|
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).
|
