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Digital Mammography
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What is the difference between screening and diagnostic mammograms?


An annual screening mammogram is a low dose x-ray of each breast used to detect changes in women who have no signs or symptoms of breast cancer. It usually involves two views per breast. Mammograms make it possible to detect tumors that cannot be felt or micro calcifications (tiny deposits of calcium in the breast) that sometimes indicate the presence of breast cancer.

 

The exam is performed by a specially trained mammographer. Following this, a radiologist will read the exam immediately and issue a report to your physician. The results of the mammogram are processed on the same day that you are at the centre and in consultation with the patient the findings are explained and discussed. If necessary an ultrasound exam follows immediately.


A diagnostic mammogram is performed when a patient has a physical sign or symptom, that the patient or the referring physician has noticed as new; or to evaluate changes found during a screening mammogram; or to view breast tissue when it is difficult to obtain a screening mammogram because of special circumstances.

 

Signs of breast cancer may include a lump, pain, skin thickening, nipple discharge, or a change in breast size or shape.

 

Typically a diagnostic mammogram takes longer than a screening mammogram because it involves special views in order to image the breast from different angles and/or magnify a questionable area to produce a detailed picture that can help the doctor make an accurate diagnosis. Upon completion of the exam, the patient will meet with the radiologist to discuss the findings.

What is Mammography?

A mammogram is a low dosage x-ray of each breast that is carefully evaluated by a radiologist. Mammography can reveal both harmless and cancerous growths when they are too small to be felt by you or your physician.

The American Cancer Society endorses mammography, along with yearly physical examinations and monthly self-examinations, as the most effective means of detecting breast cancer at its earliest and most treatable stage. Generally, mammography can reveal benign and cancerous growths before you or your physician can feel them. If detected at the earliest stage, breast cancer has a five-year survival rate of over 95 percent, as small breast cancers are more treatable and can be removed before they spread to other parts of the body.

What are the advantages of digital mammography?

Our centre uses the latest 3D intelligent digital mammography with tomography that was installed in January 2020.

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The advantages of digital mammography are significant. The workflow of the exam is more efficient, since the mammographer does not have to leave the patient in the room to process the image. The monitor in the room immediately reveals the image, allowing the mammographer to QA the image, and decide if repositioning is necessary. This ultimately leads to fewer retakes. As mentioned above, the dose is lower than film screen mammography.

The most noted advantage of digital mammography is the documented improved breast cancer detection in dense breasts. This is afforded by markedly improved digitalisation of the image which improves breast cancer detection, especially in denser breasts. 

Research to date has not demonstrated that digital mammography detects breast cancer better in the average patient. Hence, film screen mammography remains a sensitive diagnostic tool and should not be discounted as inferior to digital mammography.

What can I expect during the exam?

The simple, routine exam usually takes 15 to 20 minutes. Each breast is gently compressed during the examinations and a low dosage X-ray is obtained for the radiologist to evaluate.

 

Although the compression may be slightly uncomfortable, good compression is essential for the radiologist to see all the tissue inside the breast. However, with our new curved compression plate the experience is markedly improved and is not painful. The radiologist needs to be able to examine all breast tissue, including the tissue along the chest wall and underneath the armpit. After carefully positioning your breast on the mammography machine, the mammographer will compress your breast for about 5 seconds to obtain the x-ray image. You can anticipate having at least 2 views per breast.

You may be called back for additional views, but it should be noted that these studies usually confirm normal tissue.

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