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Mammography
How often should I have a mammogram?
Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40.
The National Cancer Institute (NCI) recommends that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening.
Digital vs. traditional film mammography
Over many years “traditional” or film-screen mammography has been performed and perfected. In 1963, the largest study in the United States was begun and examined the mammograms of over 60,000 women. The conclusion: a significant decrease in the mortality (death rate) for breast cancer in women having mammograms compared to those who did not. Even after 50 years this remains somewhat controversial, although the majority of researchers believe this to be true.
In 2001, a study was begun comparing the traditional mammogram to the “new” digital mammogram in 50,000 women. The results showed that: film and digital mammograms have similar screening accuracy for the general population. Rates of false positives (incorrect diagnosis of cancer) were the same for both methods. Both technologies are 92% accurate at ruling out breast cancer
Some women do benefit more than others, and they meet at least one of these qualifications:
- Younger than 50 years old, regardless of breast density
- Any age, with very dense, or extremely dense breast tissue (very little fatty tissue)
- Pre- or perimenopausal women, regardless of age
Surprisingly, there are some women for whom film mammograms are minimally better than digital. Just as most of us now use a digital camera or cell phone with a camera and no longer use film, we in the radiology field have embraced computers and digital imaging. Lake Medical Imaging will soon be providing digital mammography for all of our patients.
As always, we still compare your previous film mammogram to the digital mammogram. If you go elsewhere for your mammograms and digital is not available, do not be concerned, since both the traditional film and the digital mammogram are excellent techniques and the images (mammograms) can be compared.
Digital mammography FAQ's
1. I have never had a digital mammogram, will I know the difference?
Probably not, since compression still has to be done to get a good image and the equipment has a similar appearance. The need for repeating an image will be less frequent and you may get done more quickly.
2. Why was digital mammography not offered sooner?
Lake Medical Imaging waited for the results of the large study comparing “film” to “digital” mammography, which have only become available and analyzed recently. In addition, the cost difference between the two techniques is large.
3. Does the new digital equipment really cost that much more than the “traditional” film-screen equipment?
Depending upon the brand purchased, the new equipment is 3-4 times more expensive and the ongoing equipment maintenance is far more expensive.
4. Will I pay more for my digital mammogram?
Yes. Digital mammograms cost more than the film mammograms. Your out-of-pocket expenses may be higher because of deductibles and co-pays.
5. Since the medical benefits of digital compared to film mammograms are minor, why is everyone converting?
Much of this relates to so called “progress,” but there are other benefits. Environmentally, film manufacturing, chemicals to develop film, disposal of chemicals and film, and the vast storage needs are detrimental. Digital mammography needs none of these. Also, since digital mammograms are electronic information, they and all of your medical information, including all of your radiology images, can be easily stored electronically, sent anywhere in the world when needed.
6. When I had my previous mammogram they used “CAD” – a computerized "second look” at my mammogram., How about now?
The same type of system, a computer aided second look, is automatically used with the digital mammogram and its interpretation, just like with the film mammograms you had before.
7. Do the Radiologists need to have additional training to read digital mammograms, and how does digital help them?
By law, each radiologist has to have additional education before s/he can interpret a digital mammogram. The digital information on the computer screen allows your radiologist to magnify areas and change the contrast (vary the black, white and gray) to see detail better. This ability to review the mammogram in many different ways, takes more time, and slows down the interpretation.
8. What is the difference between a “screening” mammogram and a “diagnostic” mammogram?
A screening mammogram should only be offered to women who have no breast symptoms, no breast lump, no breast surgery for cancer, and no increased risk based on family history or biopsies. There are two images made of each breast, in order to look for any signs of cancer. .In a diagnostic mammogram, although the actual mammogram is performed in the same manner, extra time is allotted for interpretation, extra views, ultrasound, physical examination of the breasts and discussion between the patient and the radiologist, as is needed. At Lake Medical Imaging, we make every attempt to take the time to switch from a screening study that is unexpectedly abnormal to a diagnostic exam, and perform the extra views, and ultrasound during that same visit. However, there is not always the time to make this change in schedule, so you may have to return for a second visit.
9. I heard that Lake Medical Imaging now offers two types of screening mammograms. The new one is called “Fast Track”. What is the difference?
"Fast Track” Screening Mammograms at Lake Medical Imaging are the same as the Screening Mammograms that many women have had at other centers. You come in, have your screening mammogram and leave. The results are sent to you. This is faster for the patient. If there is an abnormality, you will be asked to return for extra studies.
A Lake Medical Imaging regular screening mammogram includes a physical examination by the radiologist who reads your mammogram, and you know the results of the mammogram before you leave. Therefore it is slower for the patient. This type of screening takes longer but costs the same. If extra studies are needed, in the event of an unexpected abnormality, they are most often done at the same time. When extra studies are necessary there is a separate charge,
but no different from having the same sort of extra studies performed on a separate day.
How should I prepare for a mammogram?
If your most recent prior mammogram was performed elsewhere, you will need to obtain those films and reports prior to your exam to have available for consultation.
On the day of the exam:
- Do not wear lotion, deodorant, or powder under your arms or on your breasts
- Describe any problems you’re experiencing with your breasts with your technologist
- Remove all jewelry and clothing from the waist up. You will be given a gown that opens in the front.
For more information on this topic, please visit www.Radiologyinfo.org.