Mammography
by James J. Romano, M.D.
There is an increasing number of women seeking mammography for various
reasons. Here are some useful suggestions to keep in mind for your next
mammogram:
- Research the facility where you are going to have your mammogram
performed as well as the doctors that will read your mammograms.
Radiologists reading mammograms should have special interest and expertise
in this area. Many nowadays have additional fellowship training in breast
imaging. The radiologist should spend at least 80% of his or her time
reading mammograms. There are many facilities these days dedicated only to
breast or women’s imaging. A high volume is important. Mammography machines
are constantly improving, as often as every two to five years so find out if
they are any older than this. Many facilities fit these criteria, so don’t
just go to the first place close to home where you can get an appointment.
- Know your breast history the best you can, especially if you have
implants. Your personal physician or medical records can help with this.
Information useful to the mammographer includes: what are your previous
surgeries, what type of implants are in place, how old are your implants,
are they under the muscle or not? Implants over 8 or 10 years old have a
high risk of leakage and more likely to rupture. Do you have contracture and
how bad and how long has it been present? Where were your previous
mammograms done? Did they show any abnormalities, and, if so, what?
- Know your examination. Breast self-examination should already be well
known to you. Take the time to be specific to alert your mammographer and
technician about any areas you feel that are of concern to you for whatever
reason. Nothing is too small to point out.
- Find out what technique will be used for your mammogram. For example,
for patients with breast implants, you should have a diagnostic, not
screening mammogram. There are several imaging techniques used.
Specifically, the displacement (full view) and the compression (push-back)
techniques. Make sure your technician is familiar with these techniques.
- Obtain your previous films or copies and have them with you. This may
prevent duplicating special views or answer questions about possible “new
findings”. If previous mammograms show breast implants with a leak or
rupture, your technician needs to know this and your exam should proceed
with extreme caution.
- Be aware of pain during the test. Some discomfort is normal. If you have
severe pain during your mammogram, then stop the test. Ask for the
radiologist. Although rare, implants have been known to rupture during
mammography. You will often have some pain or discomfort up to two weeks
after the procedure.
- Review your results with the mammographer and look at your films. This
is an excellent way to become educated about your breast anatomy and have a
better sense of what is seen on the films, and how this relates to what you
may feel on your exam.
- Ask for copies of your films if you want these for your personal
records. It is your mammogram and you paid for it. This is often a free or
nominal charge service.
Mammography is a very important and useful test. Be as prepared and well
informed as you can about your history, your body, and the facility.
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