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… Increasing the Rate of Breast Cancer
Survival
Mammography is a low-dose x-ray study of the breasts.
The key role of mammography is in identifying a site of breast cancer
early in its development when it is very small and often a year of two before it
is large enough to be felt as a lump. These
small cancers have a much better response to treatment and often require much
less surgical or drug treatment. Mammography
detects approximately 2-3 times as many “early” breast cancers as physical
examination, and is the best method for the screening of breast cancer.
Today, very low doses of radiation are used for mammography. This method is referred to, appropriately, as low dose radiation. With advances in sensativity and precision of radiological equipment, very lower amounts of radiation may be used to produce a very clear and precise image.
The purpose of early detection is to prevent the onset of a more prolific form of cancer. Even though mammography is the best screening examination available today, some cancers, approximately 10%, will not be identified by mammography at a stage when they can be felt as lumps. For this reason, breast self-examination and examination by your doctor at intervals are integral components of breast cancer detection.
A typical mammogram consists of two views of each breast in which they are pressed firmly between two plates. The best time for breast examination is 5 to 7 days after cessation of menses, when the morphologic influences of hormones are minimal.
Women with implants require two additional views to visualize tissue –
using the Eklund Technique (implants are pushed back and breast tissue is pulled
forward).
The complete procedure takes only a few minutes.
It will be performed by a trained technologist under the supervision of
our qualified Radiologists. The physician will analyze the x-rays, looking for
specific abnormalities or changes related to cancer.
A written report will then be sent to your doctor.
On occasion, the doctor may order additional views or other techniques
such as an ultrasound or a follow up consultation for ongoing diagnostic reasons. In which case, the physician will contact you dirrectly to go over any details or assessments that he may have in addition to our own reports.
To prepare for a mammogram, you should dress comfortably as you would for
any upper-body x-ray in a two-piece outfit.
(You will need to undress from the neck to the waist.) Also refrain from
using any types of powders, deodorants or creams on your underarms or breasts
since these can interfere with a clear x-ray.
The Radiologist requires high technical quality in each study in order
for his report to be most accurate. Interpreting mammograms takes considerable training and
experience with each study being a supreme test for the examining Radiologist. In addition to strict federal compliance, we go beyond the federal minimum requirements to deliver both early detection and peace of mind. We
approach every patient with the idea “What would I do if this were a member of
my family?”
Every exam is interpreted as either:
Category 0. Additional examination is required.
Category 1. No abnormalities identified.
Category 2. Benign Findings.
Category 3. Most likely normal , but a subtle area is questioned which should be closely followed.
Category 4. Areas of greater concern which require biopsy in order to make a definitive diagnosis.
If you should be among the patients asked to return in six months for a special
view of an area, you fall into Category 3. Our assessment of your examination is almost definitively negative, but
there is a subtle area that we are questioning that we would appreciate
re-examining in six months to insure its stability. This request is not a cause for immediate alarm..
This is simply a diagnostic follow-up in order to confirm our previous findings. The odds are upwards of 90% that the case is not a significant finding. However, it is only by being extremely careful and cautious
with every subtle finding that we will find the early preclinical and curable
abnormalities for which we are constantly searching.
If we request a six month study, a letter will generally be sent to you and your referring physician explaining the reason for our request. Their is a high probability that this is not a significant finding. A reminder will be sent personally to you at the time of the requested repeat study. Only a limited study of the area in question will be necessary at that time.
What Do We Mean by the Term “Tailored Mammogram”?
Every patient is different with different problems, different needs, and different types of breast tissue. For this reason at Pacific Coast Medical Imaging, we “tailor” the mammogram to each patient, as opposed to the standard views taken at most breast valuation sites. Generally we do a standard four-view study. The techniques vary according to the density and type of breast tissue which we find.
Special views are added of any area which needs better definition and occasionally we will add “spot compressed views” to better define a specific area. On occasion an ultrasound study will be added of a specific area, or both breasts, to better define special areas.
Our staff is highly trained and experienced in making decisions on how to best demonstrate your breast tissue for thorough evaluation by the examining radiologist. Do not be alarmed when special views are added in the course of your study. This is part of our “Completeness” and “tailoring” of each study to the individual patient.
When your breasts are compressed the tissue is “Spread out” and
brought closer to the film allowing for a more sharply defined study.
This is necessary in order to find the subtle underlying changes (or rule
them out) necessary for a complete
study. We do not want to hurt you.
We will demonstrate to you before the study, visual examples of breasts
examined with and without proper compression.
On each study we want to have the “highest quality” study possible.
What are some limitations of screening mammograms?
