Women's Imaging Center

·        When should I start doing breast self-exams?

o   By age 20, all women are encouraged to do breast self-exams on a monthly basis. Knowing what your body normally looks and feels like will help you notice any changes

·        What is a mammogram?

o   A mammogram is a low-dose X-ray of the breast. It can detect a breast lump nearly two years before it can be felt. Screening mammograms evaluate breast health in women with no symptoms, and are used for those who seek routine breast evaluation. Mammograms are performed to examine breast tissue and recognize abnormalities

·        How will I know when it’s time to get my first mammogram?

o   The American Cancer Society and the American College of Radiology (ACR) recommend annual screening mammograms for women beginning at the age of 40

·        How should I prepare for my mammogram?

o   Here are a few things we recommend doing before you arrive for your appointment:

§  Schedule the screening when your breasts are least likely to be tender. If you still get a monthly period, this is likely the week after you finish your cycle

§  Bring any previous mammogram images if this is your first time being screened with us

§  Don’t apply deodorant or powder before your mammogram. Metallic particles from these products could show up your mammogram and create confusion

§  Take an over-the-counter pain medication about 1 hour before your mammogram to ease any possible discomfort from the exam

·        What is 3D breast tomosynthesis?

o   3D breast tomosynthesis3D breast tomosynthesis, also referred to as 3D mammography, is the latest, FDA-approved technology in breast imaging and allows radiologists to examine breast tissue one layer at a time. This type of imaging converts conventional two-dimensional digital images of the breast into a stack of 1 millimeter layers or “slices” to create a three-dimensional image of the breast. Breast tissue detail is then examined using the two-dimensional image as well as the three-dimensional image

·        What can I expect from a 3D mammogram versus a traditional 2D mammogram?

o   From a patient’s perspective, a 3D breast tomosynthesis exam is almost identical to a traditional digital mammogram. Just as with a traditional 2D digital mammogram, the mammography technologist positions the patient next to the imaging unit and places the breast to be imaged onto an imaging plate. The breast is then compressed while the imaging equipment captures multiple breast images. During a 3D tomosynthesis exam, the x-ray arm of the mammography machine makes an additional quick arcing movement over the breast, taking a series of images at unique angles. These images are then used to create a 3D rendering of the breast. These additional images only take an extra 4 seconds to capture, making this supplemental screening simple, easy, and painless for the patient

·        What is breast density?

o   Breasts are made up of a mixture of fibroglandular tissue and fatty tissue.  The breast is considered to be dense if there is a greater percentage of fibroglandular tissue as compared to fatty tissue.  “Breast density” is a term used to describe the amount of fat relative to fibroglandular tissue that the radiologist sees on a mammogram

o   Radiologists subjectively characterize each mammogram into four categories. These categories are listed below in order from least dense to most dense. If you fall into the heterogeneously dense tissue or extremely dense tissue categories, then you are considered to have dense breasts.  Approximately half of the population is considered to have dense breasts

o   The following are the four categories of breast density:





·        Why do I need to be aware of my breast density?

o   Fatty tissue appears dark on the mammogram, whereas glandular tissue appears white. More white than dark areas on the mammogram equates to a “denser” breast. Tumors also appear white on a mammogram; therefore, it can be more difficult to detect these abnormalities on a dense breast

·        Does a patient with dense breasts still need a mammogram?

o   According to the American College of Radiology (ACR) and the California Department of Public Health, the recommendation for annual screening mammography remains exactly the same for women with dense breasts as for the rest of the population. Mammography is also the only modality that can detect abnormal calcifications, which remain visible on the mammogram regardless of breast density. These calcifications are often the earliest signs of cancer

o   Mammograms remain the gold standard for breast cancer screening. There is no other screening modality recommended to replace mammography. Breast ultrasound or breast MRI may be recommended for certain patients with additional risk factors such as family history

·        I still have concerns about breast density and my risk for breast cancer, what can I do?

o   If you do not have other breast cancer risk factors, rest assured that your risk remains low. Be vigilant and practice monthly breast self-exams, have an annual physical breast exam performed by a clinician, and continue getting your annual screening mammogram exam. Following these practices can aid in early breast cancer detection