Breast Mammography

The physicians of Professional Radiology Inc. provide imaging services for women at the following locations:  The Christ Hospital Women's Imaging Center, The Fort Hamilton Hospital Women's Health Choice, The Jewish Hospital Breast Center, and West Chester Medical Center Women's Health Services.

Radiologists are doctors who have become specialized in all areas of imaging the body.  This specialization includes being able to perform biopsies of tissues that need imaging guidance and diagnosing abnormalities.  Radiologists are trained in radiation safety issues as well as the methods of acquiring images.  Radiologists must earn a medical degree and then follow the medical degree with four to six years of specialized training.  For those who read mammograms, they must have received additional training specializing in breast imaging.  For certification to be maintained to read mammograms, physicians must read a specific number of mammograms annually, continue their education with credits related to mammography, and be subjected to medical audits.  Results are then compared to both local and national results. 

Each Professional Radiology Center has an R2 ImageChecker, which is another set of eyes for the radiologists performing mammograms.  The computer aided detection system is responsible for converting mammograms into digital format and performing over a billion analyses in order to outline any suspicious areas.  This means that it will highlight any suspicious areas that should be looked at again by the radiologist.  All screening mammograms as well as most diagnostic mammograms are double read by this special second set of eyes, the R2 ImageChecker. 

A mammogram is a radiographic image that demonstrates the internal structure of the breast in picture form.  Diagnostic and screening mammograms are the two types that are performed. 

A screening mammogram is performed on women that have had no evidence of any breast disease.  A radiologic technologist will use a mammography machine to obtain two views of each breast.  This is an ideal way to screen for breast cancer early.  This is similar to other screening exams, such as a PAP smear for women, PSA for prostate cancer, glucose test for diabetes, or fecal occult blood to detect colon cancer.  Once a woman turns forty, she should have a yearly screening mammography as a routine procedure.  Earlier screening may be a priority for women with a strong family history of premenopausal breast cancer. 

Diagnostic mammography is different from a screening mammography because this occurs when there is a possible abnormality already detected, such as a lump on the screening mammogram or clinical examination of the breast.  This includes special views so that the abnormality can be evaluated more effectively.  This type of mammogram will be read by the radiologist at the time the exam is conducted. 

If you have an abnormal screening mammogram, this means that further evaluation will be necessary to see if it is suspicious.  This may mean that an ultrasound, physical exam, or MRI exam is necessary.  Most abnormal findings are benign, but if they are not found to be benign, a follow-up study or a biopsy may be needed. 

When preparing for your mammogram, try to schedule an appointment at a time in which your breasts are least likely to feel tender.  This is usually during the week following your menstrual period.  You should avoid using powders, lotions, creams, perfumes, deodorants, or antiperspirants under your arms or breasts.  This is because the metallic particles from deodorants or powders could be seen on your mammogram, causing confusion. 

When you arrive, you will be given a gown to wear and you will need to remove any neck jewelry or clothing from the waist up.  When it is time for the procedure, you will stand in front of an X-ray machine and the technician will place one of your breasts on a platform that holds the X-rays film and will raise or lower the machine's platform to match your height.  Your breast will be pressed against the platform by a plastic plate.  There will be pressure that is applied for only a few seconds in order to spread out the tissue of the breast.  You may find this feeling uncomfortable or painful. The entire procedure usually takes no more than thirty minutes. 

Once the test is complete, images will be made of your breasts.  A radiologist will interpret the resulting images and send a report to your doctor.  The radiologist will look for evidence of noncancerous or cancerous conditions that may need more testing or treatment.  If the radiologist observes areas of concern on your mammogram, you may need to have further testing.  This may involve more mammograms, such as compression or magnification views or biopsy, or ultrasound imaging.  Sometimes an MRI may be needed.

It is important to remember that nearly all women have calcifications, lumps, or abnormal densities found on their mammograms.  It is so important that your prior mammograms be present for the radiologist because the doctor will be able to use these prior tests to determine if the abnormality has changed compared to other mammograms.  If there are no suspicious features found, your doctor may want a follow-up study in six to twelve months in order to determine whether or not the area has changed. 

There are two types of breast biopsies.  The first is a cyst aspiration, and this is when a small needle will be used to draw fluid out of  a cyst.  This is common if a cyst is symptomatic or atypical in its appearance.  A core needle biopsy is another type of biopsy in which local anesthetic will be used to sample cells from an abnormality in the breast. 

It is very important that you have regular mammograms.  If cancer is found, the earlier the stage in which it is detected, the greater chance that the cancer will be curable.  One of the physicians at Professional Radiology can assist you with finding a surgeon.