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Mammography: What You Need to Know

Mammograms do not prevent breast cancer, but they can detect many breast cancers before anyone can feel them. When breast cancer is found in its earliest stages, the majority of patients survive for at least five years.

This year, more than 175,000 women will be diagnosed with invasive breast cancer. About 40,000 women will die of the disease, according to the American Cancer Society (ACS). Except for skin cancer, breast cancer is the most common cancer among women.

According to the American Cancer Society (ACS), the risk for breast cancer increases with age, especially after age 40. As a general guideline, the ACS recommends a yearly mammogram after age 40. Your health care provider, however, may propose another strategy based on your situation.

The ACS also recommends a clinical breast exam (an examination of the breasts by a health care provider) when a woman has her mammogram.

This low-dose X-ray produces an image of the inner structures of the breast. It can detect tiny calcium deposits or micro-calcifications that are too small to feel. Most of these deposits are benign, but sometimes -- especially when in clusters -- they may be an early sign of breast cancer.

There are two types of mammograms: analog and digital. Analog mammograms record images using film processing, while in digital mammography the X-rays hit an advanced detector, which senses the image data digitally and electronically.

While digital mammography is still one of the most advanced technologies available today, it is only a two-dimensional picture of the breast. Since the breast is composed of pockets of dense tissue surrounded by fat, when X-rayed, it creates an image that looks something like a smoky haze. The overlapping tissue in the image makes it difficult to see tiny “spots” called microcalcifications, and other subtle signs of early cancer.

3D Mammogram
Breast tomosynthesis (commonly referred to as a 3D mammogram) may be used in conjunction with traditional digital mammography as part of your annual screening mammogram to capture more breast images. Unlike digital mammography, breast tomosynthesis:

  • Uses high-powered computing to convert digital breast images into a stack of very thin layers or “slices”—building what is essentially a “3-dimensional mammogram”
  • Has an X-ray arm sweep in a slight arc over the breast, taking multiple breast images in just seconds, producing a 3D image of the breast tissue
  • Radiologists can now view the breast tissue a millimeter at a time, rather than viewing all the complexities of the breast tissue in a flat image

Automated Breast Ultrasound System (ABUS)
ABUS is done in addition to a traditional 2D or 3D digital mammogram and is the only breast cancer screening technology that is FDA-approved for detection in women with dense breast tissue and no history of abnormal mammograms. This automated breast ultrasound helps doctors find cancers hidden in dense breast tissue, which may be missed by traditional screening mammograms. Dense breast tissue increases the risk of breast cancer up to 4-6 times and makes it more difficult to detect cancer in a standard 2D mammogram.

Unlike 2D or 3D mammography, ABUS uses sounds waves, instead of radiation, to create 3D pictures of the breast tissue, allowing radiologists to look through hundreds of breast tissue image “slices”. This is different from what is seen with a routine ultrasound, resulting in fewer false negatives.

If you've never had a mammogram, you may be nervous about it. Knowing what to expect and how to prepare for the exam may help ease your concerns. Try these tips:

  • If your breasts are sensitive before and during menstruation, schedule your mammogram the week after your period.
  • On the day of your appointment, wear a shirt and bra that you can remove easily because you'll need to undress from the waist up.
  • Don't wear deodorant, powder, or lotion, which can affect your X-rays.
  • If you've had a mammogram before but at a different facility, arrange in advance to have the most recent X-ray sent to your current facility. Your health care provider will want to check for changes since your last screening.

A technician will help position your breast on a platform. The technician will take two X-rays for each breast, each from a different angle. The machine will compress your breast to get a clear picture of as much tissue as possible, including the armpit. This process lasts just a few seconds. Having your breast flattened may be uncomfortable, but it shouldn't hurt. The machine can be adjusted, so tell the technician if you experience any pain.

For breast tomosynthesis recipients: this exam is very similar to a traditional mammogram. Your breast will be under compression while the X-ray arm of the mammography machine makes a quick arc over the breast, taking a series of breast images at a number of angles. This will only take a few seconds and all of the images are viewed by the technologist at their computer work station to ensure they have captured adequate images for review by a radiologist.

For ABUS patients, the exam only takes 15 minutes. After your 2D or 3D mammogram, you’ll lie down on the exam table and a layer of lotion is applied to your breast. A scanner is then firmly positioned on your breast to acquire the images. The radiologist will review your 3D ultrasound images along with your mammogram results.

At some facilities, like Holy Redeemer, you may receive your mammogram results that day, or the results may come in the mail within a few weeks. A copy of the report also will go to your doctor. Follow up with him or her if you haven't been contacted in more than a month. Do not presume that no news is good news. Call your physician's office and ask for the result of the report.

If your results show an area of concern, don't panic: approximately 80 percent of breast lumps are not cancerous. Other tests, such as a diagnostic mammogram that takes more X-rays, or a biopsy, can help your doctor determine the cause.