Mammography

Mammograms are probably the most important tool doctors have to screen for breast cancer, but also to diagnose, evaluate, and follow women who’ve had breast cancer. Safe and reasonably accurate, a mammogram is an x-ray photograph of the breast, done using a technique that has been in use for about 40 years.

  • Screening mammograms are typically done every year to check the breasts for any early signs of breast cancer. 
  • Diagnostic mammograms are different from screening mammograms in that they focus on getting more information about a specific area (or areas) of concern — usually due to a suspicious screening mammogram or a suspicious lump.

About mammograms

Current evidence confirms that mammograms offer substantial benefit for women in their 40s and older. Still, there are some limitations; they may even miss some cancers. But they are still very effective for decreasing suffering and death from breast cancer. 

At the Margie Petersen Breast Center, we explain the benefits and limitations linked with yearly mammograms, including that they should be continued regardless of a woman's age, as long as there are no serious, chronic health problems such as congestive heart failure, end-stage renal disease, chronic obstructive pulmonary disease, or moderate to severe dementia. Age alone should not be the reason to stop having regular mammograms. In fact, one of the biggest risk factors for developing breast cancer is getting older.

Digital mammography

Each Providence Saint John’s digital mammography unit is equipped with a digital receptor and utilizes dedicated computers instead of conventional X-ray film. The mammograms, performed by a technologist, are then viewed electronically by one of our radiologists on computer screens designed for optimal viewing.  The images are also read in conjunction with CAD (computer-aided detection) software that calculates the density of your breast tissue. Digital mammography provides a clearer, more accurate image of the breast than analog, film mammography.

This leading-edge technology is the first step in the screening and diagnostic breast imaging process.  If an abnormality is found, the area of concern can be imaged with additional mammograms (spot compression), ultrasound and/or MRI and the patient may need to undergo a biopsy. All of this, except the MRI, is done during one appointment. In fact, these highly sophisticated and integrated services create a more efficient process allowing shorter examination times, quicker results and ultimately more convenience and less anxiety for you. It also allows us to begin creating a treatment protocol almost immediately.

How digital mammography works

A digital mammogram machine uses compression and X-rays to image your breast, but instead of capturing the image on film as with traditional mammography, the image is sent to a computer as a digital image file. Also called a full-field digital mammogram (FFDM), this technology compares well with film mammography and may benefit younger women the most.

Digital mammograms are faster than analog film mammograms, because there is no film to develop. The image can be sent immediately to the radiologist for viewing. If the image is unclear, you will be told about it right away, and the image can be retaken. This may help reduce mammogram callbacks, and stress on patients.

The National Cancer Institute did a study comparing film and digital mammography, and concluded that digital mammography is more accurate than analog film mammography at finding cancer in women less than 50 years old, and women who have dense (not fatty) breast tissue. Digital mammography also uses less radiation, reducing your lifetime exposure to X-rays.

Once your mammogram images are in the computer, your radiologist can view them on a monitor, much as you would look at digital photos. On the computer, your radiologist can closely examine the images by zooming in, adjusting the image brightness, or changing the contrast, making all areas of the breast easier to see.

Computer-aided detection (CAD) and diagnosis can be used on the digital images to help your doctor analyze the overall images, and flag areas that need closer study. CAD can find tumors that a radiologist might not spot. Once a CAD analysis has been done, a radiologist will do a visual check of those areas, and based on training and experience, decide how serious the mass may actually be.

Mammography is a good test to look for cancers that appear as spiculated masses, areas of asymmetry and/or microcalcifications. If a mass is seen on mammogram, an ultrasound can be performed Calcifications are best seen by mammography and if needed, can be biopsied using stereotactic approach.

Other types of mammography are also becoming available including 3D Mammography. This type of mammography represents the latest technology approved by the FDA in February of 2011. It gives radiologists the ability to view inside the breast layer by layer, helping to see the fine details more clearly by minimizing overlapping tissue.

During a 3D mammogram, multiple low-dose images known as “slices” of the breast are acquired at different angles, allowing us to see the breast in a way never before possible.