Breast Imaging Frequently Asked Questions

What is the difference between screening mammography and diagnostic mammography?

Screening mammography is a test to find breast cancer before it can be felt. It is done when a person has no signs or symptoms of breast cancer. Finding breast cancer early allows less aggressive treatments and decreases the chances of dying from breast cancer.

Diagnostic mammography involves obtaining additional views of the breast. It may also include focused breast ultrasound. It is performed when an abnormality has been found during screening, or in women who may be experiencing a breast lump or thickening, nipple discharge, or localized breast pain.

What is 3-D tomosynthesis?

3-D mammograms, now the standard of care, creates high-resolution detailed images of individual levels of the breast. 3-D tomosynthesis decreases callbacks for additional imaging by 15% and increases breast cancer detection by 40%.

Do I need a mammogram?

You and your provider should discuss your screening preferences. While all medical organizations agree annual screening at age 40 saves the most lives and decreases the chances of needing chemotherapy or more extensive surgery - the decision to screen or not and how often - remains yours. The American College of Radiology advises annual screening at age 40 (when the incidence of breast cancer rises) continuing as long as you are in good health and would want to undergo treatment.

Do I have dense breasts?

About one-half of women are considered to have dense breasts. Radiologists are required to describe breast density in their reports. If you have "heterogeneously" or "extremely" dense breast tissue (versus "fatty" or "scattered" density) it slightly increases your risk of breast cancer and can make detection of some findings more difficult. Increased breast density alone does not make a woman at "high risk." You and your provider should discuss whether supplemental screening with breast MR. Whole breast ultrasound screening is not recommended since it has a high number of false positives and a low yield of breast cancers relative to breast MR. It could be performed if you are unable to undergo a breast MRI.

What if I am at high risk?

You and your provider should discuss your risk for breast cancer through a risk assessment involving a series of questions including your family history among other things. If your lifetime risk of getting breast cancer is above 20% you are considered “high risk” and would benefit from supplemental screening with breast MRI.

What do I do before my mammogram?

  1. If you have had mammograms elsewhere, please call that facility and have your results sent to us before your appointment—these tests will be needed for comparison.
  2. Please do not bring your children with you—the mammographer cannot watch your children and give you her full attention.
  3. Try to schedule your mammogram for the week following your menstrual period, when your breasts are less tender.
  4. Wear a two-piece outfit to the examination, so you will only have to remove your top.
  5. Don't apply powders, ointments or creams to your chest area the day of the exam, because these products can show up on the X-ray images and can make it difficult to interpret.
  6. If you wear deodorant, please apply it sparingly, as you will be asked to wash it off before your mammogram.

What happens during the mammogram?

The procedure

You will be asked to undress from the waist up and put on an examination gown, and will then stand in front of the mammography unit, a special type of X-ray machine.

The mammographer will place a breast between two plastic plates and gradually compressed for a few seconds. (Compression causes a slight flattening which helps creates a clear picture while reducing X-ray dose.)

Two images are taken, one from the top and one from the side. The examination is then repeated for the other breast.

Following the exam

Your mammogram will be read by one of our specialty-trained radiologists, who will send the results to your provider. You will receive a written summary of the report. You can access your report through the myD-H patient portal.

If you have not received this summary within two weeks, contact your provider or the radiology department.