the breast, with special accessories that allow only
the breast to be exposed to the x-rays. Attached to the unit
is a device that holds and compresses the breast and positions
it so images can be obtained at different angles.
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6. What can I expect during my mammogram?
A specially-qualified mammography technologist
will position you to image your breast. The breast is first
placed on a special cassette and compressed with a paddle (often
made of clear Plexiglas or other soft 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 which also leads to poor image quality
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 examination process should take about half an hour. When
the mammography is completed you will be asked to wait until
the radiologist examines the images to determine if more are
needed.
You will feel pressure on the breast as it is compressed. Some
women with sensitive breasts may experience discomfort. If this
is the case, schedule the procedure when your breasts are least
tender. The technologist will apply compression in gradations.
Be sure to inform the technologist if pain occurs as compression
is increased. If discomfort is significant, less compression
will be used.
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7. What are the benefits vs. risks?
Benefits
•
Imaging of the breast improves a physician's ability to detect
small tumors. When tumors are small, effective treatment and
cure are more likely.
•
The use of screening mammography increases the detection of
small abnormal tissue growths confined to the milk ducts in
the breast, called ductal carcinoma in situ (DCIS). These early
tumors cannot harm patients if they are removed at this stage
and mammography is the only proven method to reliably detect
these tumors.
Risks
•
The effective radiation dose from a mammogram is about 0.7 mSv
which is about the same as the average person receives from
background radiation in three months.
•
Women should always inform their doctor or x-ray technologist
if there is any possibility that they are pregnant.
• False Positive Mammograms. Between 5 and 10 percent
of mammogram results are abnormal and require more testing (more
mammograms, fine needle aspiration, ultrasound, or biopsy),
and most of the follow-up tests confirm that no cancer was present.
It is estimated that a woman who has yearly mammograms between
ages 40 and 49 would have about a 30 percent chance of having
a false-positive mammogram at some point in that decade, and
about a 7 to 8 percent chance of having a breast biopsy within
the 10-year period. The estimate for false-positive mammograms
is about 25 percent for women ages 50 or older.
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8. What are the limitations of Mammography?
Interpretations of mammograms can be difficult
because a normal breast can appear differently for each woman.
Also, the appearance of an image may be compromised if there
is powder on the breasts or if you have undergone breast surgery.
Because some breast cancers are hard to visualize. A radiologist
prefers to compare the image to views from previous examinations.
Not all cancers of the breast can be seen on mammography.
Breast implants can also impede accurate mammogram readings
because silicone 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. Experienced technologists and radiologists
know how to carefully compress the breasts to improve the view
of breast tissue without rupturing the implant.
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