:::: FAQ : MAMMOGRAPHY :.

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How are mammographic images obtained?

Mammographic images are created with the use of a very low dose of x-rays that pass through the tissue on to a digital receptor. Digital receptors are specifically designed to create an electronic or digital image that can be viewed on a computer screen.

Routine screening mammography usually requires only two views of each breast. Some patients may require more than two views in order to see all of the tissue properly. Routine views include a top to bottom or craniocaudal view (CC) and an oblique view (MLO)

CC view

The CC view is taken with the x-ray beam passing through the breast from above (arrow - Fig. a). The digital receptor is placed under the lower surface of the breast (Fig. b). Fig. c shows the CC x-ray image obtained with this positioning.

MLO view

The MLO view is taken with the x-ray beam directed obliquely, from the upper-inner to lower-outer part of the breast. The x-ray tube is angled between 45 and 55 degrees (arrow), depending on the patient’s anatomy and orientation of the chest muscles (Fig. a). The digital receptor is positioned against the outside surface of the breast and chest muscle (pectoralis muscle) (Fig. b). Fig. c shows an MLO image obtained with this positioning.

How frequently should a woman have a screening mammogram?

The Pacific Breast Center strongly supports the recommendations of the American Cancer Society, the American College of Radiology and many other medical specialty organizations.

Women should begin annual screening mammography at age 40. Women who are at high risk because of a strong family history of breast cancer may be advised by their physicians to begin annual screening as early as age 25.

What is screening?

Screening mammography is the search for early breast cancer that is not suspected by the patient or her physician. When breast cancer is found when it is no larger than a dime, the cure rate is over 90%.

Who should have screening mammography?

Numerous scientific studies have proven that mortality from breast cancer can be reduced by more than 40% when women have high quality mammography annually beginning at age 40.

How do I schedule a screening mammogram?

You may contact your physician and request a referral or you may call Pacific Breast Center directly to schedule a screening mammogram.

Do I need a referral to schedule a screening mammogram?

No. You may contact PBC directly to schedule a screening mammogram. PBC strongly recommends that women have a primary healthcare provider and obtain regular physical examinations. Your report will be sent to the healthcare provider you designate. If you do not have a primary healthcare provider, PBC will provide you with a list of physicians from which you may choose one to whom the report will be sent.

If you have not had a recent breast physical examination, the radiologist may do a breast physical exam before the screening mammogram is done.

When is the best time to schedule a mammogram?

The best time to schedule your mammogram is about one week after your period, which may minimize discomfort that can occur when the breasts are swollen or tender.

Mammography

Should I have a physical examination of my breasts before or after my mammogram?

Women are strongly encouraged to have a breast physical examination before their screening mammogram.

Breast physical examination may detect subtle changes in tissue texture or vague areas of concern. When this information is made known to the mammography technologist and radiologist, special attention can be directed to that area of the breast. Such attention may help identify subtle mammographic abnormalities.

It is important for you and your physician to communicate any findings of concern to the mammographic facility, whether they were found on breast self-examination or on physical examination.

How should I prepare for my mammogram?

Bring your previous mammograms if they were taken someplace other than PBC. Bring a list of previous mammograms you may have had and where they were taken.

Avoid talcum powder, lotion or perfume under your arms or on your breasts on the day of the examination. These substances can cause artifacts that may be confused with breast calcifications on the mammogram.

Wear a two piece outfit so that you can easily remove your top and bra for the examination. A blouse that buttons in the front is ideal. Any jewelry (especially earrings or necklaces) should be easily removable.

What does it mean when I am asked to return for additional films or ultrasound?

It is not unusual for additional images or ultrasound to be requested by the radiologist who interprets your screening mammogram. This request is usually made in order to see an area of the mammogram that was not seen as well as it could be, or to get a better understanding as to whether a finding on the mammogram was benign (non-cancerous) or normal tissue.

What is a diagnostic mammogram?

If portions of the breast are inadequately seen on a screening mammogram, a diagnostic mammogram consisting of additional mammographic images may be needed to complete the study. When an area of concern is found on a screening mammogram or on physical examination of the breast, additional mammographic imaging or breast ultrasound may be needed to determine whether there is an abnormality that requires biopsy or further evaluation. In either of these circumstances, the radiologist or the patient’s physician may request a diagnostic breast imaging consultation.

A diagnostic mammogram may consist of a small spot film, focusing on a tiny area, a specialized angle view or a magnification view of a particular region of the breast. At Pacific Breast Center, the radiologist will be present to discuss the findings and recommendations and to answer questions you may have.

Do mammograms cause breast cancer?

The amount of radiation required for mammographic studies using state-of-the-art modern equipment has no measurable effect on breast tissue. In over 50 years of mammography, not a single case of cancer or other injury to breast tissue has be attributed to the radiation used for mammography.

Why are some breast cancers missed by mammography?

Although mammography is the only reliable method for detecting breast cancers that are too small to be felt by breast self-examination or by clinical breast examination, some breast cancers may be hidden by dense glandular tissue or may be so small that they are not identifiable by mammography or ultrasound. The good news is that with regular annual screening mammography, most of these breast cancers will be detected while they are still at a curable stage. The detection of small or subtle breast cancers requires excellent mammographic technique and expert analysis of mammographic images.