Digital Mammography
Also called 3-dimensional mammography or breast tomosynthesis, 3D mammography is an imaging procedure that uses x-rays to take multiple pictures inside the breast at different angles. These x-rays are used to create 3D images of the breast as well as providing a reconstructed 2D image of the inside of the breast. These 3D images may show breast cancer and other changes in the breast, such as abnormal lumps, cysts, or calcifications (calcium deposits) and dense breast tissue better than traditional 2D mammography.
The digital screening mammogram uses X-rays to create a digital image of the breast, which is viewed on a computer monitor. At Oregon Imaging Centers, all our mammography suites contain full-field digital systems and we provide 3D imaging for all of our patients. The software that Oregon Imaging implemented is a low dose x-ray using 3D technology as well as a reconstructed view that together allow the radiologist to see in and around structures within the breast. This allows for a more complete exploration of anomalies without a biopsy or other intervention.
The benefits of having a digital mammogram include better imaging of dense breast tissue and the chest wall, shorter exam times and a lower radiation dose. Both 2D and 3D are conducted using digital technology and both are effective for women with and without dense breast tissue.
The digital screening mammogram uses X-rays to create a digital image of the breast, which is viewed on a computer monitor. At Oregon Imaging Centers, all our mammography suites contain full-field digital systems and we provide 3D imaging for all of our patients. The software that Oregon Imaging implemented is a low dose x-ray using 3D technology as well as a reconstructed view that together allow the radiologist to see in and around structures within the breast. This allows for a more complete exploration of anomalies without a biopsy or other intervention.
The benefits of having a digital mammogram include better imaging of dense breast tissue and the chest wall, shorter exam times and a lower radiation dose. Both 2D and 3D are conducted using digital technology and both are effective for women with and without dense breast tissue.
Our Breast & MRI Center provides you with easy access to a ‘patient navigator’ who provides support, guidance and information if you require services beyond a screening mammogram. Comforting and empowering, this reassuring woman-to-woman support helps patients confidently address the next steps in diagnosis and treatment.
The process of a mammogram is the same regardless of whether you are having a 2D or a 3D exam: You will change into a gown that opens in the front, and a specially trained and certified technologist will take care of you during your mammography exam. The technologist will position you and place your breast on a platform, compressing it with a paddle made of plexiglass and will gradually apply pressure until the breast is fully compressed. Please inform the technologist if you experience sudden or sharp discomfort during your imaging, or if there is a chance you could be pregnant. To lessen the discomfort of a mammogram, our staff uses a pad between you and the mammography machine. The imaging itself takes just a few moments but the entire process takes 20 minutes.
If you wear deodorant or use talcum powder, you’ll be asked to remove it at the clinic. We recommend you wear a two-piece outfit since you will be asked to remove your clothing from the waist up.
Prep Forms
You will receive a letter with the results of your mammogram in about five days. A copy will also be provided to the physician you indicate. Your letter will also indicate your breast density.
About Breast Density
Oregon State law SB 420 requires that women be told after a mammogram if they have “dense breast tissue”. Women with this type of breast tissue may be at higher risk for breast cancer. Every woman who receives a mammogram at Oregon Imaging Centers (or at any clinic in Oregon) will receive information about her breast density in her mammogram results letter.
If you do have dense breast tissue, your letter will also explain the risks of breast cancer and what to do. It will explain that:
- Dense breast tissue makes it harder to see small growths, which may be breast cancer.
- Women with dense breasts may want to have a screening in addition to mammography. Ultrasound and MRI are options for further screening.
- You should talk to your doctor about this. Each care plan depends on your particular medical history.
If you do not have dense breasts, your letter will indicate this. This is for your information only; no action is necessary.
Q. What is breast density?
A. Breast density is the percentage of fibrous and glandular tissue in the breast. The higher the percentage of this type of tissue, the more “dense” the breast. All types are normal.
Q. If I have dense breasts, should I continue to get an annual mammogram, or do something additional?
A. Regardless of your breast density you should get a mammogram every year starting at age 40. The American Cancer Society and the American College of Obstetrics and Gynecology; among others – all recommend women have annual-mammograms starting at age 40. Mammograms continue to be the best tool to identify breast cancer. If you and your physician choose additional screening mechanisms they will augment your mammogram, not replace it.
Q. I’ve never heard of breast density before and I’ve been having mammograms for years. Why now?
A. Oregon law SB 420 is new; it took effect January 1, 2014.
Q. What does “dense breast tissue”” mean or indicate?
A. We notify you of your breast tissue density after each mammogram. The significance of breast density varies depending on your age and health history. Mammography – even digital mammography – does not image dense breast tissue as clearly as typical tissue. Because of this, depending on your risk for breast cancer, your physician may recommend ultrasound or MRI screenings of your breasts instead of mammography. You can use this tool to assess your breast cancer risk. Read more about density here.
Q. Are there certifications for this procedure?
A. Oregon Imaging Centers is MQSA-certified, which confirms we meet all the requirements of the Mammography Quality Standards Act. The standards for the Center of Excellence certification are particularly rigorous. This certification is awarded to breast imaging centers that achieve excellence by seeking and earning accreditation in all of the American College of Radiology’s voluntary breast-imaging accreditation programs and modules, in addition to the mandatory Mammography Accreditation Program.
Q. If 3D mammography is so much more accurate than 2D, why would I choose to have standard, 2D mammography?
A. The most common reason to opt for 2D is that your insurance may not cover a 3D screening and analysis. There are two components to a mammogram bill: the imaging and the interpretation. Make sure your insurance provider will cover both. You can certainly have a 3D mammogram without coverage, but contact us to avoid billing surprises.
Q. Why does the mammogram require applying such pressure to my breasts?
A. Breast tissue is composed of super-imposed glandular tissue. Compression is used to keep each breast from moving, to reduce the amount of radiation used for the exposure, and to spread the breast tissue, making it easier to detect small cancers. Compression can make the difference between finding and missing a tiny cancer.
Q. What is the recommended age for annual mammograms?
A. If you are age 40 or over, you should have an annual mammogram. The only exception to this is if you have a family history of breast cancer, in which case you should discuss a schedule with your physician, and plan to start your mammograms earlier. Read more about why 40 is the best time to start annual screenings.
Q. What can I do to make the experience more comfortable?
A. If you have sensitive breasts, take Advil or Tylenol in advance of your appointment. If you are pre-menopausal and have breast pain related to your menstrual cycle, you may want to schedule your screening mammogram for the week following your period when breast tissue may be less tender. If possible, avoid scheduling your mammogram the week prior to your period. If you wear a two-piece outfit, you will be able to wear your pants or skirt during the procedure.
Screening Mammogram
How it works: The digital screening mammogram uses X-rays to create a digital image of the breast, which is viewed on a computer monitor. At Oregon Imaging Centers, all our mammography suites contain the latest state-of-the-art full-field 3D digital systems.
Digital mammography uses low-dose X-rays to capture images of the breast that are read by our highly specialized radiologists. Benefits of having a digital mammogram include better imaging of dense breast tissue and the chest wall, shorter exam times, and a lower radiation dose.
Why we do it: Mammography is the “gold standard” for screening and detecting breast cancer. It is important to emphasize that although mammography is an excellent screening test that can demonstrate most breast cancers, it is not a perfect test. In some women with breast cancer, mammograms may appear to be normal. For this reason you should notify your doctor, or us, if you notice a change in your breast or if you feel a lump or an area of thickening in either breast.
The experience: For a screening mammogram, you will change into a gown that opens in the front, and a specially trained and certified technologist will take care of you during your mammography exam. The technologist will position you and place your breast on a platform, compressing it with a paddle made of plexiglass and will gradually apply pressure until the breast is fully compressed. Please inform the technologist if you experience sudden or sharp discomfort during your imaging, or if there is a chance you could be pregnant. To lessen the discomfort of a mammogram, our staff uses a pad between you and the mammography machine. The process takes 20 minutes.
Prep & safety: If you wear deodorant or use talcum powder, you’ll be asked to remove it at the clinic. We recommend you wear a two-piece outfit since you will be asked to remove your clothing from the waist up.
Your results: You will receive a letter with the results of your mammogram in about five days. A copy will also be provided to the physician you indicate. Your letter will also indicate your breast density.
Diagnostic
How it works: A diagnostic mammogram begins with the same technology as a screening mammogram, but is focused on a particular area of interest. A diagnostic mammogram may require additional imaging and a breast ultrasound. A breast imaging radiologist is present in our facility to oversee the study and determine if any additional images need to be done.
Why we do it: Diagnostic mammograms require a physician’s order and are for patients with breast symptoms such as a new lump, nipple discharge, or skin dimpling. Patients who have been diagnosed with breast cancer also have diagnostic mammograms for their first five years after diagnosis. Symptomatic patients must notify their doctor of these concerns prior to having a diagnostic mammogram.
The experience: A diagnostic mammogram begins with the same technology as a screening mammogram. A diagnostic mammogram may require additional imaging and a breast ultrasound. A breast imaging radiologist is present in our facility to oversee the study and determine if any additional images need to be done.
Prep & safety: If you wear deodorant or use talcum powder, you’ll be asked to remove it at the clinic. We recommend you wear a two-piece outfit since you will be asked to remove your clothing from the waist up.
Your results: A breast imaging radiologist will discuss findings, options and recommendations, and answer questions before you leave our Breast Center. Results will also be provided to your physician or a specialist.
Additional views
How it works: During this process, the technologist will image a very specific area of your breast, focusing on any possible abnormalities. The additional view allows us to determine whether further study is recommended or if it is simply an abnormality that is benign.
Why we do it: Sometimes after your screening mammogram, the radiologist may see an area that requires further evaluation. “Additional views” are requested if a typical screening mammogram is inconclusive. This type of imaging is done using mammography or sometimes, ultrasound.
The experience: Additional views utilize focused imaging techniques to look at specific areas of the breast. This focused imaging requires the use of a smaller compression plate. This can be more uncomfortable than a traditional screening. With this in mind, our staff makes your comfort our priority.
Prep & safety: If you wear deodorant or use talcum powder, you’ll be asked to remove it at the clinic. We recommend you wear a two-piece outfit since you will be asked to remove your clothing from the waist up.
Your results: A breast imaging radiologist will discuss findings, options and recommendations, and answer questions before you leave our Breast Center. Results will also be provided to your physician or a specialist.
Needle Localization
How it works: Using images from a mammogram or ultrasound, a radiologist places a needle with a wire in the previously biopsied area. The needle is removed and the wire is left to guide the surgeon. A mammogram is used to confirm the location of the wire placement. After the placement is confirmed you will be transported to surgery.
Why we do it: If an abnormality was biopsied and it has come back either atypical or as cancer a needle localization is performed prior to surgery.
The experience: To make this procedure as comfortable as possible, you will be given a local anesthetic (Lidocaine) to numb the area to be localized. You will be awake during the procedure, and our staff will monitor and assist you throughout the procedure. When the procedure is complete, we will escort you to the surgical center.
Prep & safety: If you wear deodorant or use talcum powder, you’ll be asked to remove it at the clinic. We recommend you wear a two-piece outfit since you will be asked to remove your clothing from the waist up.
Your results: A breast imaging radiologist will discuss findings, options and recommendations, and answer questions before you leave our Breast Center. Results will also be provided to your physician or a specialist.
Stereotactic Breast Biopsy
How it works: A stereotactic breast biopsy uses a hollow biopsy needle to obtain a tissue sample. A digital mammogram is used to ensure that the hollow biopsy needle is targeted to the precise location of interest. When the needle is inserted, another set of images is acquired to confirm positioning, and then the tissue sample is removed.
Why we do it: A Stereotactic Breast Biopsy is a minimally invasive surgery used to obtain a small tissue sample, which can be evaluated by a pathologist to determine the presence of cancerous tissue.
The experience: To make this procedure as comfortable as possible, you will be given a local anesthetic (Lidocaine) to numb the area to be biopsied. You will be awake during the procedure, and our staff will monitor and assist you throughout the procedure.
When the procedure begins, the technologist will help you lie on your front on the stereotactic table with one breast positioned through an opening in the table. (If you will need medication to hold still or calm your nerves, we will help you obtain a prescription for oral medication from your physician.)
A digital mammogram will be obtained in this position and used to ensure that the hollow biopsy needle is targeted to the precise location of interest. Once the needle is inserted, another set of images are acquired to confirm positioning, and then the tissue sample is removed.
When the procedure is complete, the area(s) biopsied will be bandaged with steri-strips (butterfly band-aids). Before discharging you, we will review after-care instructions with you, and provide you with an ice pack to reduce the discomfort and bruising. Please note that bruising and discomfort is to be expected.
Prep & safety: Please arrive 30 minutes before your scheduled appointment time. Arrange for a family member or friend to accompany you. We require you to have a driver before being discharged.
Your results: The samples will be sent to pathology and the results will be sent you your physician as well as Oregon Imaging Centers in 2-3 days.
