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The National Cancer Institute suggests that women with no family history and a normal breast examination get their first mammogram at age 40, and every year after that. Women who are at a higher risk of breast cancer or are experiencing any breast symptoms such as lump or nipple discharge should talk to their primary doctor about their specific situation to ensure that they receive appropriate care.
Digital mammography – low energy x-rays pass through the breast exactly like conventional mammograms but are recorded by means of an electronic digital detector instead of the film. This electronic image can be displayed on a video monitor like a TV or printed onto film. Again, this is similar to digital cameras that produce a digital picture that can be displayed on a computer screen or printed on paper. The radiologist can manipulate the digital mammogram electronically to magnify an area, change contrast, or alter the brightness.
There are different types of mammograms:
A screening mammogram is used to find breast cancer in women who have no personal history of breast cancer and a normal clinical breast exam. The exam consists of two to three x-rays of each breast taken by a certified mammography technologist and interpreted by a radiologist. It is not uncommon for the radiologist to ask for a magnified image of a specific area of the breast in order to make an accurate diagnosis. In these cases, additional imaging may be recommended.
A diagnostic mammogram is recommended for patients who have noticed an area of concern or suspicious change in the clinical examination of the breast. If your doctor has noticed a change in your breast clinical exam, a diagnostic mammogram and/or ultrasound will be ordered to clarify the finding and determine if a biopsy is needed. The exam takes longer because it is monitored by the radiologist and tailored to the individual patient.
The day of your mammogram you should make sure not to use any deodorant, powder, or lotion of any kind under your arms or on your breasts, these products can interfere with the reading. It is important for the radiologist to compare your current mammogram with any previous studies. If you have had mammograms at another institution, please bring them with you at the time of your appointment.
Some cancers are discrete in your mammogram, and may only become visible if the previous study is available for comparison. The mammogram itself involves compression. If you have very sensitive breasts, try to avoid scheduling your mammogram the week before your period because that is the time during which breasts are most sensitive.
A breast ultrasound helps the radiologist determine if a lump is cystic or solid. Lumps that are clearly filled with fluid are called cysts. If the lump looks like it may be solid, often a biopsy will be needed to make the final diagnosis.
Ultrasound involves scanning the breast with gel and a transducer. There is no breast compression, and most women find the procedure painless. Though ultrasounds can be very helpful, they do not take the place of mammography because most early cancers that are visible as micro calcifications in the mammogram will not be visible with the ultrasound.
Houston Methodist San Jacinto Hospital offers the latest MRI technology. Our MRI is conveniently located onsite near the Women’s center. MRI is an imaging technique that uses magnetic fields instead of radiation to look inside the body. During your breast MRI you will be asked to lie face down with your breasts placed in openings in the table. A contrast material is injected through a vein. The exam generally lasts between 30 minutes and one hour and usually both breasts are examined simultaneously.
It is very important to stay still during the MRI for an accurate reading. If you are claustrophobic, you can ask your doctor about a mild sedative that may help make the procedure more comfortable.
The indications for breast MRI are constantly changing as more data becomes available. In addition to being used as a better tool for breast cancer detection in patients with high risk for breast cancer, this new technique can be used to help identify questionable findings arising from a complex mammogram or physical exam. Breast MRI is useful for deciding treatment in women who have already been diagnosed with cancer, patients with very dense breast tissue, and those with a strong family history of breast cancer.
Bone density scanning, also called dual-energy x-ray absorptiometry (or DEXA) is an enhanced form of x-ray technology that is used to measure bone loss. The test is used to assess the strength of the bones and the probability of fracture in women at risk for osteoporosis. DEXA is most often performed on the lower spine and hips.
In general, the test is recommended for women 65 and older along with your postmenopausal women who have further risk factors for osteoporosis, including: a history of bone fractures, smoking, a vitamin D deficiency, excessive alcohol or caffeine consumption, low body weight, early menopause or late onset of menstrual periods, physical inactivity, taking a medication known to cause bone loss, low estrogen levels, hyperparathyroidism and hyperthyroidism.
This is a painless test which only takes 10 to 30 minutes. You will be asked to lie flat on your back on a padded table. The DEXA machine scans the spine and hip. The technologist may place a special pillow under your knees for part of the test. The exposure to radiation is minimal.