3D Screening and Diagnostic Mammography
A mammogram is an x-ray picture of the breast that doctors use as a screening and diagnostic tool.
Screening mammograms usually involve taking two or more x-ray pictures of each breast. The x-ray images can detect tumors that cannot be felt in women with no signs or symptoms of the disease. Screening mammograms can also find abnormalities that may indicate the presence of cancer, such as microcalcifications (tiny deposits of calcium).
Doctors use diagnostic mammograms to evaluate when a lump or other potential signs of breast cancer is present. In addition to a lump, signs of breast cancer can include:
- Focal breast pain
- Thickening of the skin of the breast
- Nipple discharge
- Change in breast size or shape
A diagnostic mammogram can also:
- Evaluate areas of concern found during a screening mammogram
- View breast tissue when special circumstances make it is difficult to obtain a screening mammogram
How Does Mammography Work?
During a mammogram, a patient’s breast is positioned on a flat support plate while another plate will firmly compress it from above. Compression of the breast is necessary to:
- Hold the breast in place to reduce any blurring of the x-ray image
- Even out the shape of the breast so that the x-rays can travel through a shorter path to reach the detector. This reduces the radiation dose and improves the quality of the x-ray image.
- Visualize breast tissue in a single plane so that small abnormalities are less likely to be obscured by overlying breast tissue.
An x-ray machine emits a small burst of x-ray beams that pass through the breast to a detector on the opposite side. The detector transmits these as electronic signals to a computer that converts them to a digital image. These images are called mammograms.
Low-density tissues, like fat, appear translucent (i.e., darker shades of gray approaching the black background). Areas of more dense tissue, such as connective tissue or tumors, appear whiter on a gray background. Standard mammograms include images of both the top and side views of each breast. Additional images can be taken if necessary.
Three recent advances in mammography include digital mammography, computer-aided detection, and breast tomosynthesis
How Do I Prepare?
Before any mammogram, patients should disclose any new abnormalities with their breasts, as well as any prior hormone usage, surgeries, or medical history involving breast cancer in the patient or family. In addition to this, bring any prior mammograms from other facilities as they may provide additional information about any developments in the breasts over time.
It is also important to keep in mind that patients should not schedule mammograms when breasts are swollen or tender to avoid discomfort as well as inaccurate mammogram pictures. Patients should avoid scheduling an appointment the week before their period to avoid this.
Things to know before your appointment:
- Do NOT wear perfumes, talcum powder, deodorant, antiperspirant, lotions, or creams before your appointment as they could show up on x-rays as calcium spots
- For convenience, it might be easier to wear a two-piece outfit so you will only need to remove your top for your appointment
What Will I Experience During My Exam?
At the exam, patients will be required to undress from the waist up, with most clinics providing a special gown that can expose one breast at a time during the procedure. The mammography device has a platform on which the breast will be placed and a plastic paddle which will be used to gently compress the breast on the platform in order to hold the breast in place. This will allow the x-ray to produce a sharp clear picture by holding the breast in place and spreading out the breast tissue evenly so abnormalities are easier to spot.
The technologist will help the patient place a single breast on the x-ray machine and will take x-ray pictures with two different views of the patient’s breast; a top/bottom view and an angled side view. The same process will be repeated on the other breast.
You and your doctor will be sent a copy of your results after a radiologist reviews the images. You will be contacted if additional imaging is necessary.
How Do I Get My Results?
While a technologist will be the one taking a patient’s x-ray pictures, only a qualified radiologist can confirm and interpret the results of the x-rays. You and your doctor will be sent a copy of your results after a radiologist reviews the images. You will be contacted if additional imaging is necessary.
What Are the Benefits and Risks of Mammography?
- Early detection of breast cancer
- Detection of other abnormalities that can occur in the breast
- Early detection provides more treatment options and higher chances of survival in cases in which cancer is present
- Mammographic is non-invasive, uses minimal radiation, and is without lingering side effects
- False-Positive Mammograms: 5-15% of mammograms cannot provide clear results and require additional testing for confirmation
- Excessive radiation exposure can increase the risk of cancer, but small doses for diagnostical purposes should pose very minimal risk
While mammography is one of the most common examination methods for detecting breast cancer, it cannot detect all types of breast cancers and may sometime provide a false-negative result.
On the other hand, mammograms also have the possibility of providing a false positive result which would require additional testing like a breast biopsy in order to confirm the mammogram results.
Such factors that have affected the efficacy of mammogram results include:
- Increased breast density
- Breast implants
- Spots in x-ray images from perfumes, talcum powder, deodorant, antiperspirant, lotions, or creams
Breast imaging techniques are being continually researched in order to improve the accuracy of test results and to improve the early detection of harmful cancers among women.