The “Ins and Outs” of Mammography: Straight from the Imaging Center Experts

The registered mammography technologists at EIRMC have seen it all and heard it all. They've helped countless women overcome anxiety during their mammograms, and understand the most common fears of women. In fact, they've put together a list of frequently asked questions.

To schedule a mammography at EIRMC's Imaging Center, call 227-2612.

I received a mammography result letter that says I have "dense breast tissue". What does this mean?

In all breast tissue, there are areas of fatty tissue and glandular tissue. Some women have breasts that may be comprised of almost all fatty tissue (fatty breast tissue). Others have a combination of fatty and glandular (scattered, fibroglandular densities and some women have mostly glandular breast tissue with little or no fatty tissue, known as dense breast tissue). The reason for this difference can be genetic, hormonal, nutritional, or due to child bearing or breast feeding.

Fibroglandular or dense breasts are a condition, not a disease. Dense breasts do, however, limit the sensitivity of mammography and carry an increased risk of breast cancer. Simply said, this type of tissue is hard to "see through" and evaluate with complete accuracy. On mammography, dense or extremely dense glandular tissue can "hide" an abnormal area. Dense breast tissue, if not compressed extremely well on mammography, can also give a false abnormal appearance. Both of these scenarios may lead to extra imaging, using a combination of mammography, ultrasound and/or breast MRI.

Your result letter categorizes your breast tissue density. Many states are enacting laws to help keep people informed about their personal type of breast tissue; thus enabling you to make an informed choice about your health care.

- Cari Medeiros, BS RT(R)(M)

Why can't I just have a breast ultrasound instead of a mammogram?

The gold standard for breast cancer screening remains mammography. Mammography can show changes in breast tissue two years before it can be felt. This allows for early diagnoses and treatment, when breast cancer is most curable. Ultrasound cannot detect some of the very small changes that indicate early breast cancer. It is, however, an effective modality to be used in conjunction with mammography, when indicated. Death rates from breast cancer have declined 30 % from 1989-2009, likely due to increased screening mammography.

- Cari Medeiros, BS RT(R)(M)

Why is yearly screening important?

We are going to answer this by talking about two stages of breast cancer:

DCIS- Ductal Carcinoma In Situ- cancer cells are present and confined to the duct of the breast. These account for 25-30% of breast cancer. DCIS left untreated often becomes invasive carcinoma.

Invasive Carcinoma- When malignant cells break through the membranes of the duct and they invade the surrounding tissue.

Obviously we want to "find" breast cancer at its earliest stage. This is accomplished by yearly mammography with careful comparison to prior year's images. By looking at changes from year to year, we are able to accurately detect small changes.

Kristie Anderson, AS RT(R)(M)

Do men ever get breast cancer?

Although male breast cancers are rare (less than 1% of breast cancers), the incidence rate has increased .8% annually from 1975 to 2008. It is not recommended that men participate in screening mammography, but self-breast exam is appropriate for both males and females.

-Kristie Anderson, AS RT(R)(M)

What is this CAD charge on my mammogram bill?

CAD refers to computer aided detection. It is a form of software used with most digital mammography systems that "searches" the digital image looking for abnormalities. CAD will flag certain areas of the breast that meet specific criteria. Most radiologists read the mammogram first and then run CAD afterward as a double check. Using CAD as a "second reader" has been shown to detect 20% more breast cancers than using a radiologist reading alone.

-Cari Medeiros, BS RT(R)(M)