Screening Mammography

Screening mammography is the process of using X-ray images to examine the breasts. It is the single most effective tool for detecting breast cancer and other diseases.

Screening mammograms are also used as a preventive measure for women who show no symptoms of breast disease. They usually involve two to three views of each breast.

Schedule a Screening Mammogram

Why Are Mammograms Important?

Mammograms can show changes in the breast tissue before a patient or physician can feel them. Mammograms can detect cancer in its earliest stages when it is most treatable.

Latest Technology

At every Northside Hospital imaging location, we use the latest digital technology, including 3D mammography or breast tomosynthesis, to provide our highly-trained radiologists with the most detailed images available. This allows for faster and more accurate results and diagnoses.

What Can I Expect During My Mammogram?

Even though you will be given a wrap to wear during your mammogram, make sure you wear two-piece clothing, as you will need to undress from the waist up.

A skilled technologist will place your breast on a platform that will be adjusted to your height. Your face, arms and body will be placed in a position that will not obstruct the view of your breast.

A clear plastic plate will be lowered slowly on each breast, so there is enough compression to spread out the tissue for better visualization. Compression is only applied for a few seconds and is not harmful to the breast. A screening mammogram usually involves two to three views of each breast.

Are Mammograms Painful?

While breast compression can cause some discomfort, it helps doctors obtain better results by:

• Spreading out the breast tissue so that the maximum amount of tissue can be examined
• Allowing a lower X-ray dose to be used, since the X-ray beams pass through a thinner amount of tissue
• Holding the breast in place to prevent blurring caused by motion

Who Should Have a Mammogram?

The American Cancer Society recommends all women between the ages of 35 and 40 have a baseline screening mammogram. Beginning at age 40, women should have a screening mammogram every year. In addition, women age 40 and older with certain risk factors should discuss an appropriate screening program with their physicians.

Breast Cancer Risk Factors

Some of the known risk factors include:

• Family or personal history of breast cancer
• Early menstrual onset or late-onset menopause
• Use of oral birth control medicine
• Use of hormone replacement therapy
• Alcohol use (two or more drinks per day)

Preparing for a Mammogram

Before scheduling a mammogram, we recommend you discuss any problems with your doctor. Inform him or her of any prior surgeries, hormone use, and family or personal history of breast cancer or symptoms of breast cancer.

You should not schedule your mammogram for the week before your period if your breasts are usually tender during that time. Always inform your health care providers if there is any possibility that you are pregnant.

If you have had a mammogram at another facility, please obtain your previous mammograms and bring them to your appointment. Comparing previous images with current images is the best way to detect changes in the breast tissue. Learn more about mammography procedure preparation with our prep manual. 

What Is Seen on a Mammogram?

When interpreting your screening and diagnostic mammogram, the radiologist evaluates the skin, nipple, breast tissue and underarm. The radiologist compares the right and left breasts for symmetry and to previous mammograms for changes. If a new finding is identified and or a finding has changed from the previous mammogram, then additional mammogram images may be taken or a breast ultrasound may be performed. The following is a list of findings that may be identified on your mammogram.

• Skin: Changes of the skin may appear on the mammogram. There may be skin thickening in the scan associated with edema from infection, possibly associated with an abscess, trauma secondary to seatbelt injury or postsurgical changes, post-radiation changes, or a malignancy suggesting possible inflammatory breast cancer. Nipple changes of the breast may appear as nipple retraction, which could represent a chronic benign process or may suggest that a mass is pulling and or retracting the nipple. Skin changes of the nipple may be associated with Paget’s disease of the nipple.
• Asymmetric density: An asymmetric density is an area of increased whiteness seen on the mammogram, which may represent stable benign-appearing asymmetric fibroglandular tissue, benign postsurgical and or post-traumatic changes, or a malignant process such as infiltrating lobular carcinoma. Additional mammograms and or breast ultrasounds may be performed to evaluate the area of asymmetric density if there has been a change since the previous mammogram.
• Mass: A mass is a structure with borders. The mass may appear as an oval or round white density or an irregular marginated density on a mammogram. The mass may represent a benign mass, such as a cyst, fibroadenoma or lymph node. The lymph node may be within the breast or in the underarm (axilla). An enlarged axillary lymph node may respond to a process that is occurring in the breast, such as a malignancy, or may represent a systemic process, such as leukemia or lymphoma, versus a benign process, such as systemic lupus erythematosus (SLE). The irregular mass may represent a malignant mass, such as infiltrating ductal carcinoma. To further evaluate the mass, additional mammogram images and breast ultrasound will be performed.
• Calcifications: Calcifications are granular dots and or linear densities that appear as white densities on a mammogram. The calcifications may be associated with a benign process, such as fibrocystic changes, milk of calcium in microcysts, calcifying oil cysts, dystrophic calcifications from previous trauma and or postsurgical changes, a degenerating fibroadenoma, secretory-type calcifications, or vascular-type calcifications. Calcifications may also be suggestive of an atypical process if grouped together and varying in size and density. The atypical calcifications may represent atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH) or lobular carcinoma in situ (LCIS). Calcifications in a group with a branching appearance and varying in size and density are suggestive of intra-ductal cancer, also known as ductal carcinoma in situ (DCIS). Additional mammogram images with magnified views of the calcifications may be performed to further characterize and evaluate them.

If My Mammogram Shows an Abnormality, What Do I Do Next?

The majority of abnormalities detected by screening mammograms are benign. You will be asked to come back to do a diagnostic mammogram, where additional images will be taken. If a finding is identified on a mammogram and or breast ultrasound and thought to be suspicious, the radiologist will discuss these findings with you and recommend a biopsy.

The biopsy options include image-guided, vacuum-assisted or surgical excisional following image-guided needle localization. The type of biopsy recommended depends on the suspicious finding identified on the mammogram and ultrasound. The radiologist will make a recommendation based on the imaging findings.