WHAT IS MAMMOGRAPHY?

Mammography is specialized, non-invasive medical imaging technique that uses a low-dose x-ray system to picture the breasts. A mammography exam, called a mammogram, aids in the early detection and diagnosis of breast diseases. Advancement in mammography include ductography, and recently digital mammography and breast tomosynthesis.

Digital mammography, also called full-field digital mammography (FFDM), is a mammography system in which the x-ray film is replaced by a detector plate that convert x-rays into mammographic pictures of the breast. These systems are similar to those found in digital cameras and their efficiency enables better pictures with a lower radiation dose.

These images of the breast are transferred to a computer for review by the radiologist and for long term storage. Digital mammography has many advantages over conventional mammography including superior resolution which enables much smaller lumps and calcification to be picked up easily. It also reduces the need for repeats.

At ARRIVE ALIVE, because we care, we use the latest GE Sonographe Essential Digital Mammography System which ensures very minimal dose of radiation with the use of an automatic modulation parameter, to produce very high quality pictures of the breast.
Ductography (also called galactography or ductogalactography) is a special type of contrast-enhanced mammography used for imaging the breast ducts. Ductography can aid in diagnosing the cause of an abnormal nipple discharge and is valuable in diagnosing intraductal papillomas and other conditions. Papillomas are wart-like, non-cancerous tumors with branches or stalks that have grown inside the breast duct.

WHAT ARE SOME COMMON USES OF THE PROCEDURE?
Mammograms are used as a screening tool to detect early breast cancer in women experiencing no symptoms. They can also be used to detect and diagnose breast disease in women experiencing symptoms such as a lump, pain, skin dimpling or nipple discharge.

Screening Mammography
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. Current guidelines recommend annual screening mammography for women from the age of 40. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and when breast-conservation therapies are available.

Diagnostic Mammography
Diagnostic mammography is used to evaluate a patient with abnormal clinical findings—such as a breast lump or nipple discharge—that have been found by the woman or her doctor. Diagnostic mammography may also be done after an abnormal screening mammogram in order to evaluate the area of concern on the screening exam.

HOW SHOULD I PREPARE?
Always inform your doctor or mammographer if there is any possibility that you are pregnant. Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium deposit thus mimicking pathology.

Describe any breast symptoms or problems to the mammographer performing the exam. Obtain your prior mammograms and make them available to the radiologist if they were done at a different location. This is needed for comparison with your current exam.

WHAT DOES THE EQUIPMENT LOOK LIKE?
A mammography unit is a rectangular box that houses the tube in which x-rays are produced. The unit is used exclusively for x-ray exams of the breast, with special accessories that allow only the breast to be exposed to the x-rays. Attached to the unit is a device that holds and compresses the breast and positions it so images are obtain from the side and an image from above the compressed breast.

HOW DOES THE PROCEDURE WORK?
The mammographer position the breast on the mammography unit and then apply compression. Breast compression is necessary in order to:
  • Even out the breast thickness so that all of the tissue can be visualized.
  • Spread out the tissue so that small abnormalities are less likely to be hidden by overlying breast tissue.
  • Allow the use of a lower x-ray dose since a thinner amount of breast tissue is being imaged.
  • Hold the breast still in order to minimize blurring of the image caused by motion.
  • Reduce x-ray scatter to increase sharpness of picture.
    • You will be asked to change positions between images. The routine views are a top-to-bottom (cranio-caudal) view and an angled side (medio-lateral) view. The process will be repeated for the other breast. When the examination is complete, you may be asked to wait until the radiologist determines that all the necessary images have been obtained. The examination process takes about 15-30 minutes.
WHAT WILL I EXPERIENCE DURING AND AFTER THE PROCEDURE?
No radiation remains in a patient's body after mammogram examination. You will feel pressure on your breast as it is squeezed by the compression paddle. Some women with sensitive breasts may experience discomfort. If this is the case, schedule the procedure when your breasts are least tender.

Be sure to inform the mammographer if pain occurs as compression is increased. If discomfort is significant, less compression will be used. Always remember compression allows better quality mammograms.

WHO INTERPRETS THE RESULTS AND HOW DO I GET THEM?
A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyse the images and send a signed report to your referring Doctor, who will discuss the results with you. You may discuss the report the report with the radiologist if you wish.

Follow-up examinations may be necessary. Your doctor will explain the exact reason why another mammogram is requested. Sometimes a follow-up exam is done because a potential abnormality needs further evaluation with additional views or a special imaging technique.

A follow-up examination may also be necessary so that any change in a known abnormality can be monitored over time. Follow-up examinations are sometimes the best way to see if treatment is working or if a finding is stable or changed over time. Breast ultrasound may also be needed in women with breast which appear mammographically dense.

WHAT ARE THE BENEFITS?
Imaging of the breast improves a physician's ability to detect tumours when small and early. When cancers are small, the woman has better treatment options. The use of screening mammography increases the detection of small abnormal tissue growths confined to the milk ducts in the breast, called ductal carcinoma in situ (DCIS).

These early tumours cannot harm patients if they are removed at this stage and mammography is an excellent way to detect these tumours. It is also useful for detecting all types of breast cancer, including invasive ductal and invasive lobular cancer.

NOTE:
Breast implants can impede accurate mammogram readings because both silicone and saline implants are not transparent on x-rays and can block a clear view of the tissues behind them, especially if the implant has been placed in front of, rather than beneath, the chest muscles. But the good news is an experienced mammographer knows how to carefully compress the breasts to improve the view without rupturing the implant.