FAQs

What is a mammogram?

A mammogram is a low dose X-ray of the breast performed on specialized equipment that allows the breast tissue to be compressed.  Compression is necessary to present uniform tissue thickness and to hold the breast securely for the few seconds it takes to expose the image. There are two types of mammograms – screening mammograms and diagnostic mammograms. Both types are addressed in this FAQ section 

Does a mammogram find all breast cancers?

Unfortunately, no. There currently is no 100% effective method for detecting breast cancer. Many cancers are too small or soft to be felt, but can be seen on a mammogram. Some types of cancers can be felt more easily than they can be seen on a mammogram. In fact, 10-15% of breast cancers cannot be seen on the mammogram.  Therefore, your best protection against breast cancer is to use every detection method available – by breast self-examination, your doctor's breast examination and your annual screening mammogram.

What are the benefits of a mammogram?

Several large scientific studies conducted around the world show that regular screening with mammography reduces the number of deaths from breast cancer for women age 40 and older.  Mammography’s greatest benefit is that it allows most breast cancers to be detected before they can be felt.  Earlier detection allows for earlier, and more effective, treatment.

What is the difference between a film mammogram and a digital mammogram?

Film and digital mammography are both accomplished in the same manner — by exposing the compressed breast tissue to X-ray radiation.  Film mammography creates an exposure on a piece of film that is then processed to provide a very high resolution image that the physician can review using a light box.  Film mammograms are physically stored in patient files. In the digital mammogram, the image is captured, stored and can be accessed electronically.

Are there limitations to mammography?

Yes.  Beyond the 10-15% of breast cancers that cannot be detected by mammography, many are difficult to distinguish from normal, non-cancerous tissues.  In these cases, the breast radiologist will perform further mammographic studies, diagnostic ultrasound and even biopsy the suspicious area in an effort to make a clear diagnosis.

What are the benefits of digital mammography?

Digital mammography allows a radiologist to electronically view, store and retrieve digital images. Benefits of digital mammography include:

1. Fewer repeat images are required
2. The necessity to recall the patient may be reduced
3. An important recent-large scale study indicated that women with dense breast tissue may receive additional diagnostic benefit from digital mammography

Is a mammogram painful?
 
For most women, a mammogram is not painful, merely uncomfortable – and only for the brief time that their breasts are compressed. Try to schedule your mammogram at a time other than during your period, because your breasts may be more tender or sensitive at that time.

What information does Solis need to perform my mammogram?

Please have the following information handy when you schedule your visit:

1. Family history of breast cancer
2. Gynecological history
3. If you are taking any hormones
4. If you have breast implants
5. If this is your first visit, and you have had a previous mammogram, we will need to obtain copies of your prior films.  Please tell us where your prior mammograms were performed so that we can acquire them for review.

Should I do anything special on the day of my mammogram?

We ask that you avoid use of powders and deodorants that morning, if possible, because they sometimes leave residue that can be mistaken on a mammogram for calcifications, which may require a closer look on a second mammogram.

What is a screening mammogram?

A screening mammogram is used to detect breast changes in women who have no symptoms of breast cancer. The screening study usually involves two X-rays of each breast. Mammograms make it possible to detect tumors that cannot be felt. Mammograms can also find microcalcifications (tiny deposits of calcium in the breast) that sometimes are associated with breast cancer.

Do I need a referral from my physician for a screening mammogram?

You do not need a referral for a screening mammogram.  However, you must provide the name of your physician so we can send him or her a report.

How is a screening mammogram performed?

Both film and digital mammography require identical positioning of the breast in the mammography device, and adequate compression of the breast tissue to obtain high-quality images. A Solis technologist will obtain a minimum of two views of each breast during the examination.   The entire exam will take approximately 5-10 minutes.

Click Here to watch a mammogram screening.

How long should I plan to be at the Solis facility for my screening mammogram?

Typically, you will be in and out of our office within 45 minutes.

Who will interpret the results of my mammogram?

A Solis radiologist will read your mammogram, and compare it to your prior mammograms, if applicable.  Our radiologists specialize exclusively in breast imaging.

When will I receive my results?

At Solis, our radiologists interpret and report all screening mammograms within one business day of when they are taken.  Written reports are then sent to both you and your physician.

If I need to come back, how will I be notified?

If we need to recall you for further mammography or other workup, we will contact you directly, and we will make every attempt to get you back in for the further studies within 48 hours.

Why might I be called back for a second mammogram?

You will be recalled if the radiologist notices something about your mammogram that requires further examination.  Don't worry – getting a callback does NOT mean you have cancer. About 1 out of every 10 patients is recalled for additional views, but most do NOT have cancer.

How is a diagnostic mammogram different from a screening mammogram?

Diagnostic mammograms differ from screening mammograms.  The purpose of a screening mammogram is to detect signs that might be related to cancer in patients with no symptoms, while a diagnostic mammogram is focused on areas of interest identified by the physician on his or her review of the screening images. Diagnostic mammograms may also be used to evaluate a clinical symptom, such as a lump felt by the referring physician or the patient, any abnormal discharge from the nipple, or breast pain.  Diagnostic mammograms are also prescribed for women who have been determined to be at an increased risk of breast cancer, those who may have a region of very low suspicion being followed at shorter intervals, or women who are being followed after treatment for breast cancer.  In addition to the types of views done during a screening mammogram, your diagnostic mammogram may also involve more specialized views.

How long will I be at the Solis office for a diagnostic mammogram?

When you are called back for a diagnostic mammogram, plan to spend at least two hours in our office.  In this visit, we will usually perform all of the imaging studies necessary and plan the next steps that you will take.

What other procedures might be performed?

That depends on your individual situation. The diagnostic appointment will include a diagnostic ultrasound if the breast radiologist believes this will assist in the diagnosis. In the event that a biopsy is recommended, it will typically be scheduled for a later, more convenient time.

When will I get the results of my diagnostic appointment?

The Solis radiologist will interpret the mammogram in the center's diagnostic mammogram reading room as well as any other imaging that is performed, and will meet with you briefly before you leave to discuss the findings.

What is ultrasound?

You may be told that you need an ultrasound as a follow-up to your mammogram.  Ultrasound is an imaging technique that bounces sound waves off internal structures to create an image or series of images called a sonogram. You may be more familiar with this technique as the way fetal development is checked in pregnant women. When a woman or her physician has felt a lump, or when a mammogram raises questions about an area of the breast, ultrasound can be used to provide more information and to avoid unnecessary surgical procedures.  Ultrasound is also sometimes used when the tissue of the breast is very dense and prevents the breast radiologist from getting a clear mammographic view of an area of interest.

What is diagnostic breast ultrasound?

Diagnostic breast ultrasound is used in addition to mammography to help distinguish the characteristics of a lump or a breast mass. Use of ultrasound allows our physicians to avoid unnecessary surgical procedures. Ultrasound is performed by the radiologist when it is needed to help make a diagnosis, or to clarify mammographic information.

When is an ultrasound exam performed?

An ultrasound breast exam is used primarily as a diagnostic tool – it is not a primary screening method for breast cancer. It may be utilized when:
     • An area of concern has been found on a diagnostic mammogram.
     • You are experiencing nipple drainage, or have an area where the skin has retracted on your breast.
• You have very dense breasts. When breasts are mostly dense tissue, rather than being composed of primarily fatty tissue, mammograms are not as predictive for detecting cancer because dense tissue shows up on the film as white in color, similar to the appearance of breast cancer.

How is the ultrasound examination performed?

While you are lying on your back on a padded table, a gel is spread over your breast, and a transducer is moved over the area of the breast to be imaged. This painless procedure uses sound waves to digitally show structures inside the breast.  The images can be captured electronically.

Do I need to do anything special before having this procedure?

No.

When will I get the results?

You will receive your results as a part of the report for your diagnostic exam, along with the results of your diagnostic mammogram.

What is a biopsy?

If it is determined that you do have a lump or mass inside your breast that needs further evaluation, a biopsy will be required. In the type of biopsy performed by Solis, small samples of tissue from the area in question are removed and tested. This can be a scary time, but it does NOT mean you have cancer – biopsies are performed when the doctor needs to determine whether an area of concern is a cancer, or if it is a benign condition that looks like a cancer. Once the biopsy is performed, the tissue specimens will be reviewed by a pathologist to determine if the tissue is benign or cancerous.  We typically receive the results of the pathology examination within 24 hours of the biopsy, and will communicate those results to you as soon as possible.

Solis physicians use one of two methods to perform biopsies – both are minimally invasive and do not require hospitalization. Usually, patients can return to their usual activities the next day. The two methods we use are:

• Stereotactic Biopsy
• Ultrasound-guided Biopsy

What is a stereotactic breast biopsy?

A stereotactic biopsy is a reliable, minimally invasive method used if areas of concern were detected by a mammogram, ultrasound or MRI. 

How is this procedure performed?

Most stereotactic biopsies are performed on small lesions that are difficult or impossible to visualize under ultrasound and cannot be felt.  They are performed with the patient lying on a special stereotactic biopsy table.  The table is designed to allow specialized digital mammography equipment to image the breast from two or more angles, and then calculate the exact position of the lesion within the breast.  Before the radiologist performs the procedure, a local anesthetic will be used to numb the breast.  After making a small nick in the numbed skin, the radiologist will guide the biopsy needle to the lesion, and remove several small samples of tissue.  The skin nick is closed with a bandage.  The tissue specimens are sent to a pathologist for review and interpretation.

How is a stereotactic biopsy different from a surgical biopsy?

Unlike the stereotactic biopsy, which is performed under local anesthetic and involves only a small skin nick, a surgical biopsy is much more invasive and may require general anesthesia.  The incision is also much larger, more tissue is removed and stitches are required to close the wound.  While you will usually be able to perform your regular activities after a stereotactic biopsy, a surgical biopsy takes time to heal and a return to the physician for removal of stitches. 

How long will this procedure take?

The biopsy procedure is fairly short, and your entire visit, including preparation and the post-biopsy mammogram should not take more than two hours.

Do I need to do anything special before having this procedure?

Yes. You need to let us know at the time you make your appointment about any over-the-counter or prescription medications that you are taking. If you take daily aspirin or use ibuprofen (Advil, Motrin) or Aleve on a regular basis, we will ask you to discontinue using these medications five days prior to the procedure.  If you take warfarin (brand name Coumadin), we will consult with your physician about possibly discontinuing this medication.  We will have you discontinue these drugs to prevent possible bleeding complications.

Will I have to modify my activities?

Other than common wound care instructions, which our staff will carefully go over with you, your activities should not be impacted at all.  We do not recommend activities, like running, that put a stress on the breast until the incision has healed, but most of our patients report minimal impact from the procedure.

Will I have a scar?

The incision is very small. Our physicians make the incision with minimal, if any, cosmetic impact.

When will I get the results?

Usually within two days. We will schedule an appointment for you to receive your results when your pathology reports are available.  We will also consult with your referring physician.

What is ultrasound-guided breast biopsy?

Ultrasound-guided breast biopsy is a highly accurate way to evaluate suspicious masses within the breast that are visible on ultrasound, whether or not they can be felt on clinical examination. After placing an ultrasound probe over the site of the suspicious area, and injecting a local anesthetic, the radiologist guides a specialized biopsy needle directly into the mass, and removes one or more tissue samples.

When is ultrasound-guided biopsy utilized?

Ultrasound-guided biopsy may be recommended if an area of concern is found on your mammogram or ultrasound exam, and it is of a type best approached using ultrasound guidance. Solis Women’s Health radiologists use this technique to remove samples of tissue from an area in your breast that needs further examination. The sample is then sent to pathology for evaluation in the same manner as for a stereotactic biopsy.

How should I prepare for the procedure?

Yes. You need to let us know at the time you make your appointment about any over-the-counter or prescription medications that you are taking. If you take daily aspirin or use ibuprofen (Advil, Motrin) or Aleve on a regular basis, we will ask you to discontinue using these medications five days prior to the procedure.  If you take warfarin (brand name Coumadin), we will consult with your physician about possibly discontinuing this medication.  We will have you discontinue these drugs to prevent possible bleeding complications.

How is the procedure performed?

You will be placed either on your back or turned slightly to the side while the ultrasound probe is used to locate the lesion. A local anesthetic is injected to be sure that you will feel no discomfort during the procedure. A small nick is made in the skin at the site where the biopsy needle is to be inserted. A Solis radiologist will constantly monitor the lesion site with the ultrasound probe and guide a specialized biopsy needle directly into the mass to obtain the tissue samples.

What will I experience during the procedure?

You will be awake during your biopsy and should have little or no discomfort. Generally, the biopsy is completed in less than an hour. It is not necessary to close the tiny skin incision with sutures; a small compression dressing will do. Most patients are able to resume their usual activities later the same day.

Who interprets the results and how do I get them?

Solis sends the tissue specimens to a pathologist for interpretation, and typically receives the report of that interpretation within 48 hours of the procedure.  We will schedule an appointment for you to discuss your results as soon as possible.  We will also consult with your referring physician.

What if cancer is found?

If breast cancer is found, our staff will spend time talking with you and your family members about your results and what your next steps should be, and answer any questions that you might have.  Before you leave, our office can also set up an appointment for you with a surgeon selected by you and your referring physician.

What is breast MRI?

If you are a high-risk patient for whom additional studies are required beyond that provided by mammography and/or ultrasound, or if you have a diagnosed breast cancer, you may be referred for imaging by breast MRI.  Breast MRI is a non-invasive study that allows the physician to “see” inside of the breast using magnetic and radiofrequency waves.  Breast MRI is typically performed using an injected contrast agent, to allow the clinician to image even the smallest breast lesions.  Because of its ability to visualize structures in a manner that is different from mammography or ultrasound, MRI is not affected by the relative density of breast tissue.

How is a breast MRI performed?

For an MRI of the breast, the patient is first prepared by the insertion of an IV catheter in one arm.  This catheter is used to inject a contrast agent at the appropriate time during the MRI.  The patient lies on her stomach on the MRI table, with both breasts positioned in cushioned recesses in the table.  The entire table is then advanced into the opening of the MRI.  The patient is asked to lie still for up to 15 minutes at a time while the computer acquires the images.  The examination is usually made up of several sessions, done in succession, and the time that the patient is actually in the MRI typically totals 40-60 minutes.  Before one or more of these sessions, a contrast agent will be introduced through the catheter.

What happens after the exam?

Once the entire exam is over, the table will move outside of the MRI enclosure, the IV will be removed and you will be free to change into your clothing.  The computer will process the images and they will be made available for analysis by your radiologist.  Your results will generally be available within 24 hours.

What is the difference between breast MRI and Mammography?

Mammograms use X-rays to generate images of breast tissue in the search for breast cancer.  It is critical that the mass or other abnormality contrast in appearance from the surrounding tissue to allow identification.  MRI, with contrast that is far greater than mammography, can be valuable in distinguishing subtle differences between benign and malignant tissue. MRI does not, however, identify certain types of small calcifications that may be indicative of a cancer.

Should I get a screening MRI rather than a screening mammogram?

No. The screening mammogram is still the first line of defense in the early detection of breast cancer.  Certain patients at very high risk for breast cancer, and who the physician believes will benefit from Breast MRI, may be referred for this study, but it will not benefit most patients, and is only recommended in certain situations. Solis Women’s Health has carefully developed selection criteria that are based on published studies.  Your physician will be guided by these criteria.

Why would a breast MRI be recommended after a diagnosis of breast cancer?

Breast MRI has been found valuable in finding other cancers in the breast in which the diagnosis was made, and also in the patient’s opposite breast.  These cancers often cannot be seen by mammography, and their detection by MRI may provide the surgeon, and the rest of your care team, with more knowledge upon which to plan your therapy.

Breast Cancer Facts

• Breast cancer is the leading cause of cancer deaths in women between the ages of 15 and 54, and the second leading cause of cancer deaths in women 55-74.  Breast cancer accounts for approximately 15% of all cancer-related deaths in women in the U.S.
  
  
• In 2006, about 41,000 women and 460 men died from breast cancer in the U.S.  Death rates from breast cancer have been declining.  These decreases are believed to be the result of early detection, primarily through the use of regular screening mammography.
  
  
• No way to prevent breast cancer has been discovered, but treatment is most effective when a cancer is discovered early.
  
  
• Early detection through mammography is the most promising approach for reducing the toll from breast cancer. Evidence indicates that the availability of screening mammography reduces mortality from breast cancer by 20-30%.
  
  
• When breast cancer is found early, the survival rate is very high.  There are more than two million breast cancer survivors living in the U.S. today.
  
  
• Women who get regular screening mammograms will reduce their risk by 63%.
  
  
• The American Cancer Society recommends that all women age 40 and older receive an annual screening mammogram.
  
  
• A clinical breast exam by a doctor should be a part of every woman’s periodic health exam.