Which is the Right Mammogram for You?

by Marie Borsellino, M.S.N., R.N., O.C.N., October 01, 2016

A mammogram is an x-ray of the breast. It is considered a 2D or 2 dimensional image. Screening mammograms are routinely administered to detect breast cancer in women or men who have no apparent symptoms. They consist of two “views” or pictures of the breast. If something suspicious is seen on a 2D image, you will be called back for more film views, and ultrasound or both.

If someone presents with some of the following signs they will not have a screening mammogram but rather require a more detailed imaging. A diagnostic mammogram is indicated which consists of four “views” or pictures of the breast. The signs include:

  • A lump
  • Breast pain
  • Nipple discharge
  • Thickening of skin on the breast
  • Changes in the size or shape of the breast

A diagnostic mammogram based on the facility and the type of mammography equipment available may have to do a diagnostic mammogram for patients with breast implants.

A new digital technology, breast tomosynthesis or 3D imaging has shown to be an advance over 2D mammography.

A new digital technology, breast tomosynthesis or 3D imaging has shown to be an advance over 2D mammography, with higher cancer detection rates and fewer patient recalls for additional testing. The idea of having the additional component of 3D and not having to come back helps so much to decrease anxiety as well as better breast screening accuracy.

What to expect from a 3D mammography exam?

During the 3D part of the exam, the x-ray arm sweeps in a single motion over the breast taking multiple images. Then a computer produces a 3D image of the breast tissue in one millimeter slices. The radiologist can see all aspects of the breast better as it is separated like pages in a book.

What are the benefits?

With 2D digital mammography, the radiologist is viewing all the complexities of the breast tissue in a one flat image. Sometimes breast tissue can overlap, giving the illusion of normal breast tissue looking like an abnormal area. That’s why the radiologist has to call you back for more “views”.

By looking at the breast tissue in one millimeter slices, the radiologist can provide a more confident assessment. In this way, 3D mammography finds cancers missed with conventional 2D mammography.

What should I expect during the 3D mammography exam?

3D mammography complements standard 2D mammography and is performed at the same time with the same system. There is no additional compression required, and it only takes a few more seconds longer for each view.

Is there more radiation dose?

Very low X-ray energy is used during the exam, just about the same amount as a traditional mammogram done on film.

Who can have a 3D mammography exam?

It is approved for all women who would be undergoing a standard mammogram, in both the screening and diagnostic settings. Speak with your health care provider for the testing that is appropriate for you.

References

American College of Radiology (2014). Breast imaging special report. Retrieved from:
http://www.acr.org/~/media/ACR/Documents/PDF/Pubs/Bulletin%20Archive/2014/44BreastImagingSpecial.pdf

National Cancer Institute (2016). Mammograms fact sheet. Retrieved from:
https://www.cancer.gov/types/breast/mammograms-fact-sheet

 

Labels: Breast Cancer, Education, Prevention

Marie is the Oncology Nurse Navigator for the Managing Cancer at Work program and has worked in the field of oncology for 28 years in  many different roles. Her passion is finding new ways to connect and support patients and their caregivers with a cancer diagnosis. Besides reading oncology journals her interests are her family, listening to live music, and her addiction to yoga.