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Mammography

Last updated Jan. 18, 2019

Approved by: Maulik P. Purohit MD MPH

Blausen.com staff. "Blausen gallery 2014

A Mammography (or X-ray of the Breast) is an imaging technique that uses low-dose X-rays to examine the breasts and detect breast disease early.


Background Information:

What are the other Names for the Procedure?

  • Breast X-ray
  • Digital Mammography
  • X-ray of the Breast

What is Mammography radiology procedure? (General Explanation)

  • A Mammography (or X-ray of the Breast) is an imaging technique that uses low-dose X-rays to examine the breasts and detect breast disease early
  • The technique involves a Digital Mammography and computer-aided detection (CAD)
  • Computer-aided detection:
    • CAD identifies areas of abnormal mass, density, or calcification in the breast that may indicate the presence of breast cancer
    • CAD highlights these areas on the images for analysis
  • Digital Mammography:
    • It is also known as Full-Field Digital Mammography (FFDM)
    • Instead of using X-ray film, FFDM uses solid state detectors that convert x-rays into electrical signals
    • These electrical signals are used to produce images of the breast

What part of the Body does the Procedure involve?

A Mammography procedure involves the human breasts.

Why is the Mammography radiology procedure Performed?

A Mammography is used for the following:

  • Early detection of breast cancer in women experiencing any symptom, or no symptoms at all
  • Any kind of abnormal changes in the breasts that cannot be felt by the patient or physician
  • Annual checkups for women, over the age of 40 years
  • Women, who previously had breast cancer, or those who have a higher genetic risk of getting breast cancer may need to start screening before age 40 years, according to medical expert’s advice
  • To examine the effectiveness of breast cancer treatment

The patient may need to go through a diagnostic Mammography, if they have an abnormal screening mammogram, or abnormal clinical findings, such as breast lumps.

What is the Equipment used? (Description of Equipment)

The equipment used for a Mammography is described below: 

  • It is a rectangular box, which produces X-rays
  • The box is attached to a device that can hold and position the breast, so that images can be obtained from different angles
  • The device allows only the breasts to be exposed to the X-rays

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Mammography procedure.

What is the Cost of performing the Mammography radiology procedure?

The cost of a Mammography procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities. 

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding a Mammography procedure and what needs to be done.
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician.
  • Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently.

What are some Helpful Resources?

http://www.cancer.gov/cancertopics/factsheet/detection/mammograms

http://womenshealth.gov/publications/our-publications/fact-sheet/mammograms.html

Prior to Mammography radiology procedure:

How does the Mammography radiology procedure work?

X-rays produced by the mammogram device, passes through body part (breasts) and produces images on a recording plate.

How is the Mammography radiology procedure Performed?

  • The Mammography is an outpatient procedure
  • The breasts are positioned on a platform and gradually compressed, so that even small abnormalities can be visualized. Due to this only a low dose of X-ray is required
  • The patient will be asked to stay still during the imaging procedure, so as to prevent blurring of the image
  • They may be also asked to change positions, in order to obtain images from different angles

Where is the Procedure Performed?

The Mammography is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

A qualified radiologic technologist (RT) will perform the Mammography procedure.

How long will the Procedure take?

The procedure may take about 10-15 minutes to perform. However, there may be some waiting time involved, before and after the procedure and the patient may be in the clinic for up to an hour.

Who interprets the Result?

  • The radiologist interprets the results from a Mammography and informs the primary care physician, who then informs the patient
  • The patient may be asked for follow up exam, if there is a suspicious finding that needs to be clarified, or in order to see the progress of a treatment
  • A detailed report of the mammogram should be given by the physician within 30 days

What Preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Mammography procedure:

  • Do inform your physician about any abnormal findings or problems in the breasts, any past surgeries, family and personal history of breast cancer, pregnancy, and hormonal use
  • It is recommended that you avoid using any cosmetic lotions, deodorant, or talcum powder on the breasts, as these may appear as calcium spots on a mammogram
  • The recommended time to get a mammogram is a week after your period. Do not schedule a mammogram, if your breasts are tender, just before the period
  • It is advisable to make all previous mammograms available to your physician, during the time of the exam, if possible
  • You shall be informed of the results, even if a mammogram is normal. In case you do not hear about the exam results, please make sure to inquire your healthcare provider about it

What is the Consent Process before the Procedure?

A physician will request your consent for a Mammography procedure using an Informed Consent Form. 

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent. 

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of the procedure:

  • Helps in an early detection of breast cancer; can detect ductal carcinoma, invasive ductal, and invasive lobular cancer
  • Radiation from the procedure does not remain in the patient’s body and generally, there are no side effects observed

Following are the risks of the procedure:

  • There is a very minimal chance of getting cancer from excessive exposure to radiation
  • There is a chance of false positive mammograms, where tests are positive, even though there is no risk of cancer. In such cases, the patients may have to go through additional imaging tests or biopsies, to confirm the absence of cancer
  • It is highly advised that women inform their doctors if they are pregnant, prior to the procedure

What are the Limitations of the Mammography radiology procedure?

Following are limitations of the Mammography procedure:

  • Mammograms alone are not enough to determine, whether a breast cancer is benign or malignant. Further tests may be required for a definitive diagnosis
  • Not all cancers are visible on mammograms
  • Talcum powders or deodorants applied to the breasts, may give false positive results
  • It may be hard to obtain an accurate mammogram, if the patient has implants; silicon and saline implants may block the view of breast tissues behind them
  • In case of breast implants, the patient should inform their doctor or radiologic technologist in advance about the implants, so that accurate mammograms may be obtained

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

  • What is a Mammography procedure?
  • Why is this procedure necessary? How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • What are the possible side effects from the procedure? How can I minimize these side effects?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any lifestyle restrictions or modifications required, after the procedure is performed?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Is there any medication that needs to be taken for life, after the procedure?
  • What are the costs involved?

During the Mammography radiology procedure:

What is to be expected during the Mammography radiology procedure?

  • The individual will feel pressure on their breast, as the breast is compressed on the device platform. This may lead to some discomfort
  • In case of pain during the procedure, they should notify the technologist to use less compression

What kind of Anesthesia is given, during the Procedure?

A local anesthetic is applied to the breast, during the procedure.

How much Blood will you lose, during the Procedure?

There is no blood loss involved, during a Mammography procedure.

What are the possible Risks and Complications during the Mammography radiology procedure?

The following risks are possible during the procedure:

  • There remains a slight possibility of cancer occurrence, due to radiation exposure
  • False positive results may unnecessarily lead to additional testing and diagnostic procedures

What Post-Operative Care is needed at the Healthcare Facility after the Mammography radiology procedure?

Generally, no significant post-operative care is needed at the healthcare facility.

After the Mammography radiology procedure:

What is to be expected after the Mammography radiology procedure?

Generally, no complications or side effects are observed after the procedure.

When do you need to call your Physician?

Some individuals may experience a little discomfort and pain in their breasts after the procedure, for a short period; do contact your physician if the need arises in such a case.

What Post-Operative Care is needed at Home after the Mammography radiology procedure?

No specific post-operative care is needed at home after the procedure. The patient may resume their normal activities, after a Mammography.

How long does it normally take to fully recover, from the Procedure?

The patient should fully recover within 24 hours and be able to resume their normal activities.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

A Mammography procedure does not involve the removal of any body tissue. No tissue is extracted during a mammogram.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from, after the Mammography radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the health care facility has with the physician and other health care providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The hospital, where the procedure is performed
  • Interventional radiologist, performing the procedure
  • Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Mammography procedure is performed.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: March 20, 2014
Last updated: Jan. 18, 2019