Screening Mammography

Mammography is a specific type of imaging that uses low-dose x-rays to visualize the breasts. A mammogram is used as a screening tool to detect early breast cancer in women experiencing no symptoms.

Mammography plays a central part in early detection of breast cancers. Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA), and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40. The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk due to a family history of breast cancer should seek expert medical advice about whether they should begin screening before age 40.

Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available. Even with the advent of supplemental breast imaging modalities, mammography is the best screening tool for breast cancer available today. However, mammograms do not detect all breast cancers. Also, a small portion of mammograms indicate cancer is present when it is not (called a false-positive result).

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.

What to expect with your procedure

Mammography is performed on an outpatient basis. All HVR breast imaging sites now utilize digital mammography.

During digital 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 plastic paddle. The technologist will carefully compress your breast, but some women find this to be uncomfortable.

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 stand behind a glass shield during the x-ray exposure. You will be asked to keep very still and hold your breath for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The routine views are a top-to-bottom view and an oblique side view. The process will be repeated for the other breast.

When the examination is complete, the patient will be asked to wait until the technologist determines that the images are of high enough quality for the radiologist to read. The radiologist will interpret the mammogram and issue a report within a few days.

The examination process should take about 30 minutes.

Preparing for your procedure

Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time. The best time for a mammogram is one week following your period. 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.
• If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam.
• Ask when your results will be available; do not assume the results are normal if you do not hear from your doctor or the mammography facility.