Breast Health Frequently Asked Questions
WHEN SHOULD I GET A MAMMOGRAM?
South Sound Radiology follows the American Cancer Society (ACS) guidelines for screening mammograms:
- Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
- Clinical breast exam (CBE) should be part of a periodic health exam, about every 3 years for women in their 20s and 30s and every year for women 40 and over.
- Women should know how their breasts normally feel and report any breast changes promptly to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.
- Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.
HOW CAN I RECEIVE A SCREENING MAMMOGRAM?
Call (360) 493-4646 to make an appointment.
While a clinician’s referral is not required for a screening mammogram, we do need to know the name of your clinician so that we may send them a report.
WHY DO I NEED TO PROVIDE MY CLINICIAN’S INFORMATION?
Our standard protocol for any patient requesting a mammogram, is that they have a doctor of record that SSR can send a copy of the report to. This ensures that a medical professional knows you as a patient and can provide any follow-up care that may be needed. It also provides a contact should our staff or radiologists need to speak to you clinician.
WHAT IS THE DIFFERENCE BETWEEN A SCREENING MAMMOGRAM AND A DIAGNOSTIC MAMMOGRAM?
Like a screening mammogram a diagnostic mammogram is also a low dose x-ray examination of the breasts, but used to evaluate potential problems within the breast. If you have one or more of the qualifying symptoms, you may need a diagnostic mammogram, instead of a screening: (A diagnostic mammogram requires a clinician’s referral)
- Personal history of breast cancer
- New lump or mass
- New breast pain that is focal (localized to a specific point or area in the breast)
- New nipple inversion
- Bloody discharge from the nipple
- Short-term follow up recommended by a radiologist from a previous mammography examination
- Screening mammogram revealed a finding that needs further investigation or clarification
With a diagnostic evaluation, the technologist usually obtains the same images as with a screening exam, but also performs special customized views under the direction of the radiologist. This may include the use of special, smaller compression paddles, the use of magnification techniques, and/or breast ultrasound to focus on the area of interest or concern. Because this exam is more customized, it often requires more images be taken (as compared to a screening study), and also means that diagnostic exams from patient to patient may not be exactly the same.
I AM UNDER THE AGE OF 40 BUT HAVE CONCERNS REGARDING MY BREAST HEALTH.
If you are under the age of 40 and have a family history of breast cancer or have concerns related to your breasts, you may need to have your first mammogram earlier. Please consult with your physician for a specific recommendation.
WHY CAN’T I WEAR DEODORANT, POWDERS, OR LOTION TO MY MAMMOGRAM APPOINTMENT?
These products can contain microscopic materials which can mimic microcalcifications on your mammogram. Since microcalcifications can be an indication of breast cancer, we ask that these products not be worn on or around your breasts and under arms the day of your appointment. We do provide cleansing wipes to remove these products if going without is not an option.
CAN I GET A MAMMOGRAM IF I AM BREASTFEEDING?
The lactating breast is dense and filled with milk which can make interpreting a mammogram more difficult. Because of this we recommend women completely finish lactating before having a routine screening mammogram. However, if you are symptomatic or are feeling a lump, you should make an appointment with your physician.
WHY DO YOU HAVE TO COMPRESS THE BREAST SO MUCH DURING A MAMMOGRAM?
Compression is used during a mammogram to separate the glanduar tissue within the breast, providing differentiation between the various internal structures. It also helps reduce your radiation dose. There is no evidence that compression causes breast cancer and the amount of compression the technologist uses will depend on the actual compressibility of your breasts combined with your sensistivity level. The technologist will provide adequte compression without being excessive. Adequate compression is achieved when the skin is taut. If at any time during the mammogram you are uncomfortable, let the technologist know and she will work with you to achieve the best possible results.
I HAVE BREAST IMPLANTS. WON’T THE MAMMOGRAM BREAK THEM?
While mammographic compression could potentially cause implant rupture, it is extremely uncommon. During your mammogram, the technologist will use minimal compression when the implant is in view. Because the implant could obscure the majority of your breast tissue, specialized views called Eklund or implant displaced views will also be taken. These views allow the technologist to apply adequate compression to the tissue in front of your implants while the implant remains safely behind the compression device. Your mammogram will need to be scheduled appropriately to provide the additional time required so please notify our office staff when scheduling of your breast augmentation.
IS THERE A BETTER TIME DURING MY CYCLE TO SCHEDULE MY MAMMOGRAM OR MRI?
Yes. The best time for your mammogram is within ten days of starting your period (if you are still menstruating). Breast tenderness during this time is usually minimal, making mammographic compression more tolerable. Also, since most women ovulate 10 to 16 days after starting their period, there is a lesser chance of becoming pregnant between days 1 and 10. If you feel you may be pregnant, please inform our staff before your appointment or upon arrival.
There is also an ideal time for your MRI exam. We recommend you have your MRI 6 to 10 days after starting your period. The contrast used for your MRI will enhance or “light up” areas in your breast with increased activity. Both normal glandular tissue and abnormal tissue can enhance. Normal breast tissue is most dormant (least likely to enhance) between days 5 and 14 of your cycle, making it an ideal itime to do an MRI. This makes it easier for the radiologist to differentiate normal, glandular breast tissue from potentially abnormal areas of your breast.
A WORD ABOUT MINIMIZING RADIATION EXPOSURE.
Special care is taken during x-ray examinations to use the lowest radiation dose possible while producing the best images for evaluation. National and international radiology protection councils continually review and update the technique standards used by radiology professionals. State-of-the-art x-ray systems have tightly controlled x-ray beams with significant filtration and dose control methods to minimize radiation.