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Evaluation and Diagnosis
• In-Office Ultrasound
• Mammography
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Breast Biopsy
Benign Conditions of the Breast
• Breast Pain
• Cyst Aspiration
High Risk Evaluation
• Risk Factors for
   Breast Cancer

• Genetic Testing
• Lobular Carcinoma
   In Situ
Care of the Breast Cancer Patient

• After Surgical Treatment
  of Breast Cancer
• Lumpectomy
• Mastectomy
• Sentinel Node Biopsy
• Axillary Lymph Node
• Lymphedema
• Breast Reconstruction
• Radiation Therapy

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Evaluation and Diagnosis

What is a mammogram?
A mammogram is a safe, low dose x-ray of the breast that produces pictures of the inside of the breast.

Who should get a mammogram?
The American Cancer Society recommends that all women over the age of 40 have a mammogram yearly to see if there are changes they cannot yet detect in their breast. This is called a “screening mammogram”. Some physicians obtain a baseline between 35-40, or may do a mammogram sooner if there is a family history of breast cancer in a first degree relative such as a mother or sister at a young age. A “diagnostic mammogram” is ordered when a woman has a complaint such as a breast lump or other symptoms, or if a woman has breast implants.

What is the difference between a regular mammogram and a digital mammogram?
A standard mammogram is an x-ray of the breast in which the images are projected onto film and stored and read by the radiologist in that form. Digital mammography produces an x-ray image on a computer. The radiologist when reading the exam can refine the contrast of the image so that some lesions can be seen more clearly. Studies are still in progress as to whether one method is better than the other. Digital mammography is easier to store than film screen mammography, and allows other physicians to be able to view the images from their offices. Not all centers have digital mammography due to the cost of the equipment.

How is a mammogram done?
During the mammogram a specially trained radiology technologist will position your breast in the mammography machine. The breast is compressed (squeezed) in two different positions – from top to bottom, and from side to side. Typically several pictures are taken of each breast. The compression helps hold the breast in place for a better picture and decreases the thickness of the breast, allowing the x-ray to penetrate the breast more easily, reducing the dose needed for the picture.

Do I need to do anything to prepare for the mammogram?
If you have not had your mammograms done previously at the facility for which your appointment is scheduled, please obtain the prior films and bring them or have them sent before the day of your visit. It is important to compare previous films to the new films so the radiologist can identify any subtle changes that may have occurred. Do not wear powder, lotion, or deodorant on the day of your exam.

Is a mammogram painful?
Some women find the pressure of the compression uncomfortable, but it should not be painful and lasts only a few seconds for each picture. If you find it uncomfortable, talk to the technologist. She will make every effort to make you as comfortable as possible and answer any questions you may have. Try to schedule your mammogram after your menstrual cycle when your breasts are least sensitive. Some women who have sensitive breasts find it helpful to decrease their caffeine intake several days prior to having a mammogram taken.

How long does a mammogram take?
A screening mammogram takes only about 15 minutes. This usually includes the time it takes the technologist to review the films to make sure they are good quality. Sometimes it may be necessary to repeat some pictures. A diagnostic mammogram usually requires more time since there is an area of concern or focus, and usually requires more specialized pictures.

Who will read my mammogram?
Your mammograms will be read by dedicated breast radiologists. In addition, our radiologists are using a computer assisted detection device (CAD) to second read all mammograms. CAD technology scans the mammograms for abnormalities and may improve the early detection of breast cancers.

When will I receive my results?
Routine screening mammogram results will be sent to the physician that ordered the exam. Usually the radiologist does not discuss the results at the time of your visit, but you will receive a letter within one week. A diagnostic mammogram requires a radiologist to be present at the time of the examination and the results are usually discussed before you leave.

What are microcalcifications?
Sometimes a mammogram will show calcium deposits in the breast. Microcalcifications are benign (no cancer) in about 80% of cases. The radiologist is specially trained to identify benign calcifications by looking at their size, shape and configuration. Microcalcifications can be caused by fibrocystic changes in the breast, aging, previous biopsies, and sometimes injury. However, in some cases microcalcifications may indicate that a cancer or pre-cancer is present. These microcalcifications have a specific shape and arrangement that causes the radiologist to recommend additional testing or follow-up.

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