Services and Procedures
A mammography, also called a mammogram, is an X-ray of your breast that helps physicians diagnose breast diseases, such as breast cancer.
Mammograms are commonly used to:
- Screen for breast cancer, even if you have no symptoms
- Detect breast disease if you experience symptoms such as a lump, pain, or nipple discharge
Studies show yearly mammograms help detect breast cancers when they are potentially more curable, and breast-conservation therapies are more effective.
Current American Cancer Society (ACS) guidelines recommend you get a screening mammography annually, beginning at age 40.The National Cancer Institute (NCI) recommends you talk to your doctor about getting screened earlier than age 40 if you’ve had breast cancer, or have a genetic history of breast cancer.
UVMC uses the latest digital mammography technology, also called Full-Field Digital Mammography (FFDM). Instead of X-ray film, digital mammography uses a digital image similar to the way a digital camera captures an image.
After your exam, images of your breast are transferred to a specialized computer for evaluation. The exam procedure is the same for X-ray and digital mammograms, but a digital mammography takes less time. Film mammograms require that the technologist wait three to five minutes for films to develop in a dark room, while digital mammography images are viewed in seconds. This allows your technologist to determine if images are clear, or another set of images is needed.
Screening mammograms often detect cancer early because they can show changes in your breast such as lumps or dense areas. This is one reason the ACS recommends a yearly screening for all women age 40 or older.
After your yearly screening exam, your radiologist compares previous images of your breasts with current images to identify changes. Annual mammograms can detect breast cancer years before it can be felt during a manual breast exam. The recommended one-year interval is long enough to detect changes, and short enough to address any concerns physicians find.
Sometimes mammography images detect the existence of calcifications, which are tiny flecks of calcium in your breast not always detected during a physical exam. These calcifications may be one indicator of cancer. When certain calcifications are detected on mammogram images, they alert your radiologist that cancer might be present even if it’s not seen on the image.
When a mammogram or ultrasound shows a breast abnormality that is suspicious for cancer, or not clearly benign, a biopsy procedure may be needed.
Biopsies are performed for one of the following reasons:
- A mammogram or ultrasound shows a suspicious mass that may or may not be felt by a physical exam.
- A mammogram shows a suspicious cluster of small calcium deposits.
- The structure of your breast tissue is distorted or changed unexpectedly.
- A new mass or area of calcium deposits is present at a previous surgery site.
- A lymph node is abnormal.
We offer minimally-invasive, image-guided core biopsies using stereotactic mammography, sonography, and magnetic resonance imaging (MRI), which all guide the sampling of tissue, and make biopsies faster and more accurate. The major difference between these diagnostic procedures is the imaging method used to target the area of concern.
UVMC radiologists dedicated to breast imaging and breast care perform all diagnostic biopsies. A pathologist evaluates tissue samples to determine the type of tissue in the abnormality, and if needed, diagnose the type of breast cancer.
Prior to imaging technology, patients with abnormal mammograms received a surgical biopsy. These biopsies require a larger incision, and remove a greater amount of tissue than stereotactic, ultrasound-guided, and MRI-guided core biopsies. Surgical biopsies are now used when diagnostic biopsies show breast cancer.
Stereotactic, or X-ray-guided biopsies, are used when the abnormality can’t be visualized on an ultrasound. If you have this type of biopsy, you lie on your stomach while multiple images are taken from different angles. These computer images target the exact site of abnormalities. Throughout your procedure, additional views are taken to ensure the correct location is sampled.
In ultrasound imaging, also called ultrasound scanning or sonography, high-frequency sound waves produce real-time pictures of your breast tissue. Ultrasound exams don’t use ionizing (X-ray) radiation. Because ultrasound images are captured in real time, they can show the structure and movement of your body tissue, as well as blood flowing through your vessels. In an ultrasound-guided biopsy, you lie on your back while a radiologist uses real-time images to guide a probe to the abnormality.
Magnetic resonance imaging (MRI) is the newest and most advanced type of breast imaging. It uses a combination of magnetic and radio waves to create three-dimensional images of your breast. MRI-guided biopsies are performed while you lie on your stomach. After the MRI scan is obtained, your radiologist uses a grid within the image to locate and biopsy the area of concern. You must remain completely still for both the scan and biopsy procedure, which usually takes up to an hour, but can take up to two hours.
Preparing for a Biopsy Exam
Please arrive 30 minutes before your appointment. You will undress from the waist up so wearing a two-piece outfit may be more comfortable.
There is no extensive preparation needed for a biopsy, but eat a good breakfast before your procedure. If you take aspirin, you may be asked to stop taking it a few days before your appointment because it’s a blood thinner. The biopsy itself takes about 20 minutes, but the entire appointment may take a little more than an hour.
During the procedure, your radiologist numbs the area with an anesthetic then makes a small incision in your skin. Using the images as a guide, your radiologist inserts a probe into your breast to extract a small piece of tissue. This probe rotates automatically, taking tissue samples from different areas without requiring another incision.
Your radiologist may also insert a tiny titanium or stainless steel marker to identify the exact biopsy location for future imaging. You won’t be able to feel this marker; it can only be detected by a mammogram. Your radiologist might order a mammogram after your procedure to ensure the correct area was sampled, and check for bleeding.
After your procedure, you receive detailed, written instructions. You can drive yourself home or back to work. However, if your job is strenuous, it’s not recommended you return the day of your procedure.
After your biopsy you should:
- Limit strenuous activities such as heavy lifting or pulling for 24 hours
- Keep your incision clean and dry
- Apply ice to your breast the rest of the day
- Take acetaminophen (Tylenol®) or other pain-relievers except aspirin