Mammograms 101: Your Guide to Breast Imaging

Stephanie Carr, RT (R) (M), is a registered radiologic technologist with specialized training in mammography. She is the Mammography Team Leader for Inova Loudoun Hospital and ILH’s associated outpatient imaging centers in Ashburn, Leesburg and Dulles South.

This month, in honor of Breast Cancer Awareness Month, why not take a cue from the pink ribbons you’ve been seeing around town? Take control of your breast health by scheduling a mammogram.

If you’ve never had one, a mammogram can seem intimidating. But the routine test is typically quick and easy ­– and can help identify breast cancer at earlier, more treatable stages.

Still have questions? Here’s what you need to know about breast imaging.

What is a screening mammogram?

A screening mammogram is a routine test to look for early signs of breast cancer in women who have no symptoms of the disease. The test involves taking X-ray pictures of each breast: one from top to bottom, and one from side to side.

The American Cancer Society recommends that at age 40, women and their doctors should discuss whether annual screening mammograms are right for them, and that all women should begin the annual exams by age 45. Other organizations, such as the American College of Radiology and the American College of Obstetrics and Gynecology, recommend that women begin annual screening mammography at age 40. Your doctor can help you determine when to start screening mammograms based on your personal and family history.

What is a diagnostic (comprehensive) mammogram?

Think of this as a “problem-solving” mammogram. If you feel a lump or notice breast changes such as nipple discharge or nipple retraction, a diagnostic mammogram can help identify the cause. Women who have had lumpectomies for breast cancer in the last five years or non-cancerous (benign) breast biopsies since their last mammogram also receive diagnostic mammograms.

Many people assume that a diagnostic mammogram is better than a screening mammogram. In fact, the tests use the same equipment and take the same four images of the breast. In a screening mammogram, you’ll typically receive results several days after the test. During a diagnostic mammogram, a radiologist reads the results then and there to determine if additional breast imaging is necessary.

What’s a 3-D mammogram?

Also known as breast tomosynthesis, 3-D mammograms produce multiple cross-sectional images of the breast tissue, each just 1 millimeter thick. This technique allows the radiologist to evaluate the breast tissue one layer at a time.

In a traditional 2-D mammogram, overlapping tissue can sometimes lead to unclear results that require further testing. The current research suggests that 3-D mammography is a more effective screening tool for detecting breast cancer. However, 2-D mammograms are still very common and are also reliable for detecting cancer. Talk to your doctor and check with your insurance carrier to determine the best option for you.

What if I need additional testing?

Anyone – male or female – with a suspicious breast growth, an abnormality detected on a mammogram or other symptoms of breast cancer should undergo a breast biopsy. In a biopsy, doctors remove all or part of the suspicious tissue and a pathologist examines the cells under a microscope. Types of breast biopsy include fine needle aspirations, core needle biopsies, biopsies with vacuum assisted devices and surgical excisions.

Breast MRIs are also common. Breast MRIs use a powerful magnetic field to provide detailed 3-D images of the breast tissue. This test is sometimes used for routine screening of women at high risk of breast cancer. It’s also the best test for evaluating patients with breast implants, including determining whether the silicone implants have ruptured. Breast MRIs are also used to determine the extent of cancer after a new diagnosis or following chemotherapy for breast cancer.

Does it matter where I get my mammogram?

In short – yes! When you schedule your screening or diagnostic mammogram, make sure the facility is accredited by the American College of Radiology. This ensures that the facility is in compliance with current quality and safety requirements.

The person reading your mammogram is important, too. Ideally, the radiologist has completed a fellowship in breast imaging. Research has found that compared to general radiologists, specialty-trained breast radiologists find significantly more cancers – and at earlier stages.

Ready to make your appointment? Check out Inova’s ACR-accredited hospital imaging services or find an outpatient imaging location near you.