Mammography

Mammography is a specific type of imaging that uses a low-dose X-ray system to examine the breasts. A mammography exam, called a mammogram, is used as a screening tool to detect early breast cancer in women experiencing no symptoms and to detect and diagnose breast disease in women experiencing symptoms such as a lump, pain or nipple discharge. At BryanLGH all mammograms are done by female staff in private, comfortable surroundings.

Mammography plays a key role in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend a screening mammography every year for women beginning at age 40. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.

The National Cancer Institute (NCI) says that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening.

While mammography is the best screening tool for breast cancer available today, mammograms do not detect all breast cancers. Also note that a small portion of mammograms indicate cancer is present when it is not (this is called a false-positive result).

Research is being done on a variety of breast imaging techniques that can contribute to the early detection of breast cancer and improve the accuracy in distinguishing non-cancerous breast conditions from breast cancers.

Computer-aided detection (CAD) systems and digital mammography are some of the newer technologies we use at BryanLGH Medical Center.

Breast Localization (Pre-Surgical)

Pre-surgical breast localizations also can be done using the mammography equipment. This procedure involves inserting a small wire into a breast abnormality that was previously identified on a mammogram. The wire is placed by a skilled radiologist who will use mammography localization equipment and images to guide the wire to the proper place within the breast. This is followed by a surgical procedure to remove the sample of breast tissue. The surgeon uses the previously placed wire for a road map to the tissue that needs to be sampled. The removed tissue is then sent to a pathologist for examination.

Stereotactic (X-ray Guided) Breast Biopsy

Mammography is an excellent way to detect breast abnormalities, but in many cases it is not possible to tell from the imaging studies alone whether a growth is benign (non-cancerous) or malignant (cancerous). To make this determination it is necessary to obtain a tissue sample for microscopic examination. As an alternative to open surgical biopsy, which removes a larger specimen, a hollow needle may be passed through the skin into the suspicious lesion with the help of special breast X-rays. The sample of breast tissue obtained in this way can show whether the lesion is malignant or benign – and the procedure is much less invasive than the surgical approach. A special computerized mammography machine uses intersecting coordinates to pinpoint the area of tissue change. This method is called stereotactic biopsy or X-ray-guided biopsy. A pathologist examines the removed specimen and makes a final diagnosis so that treatment planning can begin.

A stereotactic breast biopsy is most helpful when mammography shows a mass, a cluster of microcalcifications (tiny calcium deposits that are closely grouped together), or an area of abnormal tissue change but no lump can be felt on careful breast examination.

An X-ray-guided biopsy often is done when:

A woman has a mammogram showing a suspicious solid mass that cannot be felt on breast examination
A woman has a mammogram showing a suspicious cluster of small calcium deposits (microcalcifications)
The structure of the breast tissue is distorted
A new mass or area of calcium deposits is present at a previous surgery site
The patient or physician strongly prefers a non-surgical method of assessment