Two films are done on each breast – a view from the top and one from the side. The breast is compressed by a paddle to reduce movement, minimize blurring and reduce the amount of x-rays. A radiologist will read the films and draft a report for the patient's physician and the patient will receive a letter with the results. Women should have a screening mammogram at age 35 to provide a baseline and then every year beginning at age 40.
If a screening mammogram detects an abnormality, the patient is usually called back for a diagnostic mammogram to take additional films that magnify the area or spot in question. Patients may also have a diagnostic mammogram to monitor an abnormality seen on a prior mammogram or if they have breast implants, which need to be "pushed back" to obtain an adequate film. Patients experiencing symptoms such as pain, discharge from the nipple or a lump may also need a diagnostic mammogram. The radiologist immediately reads the film and the results are reviewed with the patient.
A breast ultrasound is usually a follow-up to a mammogram when the radiologist detects an abnormality or when a lump is felt in the breast. A transducer runs over the breast area, sending and receiving sound waves to form a picture on the screen. A radiologist reviews the images and the results are discussed with the patient.
A small needle attached to a syringe is inserted into the area of the breast in question, removing cells for review by pathology. A follow-up incisional or excisional biopsy may be performed.
This type of mammogram is for areas of the breast that are difficult to locate by feel or abnormal areas found during a diagnostic mammography. Under local anesthesia, a needle is inserted in the area to be examined. A fine wire is inserted through the needle so that it catches in the breast tissue. The needle is removed and the wire is left in place. A surgeon then removes tissue for imaging by radiology. The procedure may leave a small scar and the patient may have to limit activities for several days until the area heals.
This procedure is performed on areas of the breast that are difficult to locate by feel or on abnormalities found during an ultrasound. It is the same process as Needle Localization by Mammography described above, using an ultrasound machine in place of a mammogram.