Guide to Having a Mammogram

Your Guide to Having a Mammogram

What is Mammography?

Mammography is a special type of x-ray imaging used to create detailed images of the breast. A mammography uses low dose x-ray, high contrast resolution and an x-ray system designed specifically for imaging breasts. Mammography plays an important role in the early detection of breast cancer.

Mammography can show changes in the breast well before a woman or her physician can feel them. Once a lump is discovered, mammography can be key in evaluating the lump to determine if it is cancerous.

The Types of Mammography

Screening Mammography is an x-ray examination of the breasts in a woman who is asymptomatic (has no complaints or symptoms of breast cancer). The goal of screening mammography is to detect cancer when it is still too early to be felt by a woman or her physician. Early detection of small breast cancers through screening mammography greatly improves a woman’s chances for successful treatment.

Diagnostic mammography is an x-ray examination of the breast in a woman who either has a breast complaint or has an abnormality through screening mammography. Diagnostic mammography is more involved and time consuming and is used to determine exact size and location of abnormalities. Several additional views of the breast are imaged.

How is a Mammography Performed?

During mammography, the technologist will position the patient and each breast one at a time, on a special film cassette and then compress it with a paddle (often made of clear Plexiglas or other plastic). This compression flattens the breast so that the maximum amount of tissue can be imaged and examined.

The x-ray source is turned on and x-rays are radiated through the compressed breast and on to a film cassette positioned under the breast. It is then developed in a dark room much like a regular photograph is developed.

The developed mammography films are then interpreted by a radiologist, who compares the new images of a woman's breast to each other and to any previous mammograms. The radiologist will look for shadows and patterns of tissue density to detect any abnormalities. A mammogram is like a fingerprint; the appearance of the breast on a mammogram varies tremendously from woman to woman, and no two mammograms are alike. It is extremely helpful for the radiologist to have films (not just the report available from previous examinations) for comparison purposes.

The breast is made of fat, fibrous tissue and glands. Breast masses appear as white regions and fat appears as black regions on mammogram film. Everything else: glands, connective tissue, tumors and other significant abnormalities such as microcalcifications; appear as levels of white on a mammogram.

Why Breast Compression During Mammography?

Breast compression is necessary to flatten the breast so that the maximum amount of tissue can be imaged and examined. Breast compression may cause some discomfort, but it only lasts for a brief time during the mammography procedure. Patients should feel firm pressure due to compression but no significant pain. If you feel pain, please inform the technologist. During the mammography examination, breast compression should only be applied two to four times per breast for a few seconds each time.

Breast Compression is Necessary During Mammography In Order to:

Flatten the breast so there is less tissue overlap for better visualization of anatomy and potential abnormalities.
Reduce overlapping normal shadows, which can appear as suspicious regions on the film. Allow the use of a lower x-ray dose since a thinner amount of breast tissue is being imaged. Immobilize the breast in order to eliminate image blurring caused by motion.

How Can I Prepare for My Mammogram?

Preparation for mammography requires a few simple steps from the patient and mostly requires good communication with the technologist who will perform the mammogram and a good knowledge of your previous mammogram history.

You should do the following:

Schedule your mammogram to take place one week after your period, when the breasts are less tender.

If possible, bring your previous mammogram with you, or bring a list of where and when you have had previous mammograms to your appointment.

On the day of the examination, do not wear talcum powder, deodorant, lotion or perfume under your arms or on your breasts. These substances can cause artifacts on your mammogram making the images harder to interpret.

Wear a two piece outfit so that you only have to remove your top and bra for the examination: a blouse with buttons in the front is optimal since it can be easily removed, while pullover tops are less convenient.

Charles E. Potter, CIO