FAQ - Breast Imaging Healthcare

1. I am having my very first mammogram. What should I expect?

When you come in for your mammogram, you will be asked to register at the front desk and we will make a copy of your driver’s license and insurance card so we may bill your insurance company. We will also review your medical history information for accuracy.

After registering, a mammography technologist will bring you back to the changing area. We will have you change into a gown from the waist up - it is preferable to wear a two piece outfit, no dresses. It is fine to wear deodorant. While changing, we will provide a wipe to remove all powder, lotion, or deodorant in the area to be imaged.

Once you are changed, the technologist will bring you to a mammography room and take a minimum of 4 images, 2 on each breast.The technologist will apply compression during the exam. The compression serves to separate the tissues within the breast to optimize the image quality while also minimizing your radiation exposure.The technologists will review each image for technical excellence before taking you back to the changing area.

If this is a routine screening mammogram, you may dress and leave at this point and your results will be sent to you and your doctor within the next business week. If this is a diagnostic mammogram, the technologist will ask you to wait in the changing area while she awaits instruction from the radiologist as to the next step, if any.

2. What is the difference between a screening mammogram and a
    diagnostic mammogram?

A screening mammogram is your routine, annual mammogram and does not require a doctor’s order. A screening mammogram is one in which you are not experiencing any breast problems (new lumps, onset of pain, discharge, or changes in breast appearance) and is being done to screen for breast cancer. With a screening mammogram the technologist will review the images for technical excellence before you leave.You will receive a result letter by mail and your doctor will receive a faxed report within the next business week.

A diagnostic mammogram is performed at the request of a physician for the evaluation of a new clinical finding (lump, pain, discharge, or changes in breast appearance). A diagnostic mammogram can also be requested by the radiologist as a call-back from a screening mammogram finding or as a follow up to a previous diagnostic imaging exam, needle biopsy, or breast surgery. The technologist will acquire images and show them to the radiologist who may request additional imaging be done during the visit. The radiologist will visit with you and discuss the findings, giving you a preliminary report before you leave our office. You will also receive a result letter by mail and your doctor will receive a faxed report within the next business week.

3. How old do I have to be before I can start having mammograms?

Typically most women have their baseline mammogram at age 40. If you have a family history of breast cancer or have a problem, you may need to have your first mammogram earlier. Consult with your physician for specific recommendations.

4. How often should I get a mammogram?

Starting at age 40, all women should have a mammogram annually according to the American Cancer Society (ACS) and the American College of Radiology (ACR). If you have a personal or family history of breast cancer, you may need to start annual mammography before age forty. Consult with your physician for specific recommendations.

5. My mother had breast cancer and didn’t know until it spread to other
    organs. What do I need to do to catch it earlier?

All women have the option of monthly breast self exams (BSE) starting at age 20 and should have a clinical breast exam (CBE) every three years between the ages of 20 and 40 with yearly CBE starting at age 40 according to the American Cancer Society (ACS).

Also, women with a first degree relative diagnosed with breast cancer should start screening mammography 10 years earlier than their relative’s age at time of diagnosis. For example, if your mother was diagnosed with breast cancer at age 40, you should start annual mammography at age 30.

In addition to annual mammography screening, the ACS and American College of Radiology (ACR) have also recommended screening MRI as an additional tool to annual mammography in patients with a greater than 20% lifetime risk of developing breast cancer, or if you or a first degree relative have tested positive for the BRCA-1 or BRCA-2 gene mutation. Consult with your physician for specific recommendations.

6. My friend’s breast cancer was found on a sonogram, not her
    mammogram. Can I opt for a sonogram instead of a mammogram?

Breast sonography is used as an adjunct, or additional, tool to mammography, not in lieu of mammography. It is true that mammograms are not able to detect 100% of breast cancers but it is still the most effective, cost-efficient screening tool available today when combined with monthly breast self exams (BSE) and annual clinical breast exams (CBE).And with the development of digital mammography, this tool has become even more effective, especially in women with dense breast tissue.

Breast sonography, or ultrasound, is a tool that is great for evaluating specific areas of concern such as a palpable mass, localized breast pain, swelling, or areas of concern detected on a mammogram or MRI. While it can give us valuable information that helps the radiologist distinguish benign (normal, not cancer) from possibly malignant (cancerous) tissue, it is not the best tool for detecting microcalcifications or other subtle architectural changes in the breast tissue which can indicate the earliest stage of breast cancer.

7. How much radiation am I receiving from a mammogram?

Federal government regulations require the maximum glandular dose for a breast of average size and tissue density fall below 300 mrad (3 mGv) per exposure. This translates to 1200 mrad (12 mGv) per standard 4 view mammogram.Our facility falls well below this government mandate.

8. Why can’t I wear deodorant, powders, or lotion to my
    mammogram appointment?

Certain deodorants, powders, and lotions contain microscopic materials which can mimic microcalicifications on your mammogram. Since microcalcifications can be an indication of breast cancer, we ask that these products not be worn on or around your breasts or under your arms the day of your appointment. We also provide cleansing wipes to remove deodorant if going without is not an option.

9. Can I get a mammogram if I am breastfeeding?

The lactating breast is dense and filled with milk which can make interpreting a mammogram more difficult. Because of this we recommend women completely finish lactating before having a routine screening mammogram.

If you are symptomatic or are feeling a lump, however, you should make an appointment with your physician.They may refer you for a diagnostic mammogram and/or sonogram. If a mammogram is recommended we will ask that you arrive early for your appointment so you can feed or pump immediately before your mammogram so we may acquire the best possible images. (If you bring your baby to your appointment please bring someone that can care for it during your exam.) You may continue feeding normally following your mammogram.

10. I am pregnant and feel a lump. Should I get a mammogram?

The first step is to see your OB/GYN for a breast exam. Based on their assessment, they may refer you for a sonogram of the lump. After sonographic assessment, the radiologist will determine if a mammogram is needed.

11. I am claustrophobic and my doctor has requested an MRI. How far do      have to go to the magnet?

Your breasts will need to be in the middle of the magnet therefore your entire upper body to about mid-thigh will be in the magnet. You will be lying on your stomach with your torso slightly elevated and you will enter the magnet feet first. You will also need to be able to place your arms outstretched in front of you (imagine Superman or, in this case, Superwoman!).

Some claustrophobic patients have experienced less anxiety due to this positioning. Because they are face down and can not see their surroundings, they do not feel as if they are within the magnet. If you feel you may need anti-anxiety medication for this exam, let our office staff know when you schedule your appointment. Please consult with your referring physician about contraindications and possible adverse medication interactions before requesting anti-anxiety medication for this exam. If medicine is prescribed we require you have a driver to and from our office for your appointment.

12. Why do you have to compress the breast so much during a
     mammogram?

Compression is used during a mammogram to separate the glandular tissue within the breast, providing differentiation between the various internal structures. It also helps to reduce your radiation dose.

There is no evidence that compression causes breast cancer and the amount of compression the technologist uses will depend on the actual compressibility of your breasts combined with your sensitivity level. The technologist will provide adequate compression without being excessive. Adequate compression is achieved when the skin is taut. If at any time during the mammogram you are uncomfortable, let the technologist know and she will work with you to achieve the best possible results.

13. I have breast implants. Won’t the mammogram break them?

While mammographic compression could potentially cause implant rupture, it is extremely uncommon. During your mammogram, the technologist will use minimal compression when the implant is in view. Because the implant could obscure the majority of your breast tissue, specialized views called Eklund or implant displaced views will also be taken. These views allow the technologist to apply adequate compression to the tissue in front of your implants while the implant remains safely behind the compression device. Your mammogram will need to be scheduled appropriately to provide the additional time required so please notify our office staff when scheduling of your breast augmentation.

14. Is there a better time during my cycle to schedule my mammogram
     or MRI?

Yes. The best time for your mammogram is within ten days of starting your period (if you are still menstruating). Breast tenderness during this time is usually minimal, making mammographic compression more tolerable. Also, since most women ovulate 10 to 16 days after starting their period, there is a lesser chance of becoming pregnant between days 1 and 10. If you feel you may be pregnant, please inform our staff before your appointment or upon arrival for your mammogram.

There is also an ideal time for your MRI exam. We recommend you have your MRI 5 to 14 days after starting your period. The contrast used for your MRI will enhance or “light up” areas in your breast with increased activity. Both normal glandular tissue and abnormal tissue can enhance. Normal breast tissue is most dormant (least likely to enhance) between days 5 and 14 of your cycle, making it an ideal time to do an MRI. This makes it easier for the radiologist to differentiate normal, glandular breast tissue from potentially abnormal areas of your breast.

15. What do I need for my breast imaging visit?

Please provide a current driver's license (or government issued ID) and your health insurance card(s).

 

Office: 214.442.7050
Fax: 214.442.7075

3301 E. Renner Rd,
Suite 100
Richardson, TX 75082

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Hours
Monday - Friday
8 - 5


Elizabeth Jekot MD Breast Imaging Center
3301 E. Renner Rd, Suite 100
Richardson, TX 75082

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