Breast Imaging

What is a digital mammogram?

A digital mammogram is processed and stored on a computer rather than on film. The image is faster because we no longer have to wait for films to be processed using developer and fixer chemicals. Think of a digital camera versus a 35 mm camera with film. You can almost instantly see the image versus taking the film to the store and waiting for the developing of the films before you can see the pictures.

What is the difference between a screening and a diagnostic mammogram?

A screening mammogram is ordered for someone who is not having any problems and is having the mammogram as part of their routine check up. A diagnostic mammogram is ordered on someone who is having a new problem or symptom in their breast or in patients who have a history of breast cancer. The initial images that are taken are the same, however with a screening mammogram the images are checked for technical quality and the patient is allowed to leave, if additional images are needed the patient is called and asked to return for the additional images or ultrasound. During a diagnostic mammogram a radiologist (physician) will review the images before a patient leaves the clinic and if additional images or ultrasound are needed they will be done at that time.

Why can’t I just have an ultrasound to look for cancer and not have a mammogram?

A breast ultrasound may be helpful in breast imaging; however it is not approved for use in screening for breast cancer. We utilize ultrasound in addition to a mammogram in cases where a patient may have a specific lump in their breast or in cases where a questionable area is seen on a mammogram. We also use ultrasound first in young women under age 30 who have a specific lump in their breast. We do not use breast ultrasound to look at the whole breast instead of using mammography.

Why do you have to compress?

Compression is needed to help spread the breast tissue out, this makes the mammogram clearer and easier to interpret, it helps keep the breast very still so no motion is seen on the image, and also less radiation is needed to penetrate the breast tissue.

I thought there was a new mammogram where you did not have to be compressed (squished)?

All mammogram systems involve the use of compression.

Does the compression from the mammogram cause breast cancer?

No, the compression of breast tissue needed for a mammogram does not cause breast cancer.

I have implants. Will the mammogram rupture them?

If you have implants, we will take images that include the implant using light compression. We then take images called implant displacement images, and for these images, we compress the breast tissue that is lying in front of the implant.

Why is there a chance I may have to come in for another mammogram or a breast ultrasound?

When you have a screening mammogram, the radiologist may feel that there is an area that is questionable or possible abnormal; the radiologist will recommend additional mammogram images or possibly an ultrasound. This occurs in about 5-10 % of screening mammograms. Once you return for the additional imaging with ARA, you will usually receive verbal results at the time of imaging.

What is CAD?

Computer-aided detection or CAD is a system that has been developed that analyzes a mammogram and marks areas that the algorithms may show to be abnormal. The radiologist makes the final decision and interprets the mammogram. CAD is similar to a spell checker on a computer, it marks words that the software feel may be misspelled, however it is up to the writer to determine if the word is really wrong or if it is correct.

What is breast tomosynthesis (3D mammography)?

Breast tomosynthesis is an enhanced mammogram that gives radiologists the ability to view inside the breast layer by layer. During this simple exam, multiple images, or “slices,” are taken of different angles of the breast, exposing fine details that might be obscured by overlapping tissue. Breast imaging radiologists can now view a mammogram in a way never before possible. The experience of getting breast tomosynthesis is very much like getting a standard mammogram.