What is Mammography?
Mammography is a specific type of imaging that uses a low-dose x-ray system to examine breasts and is used to aid in the early detection and diagnosis of breast diseases in women.
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 from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 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.
The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 as well as the frequency of screening.
Diagnostic mammography is used to evaluate a patient with abnormal clinical findings. Example: breast lump, nipple discharge, change in skin colour or texture, retraction of the nipple etc.
Diagnostic mammography may also be done after an abnormal screening mammogram in order to evaluate the area of concern on the screening exam.
How is the Mammogram procedure performed?
Mammography is performed on an outpatient basis. During mammography, a specially qualified radiographer will position your breast in the mammography unit. Your breast will be placed on a special platform and compressed with a paddle (often made of clear Plexiglas or other plastic). The radiographer will gradually compress your breast.
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 obscured 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.
The technologist will stand behind a glass shield during the x-ray exposure. Routinely two views of each breast are taken. They are a top-to-bottom view and an oblique side view. You must remain very still and you may be asked to hold your breath for a few seconds while the x-ray image is taken to reduce the possibility of blurring.
The images are then interpreted by a radiologist who may require further views or an ultrasound of the breast, if there is an area of concern. The ultrasound compliments the mammogram, and can pick up abnormalities that are not seen on mammogram, eg, cysts or small masses.
The examination process should take about 30 minutes but there may be a waiting period for the ultrasound.
Contrast-Enhanced Spectral Mammography
In our commitment to diagnostic excellence in woman’s health, Jackpersad & Partners Inc is proud to be the first practice in the country to offer Contrast-Enhanced Spectral Mammography.
Description and Overview
This study is performed as an adjunct to inconclusive mammography and ultrasound studies. SenoBright Contrast-Enhanced Spectral Mammography (CESM) from GE Healthcare can help physicians by providing answers regarding the presence or absence of breast cancer quicker. It can help to minimize the waiting time and anxiety to get test results. Using an iodine contrast agent, SenoBright takes two images per view at different X-ray exposures. It then combines these two images to highlight contrast-enhanced areas of unusual blood flow patterns which may be cause for increased suspicion.
- Simple, quick, five-to-ten-minute procedure is much like a regular mammography exam
- Helps minimize the wonder and the worry of waiting for results
- Exam can be performed with the same mammographic equipment.
- Reach decisions sooner regarding the presence or absence of breast cancer
- Cuts the critical patient waiting time from detection to diagnosis
Relevant Statistics and Trends
- Currently, 20% of all cancers are missed by routine screening mammography
- Of every 1,000 women who undergo routine screening mammograms, 10%, or 100, will be called back for follow-up ultrasound, MRI, or mammographic imaging
- Of those 100 women, 10 will undergo biopsy
- 70% of those biopsies will be negative, with three confirmed cases of cancer
What if you require a biopsy?
- If there is an area of concern, the radiologist may suggest a biopsy to exclude underlying cancer.
- This is a special procedure and may be booked for another day.
- The biopsy may either be done under ultrasound guidance or stereotactic guidance.
- The ultrasound guided biopsy is done under local anaesthetic in the ultrasound room.
- The radiologist uses the ultrasound probe to guide him to the lesion and he can actually watch the needle to confirm that he has biopsied the lesion.
- The stereotactic biopsy, requires a special biopsy apparatus attached to the mammogram unit and is currently only done at our Mediclinic, Westridge, Chatsmed and Hillcrest branches.
- The patient is seated for this procedure X-rays of the area of interest is taken , the area of concern is pin pointed and localized using special techniques and the exact position is determined by the computer and set for the radiologist to biopsy.
- The procedure is quite accurate.
- The specimens are then sent to the laboratory for analysis(Histology).
If on blood thinners: stop for 3 days prior to biopsy
Do INR + platelets either the morning of biopsy, or the day before.
Tomosynthesis is an imaging technique in which multiple X-rays of the breast are taken from a discrete number of angles. These cross-sectional images are used to reconstruct 3-D images of the breast being imaged. Tomosynthesis differs from computed tomography because the range of angles used is less than 360°, which is used in CT. Tomosynthesis is performed in addition to 2D mammography, and aids in further detection of breast lesions.