What is it?
Most medical experts agree that successful treatment of breast cancer often is linked to early diagnosis. Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them.
Northern Arizona Radiology uses digital mammography. Also known as a full-field digital mammography, digital mammography allows the radiologist to alter the orientation, magnification, brightness and contrast to produce images of the breast that can be seen on a computer screen. Computer-aided detection, or CAD, uses a digitized mammographic image to search for abnormal areas of density, mass, or calcification that may indicate the presence of cancer. The CAD system highlights these areas on the images, alerting the need for further analysis.
What are the advantages of digital mammography and computer-aided detection?
- The superior contrast resolution of digital mammography and its ability to manipulate images make for more accurate detection of breast cancers.
- Computer-aided detection, or CAD, obtains a second, computerized reading in the hope of finding more cancers or more accurately gauging signs of malignancy.
- Digital mammograms can be archived in various ways and easily retrieved, and copied.
How often should I have a mammogram?
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) recommends that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening.
When should I schedule my mammogram?
Before scheduling a mammogram, you should discuss problems in your breasts with your doctor. In addition, inform your doctor of hormone use, any prior surgeries, and family or personal history of breast cancer. Generally, the best time is one week following your period. Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time. Always inform your x-ray technologist if there is any possibility that you are pregnant.
How should I prepare for a mammogram?
On the day of the exam:
- Do not wear lotion, deodorant, or powder under your arms or on your breasts
- Describe any problems you’re experiencing with your breasts with your technologist
- Remove all jewelry and clothing from the waist up. You will be given a gown that opens in the front.
What can I expect during the procedure?
To image your breast, a Mammography technologist will position you near the machine and your breast will be placed on a platform and compressed with a paddle. Breast compression is necessary 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.
- Allow use of a lower x-ray dose.
- Hold the breast still - to eliminate blurring of the image caused by motion.
- Reduce x-ray scatter - to increase picture sharpness.
The technologist will go behind a glass shield while making the x-ray exposure. You will be asked to change positions slightly between views. The process is repeated for the other breast. Routine views are a top-to-bottom and side view.
The exam typically takes less than 15 minutes. The technologist will apply compression on your breast and, as a result, you will feel pressure. Some women with sensitive breasts may experience some minor discomfort. Be sure to inform the technologist if pain occurs as compression is increased. If discomfort is significant, less compression will be used.
The facts about breast density
Are you dense?
Dense breasts are normal; up to 40% of American women have them. It simply means that a woman has more fibrous, glandular tissue in her breasts than fatty tissue. Younger women typically have denser breast tissue. Older women, especially post-menopausal women, have less dense breast tissue. But if a woman takes postmenopausal hormones, her breasts may remain dense.
Breast density is measured during your annual screening mammogram
All mammography reports from Northern Arizona Radiology now contain a classification of breast density based on the Breast Imaging Reporting and Data System (BI-RADS) breast composition categories:
- Predominantly fat
- Scattered fibroglandular densities
- Heterogeneously dense
- Extremely dense
Why is breast density important?
While the reasons are not yet fully understood, women with denser breasts are at an increased risk for breast cancer. In addition, clinical studies have shown that women with dense breasts can benefit from a supplemental form of screening in addition to mammography.
For women classified as BI-RADS 3 (heterogeneously dense) and BI-RADS 4 (extremely dense). Supplemental screenings can include breast MRI, ultrasound and Breast Specific Gamma Imaging.
Breast MRI is generally recommended for women who are determined to be at high risk for breast cancer (e.g. another family member was diagnosed with the disease). For women at low to moderate risk, we offer supplemental screenings with ultrasound and Breast Specific Gamma Imaging.
Why haven’t I heard of breast density before?
The issue of breast density has only recently emerged into the national spotlight, and the majority of clinical research on the subject is less than ten years old. Seventeen states now have breast density notification laws, and that number is growing. Breast density legislation in Arizona officially takes effect on October 1, 2014. However, at Northern Arizona Radiology, we felt so strongly that this was an important issue to both doctors and patients, that we implement dense breast notification for our patients at the beginning of 2104, well in advance of the Arizona state legislation.
The clinical evidence is clear, and this is not a medical “fad.” Breast density is not only a risk factor for breast cancer, but it can also impact a woman’s ability to achieve early detection using traditional methods. It is widely agreed that early detection is the key to surviving breast cancer, so any issue that can impact a woman’s confidence in her healthcare strategy must be considered.
Learn the facts for yourself. Talk to your doctor. If you need more information, we are here to help or you can visit the following: