Wake Forest Baptist Imaging is committed to providing patients with the most advanced mammography technology available. Digital Mammography with CAD (computer aided detection) is the latest tool available to detect breast cancer at early stages when it has a better chance of being cured.
In clinical studies, digital mammography screening detected up to 28% more cancers than film screen mammography in women under the age of 50, premenopausal and premenopausal women, and all women with dense breast.
Screening Digital Mammography
A screening mammogram is a low dose x-ray of the breast used to detect abnormal changes in the breast tissue. This type of routine mammogram is for women who have no signs or symptoms of an abnormality. Women are encouraged to have a baseline mammogram between the ages of 35-39, and begin annual exams at age 40. Screening mammography should be used in conjunction with a clinical breast exam performed by your physician and monthly self breast exams.
The exam is performed in an upright position, usually standing. The mammography technologist will instruct you while they place your breast tissue in the best position to achieve maximum results for your exam, and typically two views of each breast will be obtained. The breast tissue is compressed between two plates on the machine. Compression spreads apart the tissue to give the radiologist better visualization of the anatomical structures within the breast. The applied compression will be held in place only a few seconds during the exposure, and then automatically released.
Mammograms make it possible to detect tumors that cannot yet be felt, and also microcalcifications (tiny calcium deposits) that can sometimes indicate the presence of cancer. To reduce discomfort if you have sensitive breasts, schedule your mammogram in the first two weeks following your menstrual cycle when your breasts are less tender.
Upon completion of your screening exam, the mammography technologist will review the images for quality. The radiologist will interpret your exam and send the results to your referring physician or provider, and we will notify you of the outcome as well. If there is an area that raises any question for the radiologist that needs further clarification, they may recommend you return for a diagnostic mammogram.
Diagnostic Digital Mammography
A diagnostic mammogram is also a low dose x-ray examination of the breasts, but used to evaluate potential problems within the breast. If you have one or more of the qualifying symptoms, you may need a diagnostic mammogram, instead of a screening:
- Personal history of breast cancer
- New lump or mass
- New breast pain that is focal (localized to a specific point or area in the breast)
- New nipple inversion
- Bloody discharge from the nipple
- Short-term follow up recommended by a radiologist from a previous mammography examination
- Screening mammogram revealed a finding that needs further investigation or clarification
With a diagnostic evaluation, the technologist usually obtains the same images as with a screening exam, but also performs special customized views under the direction of the radiologist. This may include the use of special, smaller compression paddles, the use of magnification techniques, and/or breast ultrasound to focus on the area of interest or concern.
Because this exam is more customized, it often requires more images be taken (as compared to a screening study), and also means that diagnostic exams from patient to patient may not be exactly the same. Also, diagnostic mammography is not considered a preventive care service by most insurance companies, and may be subject to deductibles and co-insurance. Please contact your insurance provider with questions concerning your coverage.
To complete your breast imaging evaluation, the radiologist may recommend a breast ultrasound at the time of your diagnostic mammogram appointment. This is an imaging technique that uses sound waves to look at anatomical structures within the breast and can supplement a mammogram evaluation by helping the radiologist characterize the tissue he or she is evaluating. The use of ultrasound helps the radiologist to avoid recommending unnecessary surgical procedures and make a comprehensive diagnosis. While breast ultrasound is often used as a supplemental diagnostic tool, it is not an adequate screening option and should not be used to replace mammography.