Breast Imaging FAQ
Q: Why should women get mammograms and what role do mammograms play in women's health?
A: Breast cancer is the most common cancer in U.S. women and is the 2nd leading cause of cancer death. One in 8 women in the United States will develop breast cancer in her lifetime. Because of this, early detection of breast cancer is key.
Screening mammograms have proven to decrease the number of deaths from breast cancer. They provide the best chance of detecting breast cancers when they are small and treatable. If we detect breast cancers when they are small and early-stage, more lives are saved, and women are able to undergo less extensive surgeries and system therapies. I recommend women have a screening mammogram every year beginning at age 40. This screening regimen saves the most lives.
Q: How do mammograms work, and how much information can they provide?
A: A mammogram unit is a machine that takes a low dose X-ray of the breast. The breast tissue is held in compression for a brief time during the X-ray exposure to allow for a high-quality image. Mammogram images provide essential information to the radiologist. A radiologist will evaluate the images for anything new or suspicious, such as masses or calcifications. We can also determine a woman's breast density on a mammogram.
Q: What is breast density and why is it important?
A: Breast density refers to the overall amount of breast tissue relative to fatty tissue in the breast. Breast density is a mammographic finding determined by a radiologist.
Women with dense breast tissue have a higher risk of breast cancer, and it is more difficult to detect on a mammogram if a woman has dense breast tissue. These women may benefit from additional, supplemental screening exams such as screening breast ultrasound or breast MRI.
We offer a screening ultrasound to all women with dense breast tissue, and we have also made screening breast MRI more accessible by offering a new exam called abbreviated breast MRI. Breast MRI is our best test for detecting breast cancer. However, it is not very accessible to women due to its prohibitive cost and long exam time. Abbreviated breast MRI is a much faster exam, less than 10 minutes, and it is also much cheaper than a traditional MRI. The women most likely to benefit from supplemental screening are women who have a high lifetime risk of breast cancer or women with dense breast tissue.
Q: What are 3D mammograms?
A: 3D mammograms are the most advanced technology available for mammogram screening. 3D mammograms are performed on the same machine women are used to. The only difference women may notice is the X-ray tube moves in a limited arc around the breast while the image is being obtained. The breast tissue is still held in brief compression during the X-ray exposure, and there is no notable change in length of the exam. A 3D mammogram provides a radiologist with more images of each breast, which allows for a more thorough evaluation of breast tissue.
Q: Are they more effective than regular mammograms and, if so, why?
A: Yes. 3D mammograms allow a radiologist to detect additional cancers that would not have been seen on 2D mammograms. 3D mammograms also decrease the number of unnecessary callbacks for additional imaging. It is very common to ask a woman to return for additional images following a screening exam, and having a 3D mammogram makes this a less likely occurrence.
Q: There may be slightly higher levels of radiation with 3D. Is this something to be concerned about?
A: The radiation dose from a screening mammogram is very low. The benefit of screening far outweighs the risk of low-dose radiation exposure from a mammogram.
The radiation dose from a 3D mammogram is similar to a 2D mammogram. Currently, radiologists must interpret 3D images with a 2D image. If a facility performs both a 3D mammogram and a 2D mammogram during a patient exam, the radiation dose is approximately doubled. The FDA has approved a synthetic 2D mammogram, which is created from the 3D images, and therefore eliminates the need to perform an additional 2D mammogram. We have this advanced technology that allows us to create a synthetic 2D image so our patients do not have any significant increase in radiation dose with 3D mammograms.
Q: Who should get 3D mammograms?
A: All women benefit from 3D mammograms, and we recommend 3D mammograms to all our patients.
Q: Some women reading this may be fearful of mammograms. Could you tell us what happens during a mammogram?
A: Upon arrival for a mammogram, a woman will be asked to:
- Complete a short medical history form that provides the radiologist with information about the patient's breast cancer risk and prior breast surgeries.
- Change into a gown in a private dressing room. A patient only needs to undress from the waist up.
The technologist will:
- Escort the patient into a private room where the exam is performed. The technologist will talk the patient through the entire exam and will position the patient for all images.
- The breast will be held in brief compression while each image is being taken. The compression should be firm, and it may be slightly uncomfortable but should not be painful.
It's important for women to communicate with the technologist during the exam if something is bothering them or if they have neck, shoulder or back problems that make the exam more difficult. The patient will likely be asked to hold her breath for a moment during the X-ray. The entire exam is often lasts less than 15 minutes.
Q: There are many women who avoid mammograms, either out of fear or discomfort. What would be your message to them?
A: The anxiety and fear of dying from breast cancer is much greater than the short-term anxiety that may accompany a mammogram. Breast cancer is very common, and early detection of breast cancer saves lives.
The best way to detect breast cancer early is by screening. Schedule your screening mammogram if you are 40 or older and have not had a screening mammogram within a year. Communicate your concerns and fears with the technologist performing your mammogram so they can help make the exam comfortable for you.
Q: How reliable are mammograms in cancer screening? Has the technology improved over time?
A: Mammogram technology has significantly improved since the 1980s. Digital mammography has almost entirely replaced analog film, and increasing numbers of mammography facilities are offering 3D technology. For the most reliable exam, schedule your breast imaging exams at a Breast Center of Excellence that offers the best technology available and employs dedicated breast radiologists who are experts in breast cancer detection. Quality and expertise are essential to getting the most accurate results.