When reading screening mammograms recently, it was both odd and disturbing to find several cancers all in the space of one morning. Upon review, it was discovered that in every case the patient had skipped several years between screening mammograms.
The news was disheartening because when screening mammograms are performed regularly, the chances of detecting cancer early and in its most treatable stages are much greater. Mammograms are one of the most effective diagnostic tools available to women today.
There has been recent confusion about the recommendations for screening mammograms. The American Cancer Society, The American College of Radiology and The Society of Breast Imaging all recommend yearly screening mammograms beginning at age 40 unless the patient is at high risk.
During a routine screening, a technologist will position each breast for a two-view mammogram. Sometimes a third view is necessary. The breasts are compressed to spread out the tissue as much as possible. This will eliminate shadows from overlapping tissue which might mimic a cancer, and it will decrease the amount of radiation needed to take the image. It is not a comfortable procedure, but the better compression obtained, the less likely you will need additional images.
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Usually your screening will be read within 24 to 48 hours. If you are notified that additional images are needed, don't panic. Most additional views are simply for clarification and will turn out to be normal. You will be given your results the same day, both verbally and in writing, as well any follow-up recommendations.
An ultrasound may be needed to clarify if masses are cysts or solid and to further evaluate areas that you may feel on your self breast exam. The ultrasound uses sound waves, so there is no compression.
If there is an abnormality on your mammogram or ultrasound requiring a biopsy, that procedure is performed at the same time as the additional study that confirmed the abnormality. The biopsy may be performed using mammographic images, called a stereotactic biopsy, or by ultrasound. Most biopsies are not cancerous.
Getting a mammogram can be a frightening experience, especially for women who have experienced breast cancer themselves or have supported a loved one through the diagnosis. Keep in mind that most abnormalities found on mammograms are not cancers in the end. The safest thing to do is to continue with mammograms as recommended so that if there is cancer, it can be found early.
Dr. Tamara F. Patsey is medical director of Central Baptist Hospital Breast Imaging Services.