You will be asked to undress from the waist up and change into a gown. A specially trained female technologist will then position you for the exam.
In a typical screening mammogram, each breast is examined separately, with two views of each breast:
From above (a cranio-caudal or CC view); and
From the side (a medio-lateral oblique or MLO view).
During a mammogram, the breast is compressed between two plastic plates, which may cause temporary discomfort in some women. The compression lasts no more than a few seconds and does not harm the breast. Compression is necessary for the following reasons:
Compression makes a mammogram more accurate, by reducing motion, and allowing the x-ray beam to pass more uniformly through the breast.
Compression makes a mammogram safer, by reducing the amount of radiation required for an accurate interpretation.
How long will my mammogram take?
A routine screening exam generally takes 15 minutes, or less for a routine digital
screening exam.
When is an ultrasound performed and why is it used?
Breast ultrasound uses sound waves, rather than x-rays to image the breast. If a mammogram film shows a mass, or if there is a palpable lump on the breast, this study is performed to determine if the mass is cystic or solid. Sometimes, an ultrasound can help suggest whether or not a mass is suspicious.
Ultrasound does not use radiation. It is often the first breast-imaging test in women under the age of 35 with a palpable finding. Ultrasound may also be helpful in assessing breast pain.
Ultrasound does not replace mammography, but can be used in conjunction with Mammography to obtain additional diagnostic information.
Is mammography safe?
Yes, but be sure to have your mammogram at fully accredited facility that uses digital technology.
Norwalk Radiology and Mammography Center uses state of the art equipment with the lowest possible radiation dose techniques. All of our interpreting radiologists are board-certified by the American College of Radiology and our technologists have advanced certification to perform mammography. Our center is certified by the FDA under the Mammography Quality Standards Act of 1992 and accredited by the American College of Radiology.
Do I need a referral (prescription)?
Although most patients are referred by their physician, you may schedule a mammogram without a referral (prescription). Please be aware that this is subject to the requirements of your insurance carrier or HMO, so check with them first to verify the applicable rules and coverage. The results of your exam will be sent to your physician.
If you have had mammograms in the past at any other facility, you will be asked to bring the films with you to your scheduled exam. These films help the radiologist do a comparison and look for any changes in the breast.
Why do you need my old mammograms?
Just as a person's fingerprints are unique, so too are a person's breasts. What is normal in one person may be abnormal in another. The best way for the radiologist to know that a mammogram is normal is to confirm stability from year to year.
Why would the radiologist order a follow-up mammogram in six months, rather than a year?
If you have a condition that appears benign, our radiologists may recommend a six-month follow-up examination, to more closely monitor the condition and to confirm stability.
Does a mammogram find all breast cancer?
Mammography is the best test available, but it is not perfect. Between 10-15% of breast cancers may not show up on a mammogram. (But 85-90% do!) This makes breast self examination very important. If you have any questions, do not hesitate to ask us, or your doctor. The best way to detect breast cancer early is with combination of tests: your self-examination, your doctor's examination, and frequent mammography.
What do the terms "fatty breast" and "dense or fibrocystic breast" mean?
The breast is composed of glandular tissue and adipose, or "fatty" tissue. Each woman has a unique combination of fatty and glandular tissue, predominantly related to her genetic makeup. However, as a patient ages, or gains substantial weight, she may develop more fat in the breasts.
"Dense" or "fibrocystic" refer to how much glandular tissue is present in the breast. The more you have, the denser it will appear on the mammogram and feel with the physical examination. This is predominantly a genetic trait and not related to diet or other factors, and affects 50 to 60 percent of all women.
"Fibrocystic changes" are a benign condition of the breast and range from a lumpy bumpy feeling on physical examination, to cyst (fluid filled sac) formation within the breast. The breasts may become fuller and more tender the week or so before menstruation. Some women have severe tenderness, swelling or even pain off and on all month.
What are breast microcalcifications?
Microcalcifications are tiny deposits of calcium in the breast, usually of varying shape, size and location. Although breast calcifications are usually benign, changes in the pattern, or new calcifications may indicate the presence of a small or developing breast cancer, or even a pre-cancerous condition. If calcifications are stable from year to year, or clearly benign, no biopsy is necessary. In other cases, a radiologist may recommend a biopsy to determine the cause of the calcifications.
What is a solid lump or nodule?
A solid lump or nodule refers to a mass within the breast that contains solid tissue. A lump or nodule could represent a rounded clump of normal tissue, a fibroadenoma (a benign tumor), or possibly a malignancy. These conditions often require further evaluation, such as ultrasound or biopsy.
What if I find a lump while I am pregnant?
If you find a lump or a mass, do not ignore it. See your physician immediately. Often an ultrasound (which uses sound waves, rather than x-rays) can be performed for initial evaluation. If a mammogram is necessary, it is usually safe for the fetus, especially after the 14th week of pregnancy, with the abdomen shielded by a lead apron.
Can I have a mammogram while I am nursing?
If you have a breast lump, or other problem, it is safe to have a mammogram, or an ultrasound during lactation/ nursing, to evaluate the problem. If you are scheduled for a routine, or screening examination, it is best to wait approximately six months after terminating nursing. This allows the changes in the breast from pregnancy and nursing to resolve.
What if I have breast Implants?
According to the latest literature, breast implants neither increase nor decrease a woman's risk of breast cancer. Women with implants should obtain a mammogram, according to the same recommendations as women without breast augmentation. Women who have implants do require specialized views, called Eklund or displacement views, where the implants are gently pushed back to visualize as much breast tissue as possible. The risk of rupturing the implant is minimal.
What should I do to prepare for a mammogram exam?
No specific preparation is required. Please do not use powders, talc, lotion or deodorant on the breast and in the underarm area. For your comfort and convenience, two piece outfits are recommended.
If you have had mammograms in the past at any other facility, you will be asked to bring the films with you to your scheduled exam.
What is digital mammography?
Digital mammography is similar to standard mammography in that x-rays are used to produce detailed images of the breast. The difference is that digital mammography is equipped with a digital receptor and generates computerized images immediately instead of a film cassette that needs to be developed into a film. A similar comparison is a standard camera to a digital camera. We are the first and only site in Connecticut to offer digital mammography with computer-aided detection (CAD).
What is computer-aided detection or CAD?
Computer aided detection or CAD is a sophisticated computer program that is linked to the digital mammography system and that has been shown in studies to increase the accuracy of mammography by up to 20%. After the radiologist has processed the digital breast images on the monitor and done the interpretation, CAD is activated. The system scans the images and alerts the radiologist to take a second look by flagging any potentially suspicious areas. The radiologist then reviews these areas again to determine if they need further study. CAD is like having a second set of trained eyes reviewing every mammogram. By detecting early or subtle changes, CAD can allow for earlier intervention and greater chances for cure.
What is the difference between traditional (analog) and
digital mammography?
Analog mammography uses x-ray to record images on film using an x-ray cassette. Films are then "developed" and produced and put on a light box and read by the Radiologist. With Digital mammography the x-rays produce a digital image on a screen while the patient is still in position. The technologist has the ability to review these in "real time" to determine image quality. Once completed the images are sent to the radiologist electronically at a reading station where they can manipulate, view and magnify areas of breast tissue. This enhances the information available for reading and interpretation. From the patient's perspective there is little difference because the exam is conducted in a similar way except that the exam is shorter in length. Compression of the breast is required for both digital and analog mammography.
Is digital a better technology?
While analog mammography is still a sound and reliable exam, digital mammography offers a new ability to process and view the images. This results in shorter exam time for the patient, and greater flexibility for the radiologist in interpreting the images. Much like a digital photo, the images can be enhanced, manipulated, and improved by the radiologist, so a digital mammogram can provide more information for diagnosis. Digital technology also offers better visibility of the entire breast. The capabilities of digital mammography result in fewer repeat views, which means less patient exposure.
What if I have dense breasts?
If you have dense breast tissue it is likely that digital mammography will provide better imaging quality for you with reduced radiation dose. This will be reviewed based upon your history and previous mammograms.
(The image to the right illustrates the advantages of digital mammography for dense breasts.)
Does my insurance cover digital mammography and Digital CAD?
As with any exam, you are advised to check with your insurance company prior to coming for your mammogram.
What is the difference between digital mammography and what I had
in the past?
Will you be able to compare past analog mammograms to digital mammograms? Your analog mammogram produced only an analog hard copy film that was read by a radiologist. With a digital mammogram, your image can be read and stored electronically in digital format, and may also converted from a digital image to film for reading and storage. In either case, the images can be compared from exam to exam and from digital to analog.
You will be asked to undress from the waist up and change into a gown. A specially trained female technologist will then position you for the exam.
Computer aided detection or CAD is a sophisticated computer program that is linked to the digital mammography system and that has been shown in studies to increase the accuracy of mammography by up to 20%. After the radiologist has processed the digital breast images on the monitor and done the interpretation, CAD is activated. The system scans the images and alerts the radiologist to take a second look by flagging any potentially suspicious areas. The radiologist then reviews these areas again to determine if they need further study. CAD is like having a second set of trained eyes reviewing every mammogram. By detecting early or subtle changes, CAD can allow for earlier intervention and greater chances for cure.
If you have dense breast tissue it is likely that digital mammography will provide better imaging quality for you with reduced radiation dose. This will be reviewed based upon your history and previous mammograms.