Fast facts & frequently asked questions
General questions
What happens if an abnormality is spotted? Does it mean I have cancer?
My doctor told me I needed more tests. Why?
What is a needle localization?
What are some of the risk factors associated with breast cancer?
Why is early detection so important?
What if I do not have insurance or my insurance will not cover my exam?
Mammograms
What will my mammogram be like?
Why is a baseline mammography important?
How will I get the results of my mammogram?
How often should I get a mammogram?
How much radiation am I exposed to?
Will my breast implants ‘pop’ if I have a mammogram?
What is a mammogram with breast implants like?
Should I have a mammogram if I’m breast feeding?
Breast cancer doesn’t run in my family. Why do I need a mammogram?
What is Computer Aided Diagnostics (CAD)?
Who should have a breast MRI with their mammogram?
Breast ultrasound
What will my breast ultrasound be like?
Ultrasound Guided Biopsy
How do I prepare for ultrasound-guided biopsy?
What is a stereotactic biopsy like?
How do I prepare for stereotactic biopsy?
Breast MRI
What will my breast MRI be like?
Can I have an MRI if I’ve had breast reconstruction?
MRI Guided Biopsy
What will my MRI-guided biopsy be like?
How do I prepare for an MRI-guided biopsy?
Bone Densitometry
What will my bone densitometry be like?
How do I prepare for bone densitometry?
What are the symptoms of osteoporosis?
Can osteoporosis be prevented?
What are common risk factors for osteoporosis?
What’s the difference between heel, spine and femur exams?
How much radiation am I exposed to?
Should I have a screening before menopause?
How often should I have this exam?
General questions
What happens if an abnormality is spotted? Does it mean I have cancer?
No! News of an abnormal result could make anyone anxious. Only one to two mammograms per 1,000 lead to a cancer diagnosis. Irregularities in breast tissue require careful study. More mammographic views and other diagnostic techniques like breast ultrasound, image-guided biopsy, or breast MRI can be a part of the diagnostic process.
My doctor told me I needed more tests. Why?
Gathering all the information needed to make a thorough interpretation of an imaging study takes time and can be difficult. Any abnormality requires careful evaluation and may require additional mammographic views or different exams including breast ultrasound or image-guided breast biopsy to confirm a diagnosis. The process often begins with additional mammographic views of the area of concern. If there is further concern a breast ultrasound is used to determine if a lump is filled with fluid (cystic) or is solid (could be malignant or benign). Depending on the findings from the breast ultrasound, further studies, such as breast MRI may be recommended in patients at high risk or with biopsy proven breast disease.
What is a needle localization?
A needle localization is requested when abnormal tissue is found and the lump or affected tissue is too small to feel. Needle localization is performed by a radiologist the same day as a surgical breast biopsy is scheduled. Using mammography and/or ultrasound, the radiologist guides a wire marker next to the suspicious area so that the lesion may be removed during surgery. This procedure increases the accuracy of the breast biopsy.
What are some of the risk factors associated with breast cancer?
Known risk factors for breast cancer include a family history of cancer, late pregnancy (after 35) or never bearing children, significant radiation exposure as a child, and previous breast biopsies indicating atypical or an increased number of cells. It is important to note that breast cancers can occur even if you don’t have any risk factors. This is why regular mammography screening is important for early detection of breast cancer.
Why is early detection so important?
Early detection can help doctors treat cancer early. Treatments are more likely to work well when cancer is found early.
What if I do not have insurance or my insurance will not cover my exam?
A sliding fee scale is available for our patients who meet eligibility criteria. In some cases there will be no fees applied for services received. In any circumstance, please do not delay your mammogram because you are concerned about payment. Talk to us!
Mammography
What will my mammogram be like?
Your exam will be performed in private by a female certified technologist. Before the exam, you will undress from the waist up, change into a gown, remove any powder, deodorant and/or perfumes from your underarms and breasts (because material in these products can interfere with accurate visualization of your breast tissue). A typical screening mammogram consists of two views of each breast, one from above, another from the side. Images are obtained by compressing your breast tissue between two compression paddles.
Why is a baseline mammography important?
Your first mammogram, or baseline, is valuable because it gives the radiologist a “yardstick” against which to measure current results. Occasionally, a cancerous tumor is only seen when a radiologist compares your current mammogram to one you’ve had before.
Does a mammogram hurt?
Because adequate compression is needed to detect subtle abnormalities and lower radiation exposure, there may be brief discomfort, especially if your breasts are tender. The best way to reduce discomfort is to schedule the exam a week after your menstrual cycle, stop drinking caffeinated beverages five days before the exam and take a non-aspirin pain reliever.
How will I get the results of my mammogram?
Your mammogram and any other exam results will be reviewed by TRA’s board certified radiologists who specialize in breast imaging and are then forwarded to your doctor within two business days. If you had a screening or a diagnostic mammogram, a letter explaining the results will be mailed to you. Make sure to follow up with your health provider because the results will be compared to your overall health, which only your healthcare provider can assess.
How often should I get a mammogram?
The American Cancer Society (ACS) and many other medical organizations recommend yearly mammograms for all women age 40 years and older (including those with breast implants). Both the ACS and the National Institute for Health (NIH) see a definite survival benefit for women who begin getting mammograms in their 40s. If you have a family history of breast cancer or breast conditions, your doctor may have you start annual mammogram screening earlier than 40.
How much radiation am I exposed to?
Exposure is about 0.2 rads to 0.3 rads per breast, which is about the same amount of naturally occurring radiation found in your environment. There is no evidence that this level has any effect on the breast, particularly after age 40.
Will my breast implants “pop” if I have a mammogram?
These occurrences are extremely rare and finding an abnormality with mammography far outweighs the risk. The average mammogram generates less than 4 lbs. of pressure. Most breast implants are designed to withstand hundreds of pounds of pressure. If you have breast implants, it is just as important that you participate in regular mammography screenings.
What is a mammogram with breast implants like?
Mammography with breast implants requires special positioning and additional mammographic views. A mammogram with breast implants will usually consist of four views of each breast, one from above and one from the side and two displacement views. Displacement views consist of moving the implant back toward the chest wall and bringing the breast tissue forward. Images are obtained by firmly and briefly pressing the breast tissue between a compression paddle and a plate. Adequate compression is essential to detect subtle abnormalities and reduce radiation exposure. Damage to implants from a mammogram procedure is extremely rare. In addition, visualization of breast tissue around implants can be more difficult. This makes regular self breast exam and a clinical breast exam by your doctor an important part of your breast health routine.
Should I have a mammogram if I’m breast feeding?
Unless you are experiencing symptoms, mammograms should be postponed if you are breast feeding. It takes about 3 months for breasts to return to normal after you stop nursing.
Breast cancer doesn’t run in my family. Why do I need a mammogram?
Regular mammography is important for ALL women. Three out of 4 women diagnosed with breast cancer have no risk factors for the disease. ALL women are at risk for breast cancer with the risk increasing as they age. If you are female and over 40, you need a mammogram every year regardless of your family history.
How accurate is a mammogram?
Evidence has shown that mammography is an effective tool for detecting breast cancer. When an abnormality does appear on a mammogram and biopsy is recommended, only 1 out of every 3 or 4 prove to be malignant (cancerous). Some breast cancers cannot be detected on a mammogram, but mammography is still the best tool available for detecting cancers too small to be felt. Because some breast cancers do not show up on mammograms, it is important to incorporate regular breast self exam and an annual clinical breast exam by your doctor as part of your breast health routine.
What is Computer Aided Diagnostics (CAD)?
Carol Milgard Breast Center provides computer aided diagnostics with all screening mammograms. CAD uses sophisticated computer programming to analyze medical images following initial interpretation by a radiologist. CAD is believed to improve the diagnostic accuracy of a mammogram exam by up to 20 percent.
Who should have a breast MRI with their mammogram?
In some cases, women whose mammograms and ultrasounds show abnormalities may need an MRI to confirm a diagnosis. Women with very dense breasts or scar tissue from surgeries may also require the additional MRI tests because of the difficulty of detection.
Breast ultrasound
What will my breast ultrasound be like?
Ultrasound images are obtained by gently pressing and rolling a hand-held transducer over areas of the breast or underarms. A gel is utilized to improve sound wave propagation. Breast ultrasound examinations are generally not painful.
Why have a breast ultrasound?
An ultrasound of the breast is an excellent way to evaluate abnormalities detected by a mammogram. Sometimes it is not possible to tell from an imaging study alone if an abnormality is benign or cancerous. Ultrasounds can determine if a lump is fluid filled or solid. They can also indicate abnormalities that can not be felt during a self exam or clinical exam.
What is a cyst aspiration?
A breast lump that you can feel might make you worry about cancer. Breast cyst aspiration can help your doctor find out if the lump you feel is a cyst or a tumor. Aspiration of breast cyst is done with ultrasound so
that a small needle can be inserted to the cyst and the fluid drained.
Breast MRI
Why would I need a breast MRI?
Breast MRI is considered the most accurate test available to detect breast cancer in specific circumstances and may be recommended in patients at high risk or with biopsy proven breast disease.
What will my breast MRI be like?
There is no pain associated with the Breast MRI. Personal items that contain metal such as watches, necklaces and wallets including credit cards with magnetic strips should be left at home or removed prior to the MRI scan. You will be asked to wear a hospital gown. During the MRI, you will lie on your stomach on a scanning table. Your breasts hang into a depression or hollow in the table. The table is moved into the bore of the MRI. As the procedure begins you will hear a variety of muffled thumping and beeping sounds that will last for several minutes. After the initial series of images has been taken you may be given contrast intravenously. The contrast helps improve the ability to see tumors. Additional images will be taken after the contrast injection. The entire exam takes about an hour. The results of the exam are read by a radiologist and sent to the doctor who referred you for the Breast MRI.
How do I prepare for an MRI?
No advanced preparation is needed. If your doctor has prescribed oral sedation or pain medication, avoid use of caffeinated products on the day of your exam and be sure to bring someone who can drive you home when the exam is done.
Can I have an MRI if I’ve had breast reconstruction?
Prior to your procedure you will be asked to complete a screening questionnaire to help us determine if the MRI is safe for you. You will be asked to list any reconstruction surgeries or augmentation you have had. The MRI technologist will review the screening worksheet with you prior to the procedure to ensure your safety. If you have reconstruction in progress and have tissue expanders in place the technologist will need to know the type of expander used to make sure it is compatible with the MRI.
Stereotactic Breast Biopsy
Why would I need a Stereotactic Breast Biopsy?
A Stereotactic Breast biopsy is a reliable, minimally invasive method for determining if a mammographically, ultrasonographically or MRI detected breast tissue abnormality is cancerous.
What is a stereotactic breast biopsy like?
Stereotactic breast biopsy takes place in a suite which is equipped with a special biopsy table designed for optimal access to the breast. You will be assisted onto the table into a prone position (on your stomach). While you lie on the table, images of the breast are obtained with the breast compressed. Once the lesion in the breast has been located, a local anesthetic is injected and a small (approximately 1/4 inch) incision is made. Using computer assisted x-ray techniques,the radiologist then guides a biopsy device to the area of suspicion and extracts the tissue samples needed for interpretation by a pathologist. Due to the anesthetic, most patients experience little or no discomfort during the procedure. You should be able to resume your normal activities the same day unless you were prescribed an oral sedative. Please follow your doctor’s instructions for the medication and be sure to have someone available to drive you home.
How do I prepare for stereotactic biopsy?
You may eat and drink normally prior to your procedure. You should take your medications as prescribed, but make sure to ask your health care provider about blood-thinning medications you may be taking including aspirin or aspirin-related products. Wear comfortable clothing. Most patients prefer a two-piece outfit as you will be asked to wear a gown during the procedure. Do not wear any powder, perfumes, deodorant and/or lotions on your underarms and breasts prior to the exam. Moist towelettes and deodorant are available. If you want to take a sedative during the biopsy, you must have a driver to take you home.
What is wire localization?
Wire localization is when a guide wire is placed into the suspicious area of the breast to help the surgeon locate the abnormal tissue for surgical biopsy.
Ultrasound guided biopsy
How do I prepare for ultrasound-guided biopsy?
You may eat and drink normally prior to your procedure. You should take your medications as prescribed, but make sure to ask your health care provider about blood-thinning medications you may be taking including Aspirin or Aspirin-related products. Wear comfortable clothing. Most patients prefer a two-piece outfit as you will be asked to wear a gown during the procedure. Do not wear any powder, perfumes, deodorant and/or lotions on your underarms and breasts prior to the exam. Moist towelettes and deodorant are available. If you want to take a sedative during the biopsy, you must have a driver to take you home.
MRI guided biopsy
What will my MRI-guided biopsy be like?
Your experience will be similar to the breast MRI. The exception being once the lesion is in view, a local anesthetic is injected and a small (approximately 1/4 inch) incision is made. Under the guidance of the MRI, the radiologist then guides a biopsy device to the correct location and extracts the tissue needed for interpretation by a pathologist. Following the biopsy, you should take the rest of the day easy. Normal activities can resume the next day.
How do I prepare for MRI-guided biopsy?
You may eat and drink normally prior to your procedure. You should take your medications as prescribed, but make sure to ask your health care provider about blood-thinning medications you may be taking including aspirin or aspirin-related products. Wear comfortable clothing. Most patients prefer a two-piece outfit as you will be asked to wear a gown during the procedure. Do not wear any powder, perfumes, deodorant and/or lotions on your underarms and breasts prior to the exam. Moist towelettes and deodorant are available. If you want to take a sedative during the biopsy, you must have a driver to take you home.
Bone densitometry (DEXA)
What will my bone densitometry be like?
You will lie still on a padded scanning bed, breathe normally and rest comfortably. The scan takes about 10 minutes. After your exam, you may resume your normal activities.
How do I prepare for bone densitometry?
DEXA examinations do not require special preparation. You may eat and drink normally and take any medications you regularly take before and after your exam. You should avoid wearing clothing with metal buttons or zippers for your examination. A loose fitting outfit with an elastic waist is best.
What are the symptoms of osteoporosis?
Osteoporosis is often called the “silent disease” because bone loss occurs without symptoms. People may not know that they have osteoporosis until their bones become so weak that a sudden strain, bump or fall causes a fracture or a vertebra to collapse. Collapsed vertebra may be detected by severe back pain, loss of height, or spinal deformities such as stooped posture.
Can osteoporosis be prevented?
Building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later in life because the average woman has acquired 98 percent of her skeletal mass by age 20. A good prevention program includes a balanced diet rich in calcium and Vitamin D, weight-bearing exercise, a healthy nonsmoking lifestyle with limited alcohol intake, bone density testing and medication when appropriate.
What are common risk factors for osteoporosis?
Common risk factors include being female, having a thin or small frame, advanced age, a family history of osteoporosis, being either post-menopausal or having menopause surgically induced, having an abnormal absence of menstrual periods, or eating disorders. Other risks include a diet low in calcium, use of certain medications including steroids, cigarette smoking, inactive lifestyle, and excessive use of alcohol. It is also associated with low testosterone in men.
What’s the difference between heel, spine and femur exams?
Peripheral examination of the heel or wrist is considered adequate for screening patients at low risk for development of osteoporosis. DEXA (dual energy x-ray absorptiometry) of the spine and femur is the gold standard measurement for diagnosis of osteoporosis and measurement of treatment response. The spine and hip are the areas where osteoporotic fracture occurs most frequently.
How much radiation am I exposed to?
Radiation exposure from all bone densitometry examinations is minimal, comparable to 1/10th the exposure received from the naturally occurring radiation you are exposed to in one week.
Should I have an osteoporosis screening before menopause?
Bone densitometry screening before menopause is generally not indicated without prolonged steroid use, however, your physician may recommend examination if you exhibit other significant risk factors.
How often should I have this exam?
Medical opinion on frequency of bone densitometry examination varies. Examination every 3 to 4 years after menopause is generally recommended. More frequent examination, every 6 months to annually, may be recommended to monitor response to drug therapy.
