What is a Mammogram (Full-field Digital Mammography FFDM with CAD)?

A Mammography exam, also called a mammogram, uses low-dose X-rays to capture internal pictures of breasts. Mammography is the most effective (though not perfect) medical imaging procedure for the early detection and diagnosis of breast diseases in women.

Digital mammography, also called Full-field Digital Mammography (FFDM), replaces x-ray film with solid-state detectors that convert the x-ray images into electrical signals that are translated onto a computer screen fore viewing or can be printed on special film similar to conventional mammograms. Digital mammography allows radiologists to alter the captured images for greater viewing clarity and convenient information sharing with a patient’s physician. The mammography unit is designed to accommodate virtually any size breast, large or small.

Computer-aided detection (CAD) can be applied to digital mammography exams to help radiologists identify and mark regions of interest in the breast that may be indicative of cancer. The computer software exams these regions searches for abnormal areas of density, mass, or calcification that may indicate the presence of cancer and highlights these areas on the images, alerting radiologists to the need for further analysis.

Screening mammograms aim to find cancerous (malignant) or noncancerous (benign) tumors and cysts in women without breast cancer symptoms up to two years before they can be felt. A diagnostic mammogram is used to further evaluate a patient who has abnormal clinical findings like pain, a lump or dimpled skin on the breast, or nipple discharge and may be performed after an abnormal screening mammogram to evaluate the area of concern.

Common uses of mammography:

  • As a screening for early detection of breast cancer when no symptoms are present
  • Detection and diagnosis of breast disease when symptoms such as a lump, skin dimpling, pain or nipple discharge are present
  • To detect ductal carcinoma in situ (DCIS), abnormal cells in the lining of a breast duct

Mammogram radiation safety and risks

State-of-the-art Mammography systems have tightly controlled X-ray beams with significant filtration and dose control precision to minimize secondary (scatter) radiation. This ensures those parts of a patient’s body not being imaged receive minimal radiation exposure.

If you are coming in because of a breast problem and you are or may be pregnant, inform your HDI Mammography Technologist so that we can decide the best way to evaluate your situation and take necessary precautions. Although there is no radiation that reaches the uterus during a mammogram, it’s preferred not to perform routine mammograms on women who might be pregnant.

While mammography is the best screening tool for breast cancer available today, mammograms do not detect all breast cancers. This is called a false negative result. When a mammogram looks abnormal and no cancer is present, this is called a false-positive result.

A false-positive mammogram is any exam result that requires additional screening. Sometimes false positives are due to initial images not being clear enough, requiring another exam to acquire more pictures. Five percent to 15 percent of screening mammograms require more testing. If there is an abnormal finding, a follow-up or biopsy may be performed. Most retests and biopsies confirm that no cancer was present. It is estimated that a woman who has yearly mammograms between ages 40 and 49 has about a 30 percent chance of having a false-positive mammogram and a 7-8 percent chance of having a breast biopsy within a 10-year period.

Learn about common mammogram myths associated with breast cancer risk.

adobe_pdf_iconMammography Myths Info Sheet

To learn more about effective X-ray radiation doses, visit radiologyinfo.org.

Before your exam

Breasts are often tender the week before and during your period, therefore, try scheduling your mammogram exam to take place 1 to 2 weeks after the start of your period. Be sure to discuss any new findings, prior surgeries, hormone use, and family or personal history of breast cancer with your physician. Obtain prior mammogram test results and make them available to your HDI Radiologist before undergoing your exam. If you have breast implants, ask if HDI uses special techniques designed to accommodate them. Your HDI Technologist will ask you a number of important questions about your medical history so that we can assess your breast cancer risk.

Breast implants can impede accurate mammogram readings because both silicone and saline implants are not transparent on x-rays and can block a clear view of the tissues behind them, especially if the implant has been placed in front of, rather than beneath, the chest muscles. The experienced technologists radiology physicians at HDI know how to carefully compress the breasts to improve the view without rupturing the implant.

Medications

Tell your provider and HDI Technologist about all medicines you are taking including prescriptions, over-the-counter drugs, and herbal supplements. Continue taking your current medications as normal unless specified by your physician.

Food and drink

There are no restrictions on what you may eat or drink before your procedure. If your breasts are painful, you may want to stop eating or drinking foods with caffeine for 5 to 7 days before your test.

When to arrive

Please arrive at High Desert Imaging 15 minutes before your exam appointment.

What to wear

On the day of your exam do not use lotions, deodorants, antiperspirants, powders, ointments, or perfume under your arms or on your breasts since these make it difficult to get a clear image. Since you will need to undress from the waist up, a two-piece outfit is recommended. Gowns are available if necessary.

Comfort

A mammogram exam will require your breasts to be placed on a firm flat panel one at a time while firm pressure is applied with another panel. Some women with sensitive breasts may experience discomfort. If this is the case, schedule the procedure for when your breasts are least tender, about 1-2 weeks after you start your period. Also, avoiding caffeine 5-7 days prior to your exam can help reduce any pain associated with breast compression.

Breast compression is necessary in order to:

  • Even out the breast thickness so that all of the tissue can be visualized
  • Spread out the tissue so small abnormalities won’t be obscured by overlying breast tissue
  • Allow the lowest X-ray dose because a thinner amount of breast tissue is being imaged
  • Hold the breast still to reduce any movement and eliminate blurring of the image
  • Reduce X-ray scatter to increase sharpness of picture

Be sure to inform your HDI Technologist if pain occurs as compression is increased. If discomfort is significant, less compression will be used.

Scanning

You will be asked to remove clothing from your waist up and to remove jewelry or other objects that might get in the way of the test. You will then stand in front of the mammography machine and your technologist will position one breast on the platform and compress it with a paddle. He or she may put a marker on any moles, scars, or other spots that might affect the breast image. The technologist will move the flat plastic paddle down on top of your breast to squeeze or compress your breast gently against the X-ray plate. Pressure is necessary to keep the radiation level as low as possible and helps take the best picture of your breast tissue.

During the exam, you will be asked to hold your breath for a few seconds while the image is taken. Your HDI Technologist will walk behind a wall or into the next room to activate the X-ray machine that will remain on for a few seconds at most. Your position will be changed slightly between images. Routine views are a top-to-bottom view and an oblique side view. The process will be repeated for the other breast. You may hear a whining noise that persists even after the X-ray is turned off. This is just a mechanical part of the tube that is winding down from a high speed after being turned off after the X-ray image was captured.

Length of scan

Mammogram exams take approximately 30 minutes.

After your X-ray exam

When your mammography examination is complete, you will be asked to wait until your HDI Technologist determines that the images captured are clear enough for the radiologist to read. If the images are sufficient for study, you will be free to go. If the images need to be retaken, you may be asked to remain in order to capture certain images or we will continue your exam by rescheduling for the next available time that is convenient for you. Normal activities, diet, and medications may resume after your exam unless instructed otherwise by your HDI Technologist or doctor.

Scan results 

We pride ourselves on delivering superior studies and rapid exam results. Mammogram exams are typically read within 24 hours with results sent to your primary care physician who will go over them with you in detail. We’ll also provide you with a DVD copy of your exam images.

If you have additional questions about screening or diagnostic mammograms, please use our online contact form or call us at 775.621.5800.