Getting a mammogram

Getting a mammogram

By Patricia L. Dawson, MD, PhD, FACS
Breast Cancer Surgeon

Frequently women will ask me: Where should I get my mammograms? There are several things to think about.

First, you want to go to a Center that is accredited by the American College of Radiology. This means that they have high quality images and well-trained radiologists. It is preferable to have a digital mammogram but if that technology is not available, then film mammograms are better than not having one done. While it is not clear that digital mammograms improve survival, they do allow the radiologist to examine the images more clearly and to use computer assisted diagnostic tools.

The radiologists’ experience is also important. Dedicated breast centers usually have radiologists who are specialized in breast imaging. These sub-specialized radiologists are very experienced in using mammograms, ultrasound, and breast MRI to diagnose breast disorders and are less likely to miss abnormalities.

Convenience is also a consideration. You want to make it easy to get your mammograms. Some Breast Centers will have mobile mammography programs that will bring mammogram screening to your place of work, local community or senior center, or even your church or synagogue. If possible, it is a good idea to get your mammograms at the same Center or within the same hospital system every year. That way the radiologists have easy access to your prior studies and can compare them to the current ones.

Here are some other things to know about getting mammograms:

  • Screening mammograms are for women who have no breast symptoms or concerns. If you have felt a lump or have other symptoms, it is best to call the Center and your primary provider and let them know. It may then be possible to change your study to a diagnostic exam – which is a more detailed evaluation. If you have not told the Center staff before your visit about your change in exam or symptoms, be sure to let the technologist know once you are there. They may be able to convert the exam to a diagnostic visit, which will focus on identifying any problems that could be causing the symptom. With a diagnostic evaluation, an ultrasound may be done as well, if the radiologist feels it would be helpful.
  • Remember not to use any deodorant the morning of your mammograms. Some deodorants have metals in them that can result in confusing findings on the mammograms. If you forget, let the technologist know and they can usually provide you with a cleaning wipe.
  • Some women worry that mammograms may be painful. In order to get a good image the technologist tries to uniformly flatten the breast tissue. The compression is only held for about 4-5 seconds. Most women feel momentary discomfort that resolves when the compression is released. If you are really worried about discomfort, it is OK to take a Tylenol or ibuprofen before you go for your study.

Despite differences in opinions among physicians about the frequency of mammograms, there is agreement that regular screening mammograms can diagnose cancers earlier, allow for less aggressive treatment, and save lives. Don’t forget to get yours!

Comments
Patricia L. Dawson, MD, PhD, FACS
Mammograms result in minimal radiation exposure. We are learning more about how to characterize invasive tumors in order to better tailor therapy. The pathological features, Estrogen and Progesterone Receptor status, HER-2/neu status and OncotypeDx testing are all tools to help understand which women will benefit from chemotherapy and/or anti-estrogen therapy and which won't. Treatment should not be started until the best individualized treatment plan has been established and the patient understands the pros and cons of the treatment recommendations and alternatives.
9/25/2012 5:35:26 PM
Pixel
. This matter of unsneescary or excessive treatment is then repeated in the penultimate paragraph: therapies such as surgery, radiation, chemo and long-term hormone pills can mean serious, long-term side effects, Warner says. What about the pathology report, what about the Oncotype Dx test? This article suggests doctors have no tools for distinguishing between types of tumors!I've seen this suggested in other articles too. It seems a dangerously misleading omission. Or am I missing the point, somehow? (Are some women rushed into treatment without adequate testing on their particular tumor?) What's your take on this?
9/25/2012 1:39:13 PM
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