WHAT IS 2D/3D MAMMOGRAPHY? WHAT IS TOMOSYNTHESIS?

Breast Center of New England performs all screening and most diagnostic mammograms using 2D/3D technology (3D is known in the medical world as “tomosynthesis”). A 2D mammogram is a single picture of each breast. Tomosynthesis, on the other hand, is a set of pictures of each breast. Each picture shows a small slice of breast tissue so that every structure – normal or abnormal – can be examined individually. Radiologists use the 2D and 3D pictures of the mammogram to look at different things to determine if anything suspicious is present.

WHAT DOES IT MEAN TO GET CALLED BACK FROM A SCREENING MAMMOGRAM?

Patients are called back, or asked to return for additional testing, if there are significant changes on a screening mammogram. This additional testing could be done with a diagnostic mammogram, breast ultrasound, or both. About 10% of women will get called back from their screening mammogram, and only about 10% of the women who are called back will need a biopsy.

CAN I STILL HAVE A MAMMOGRAM IF I HAVE BREAST IMPLANTS?

Yes – we do it all the time! The technologist will perform the standard mammogram views (two pictures of each breast). Then, she will perform “push-back” views, additional pictures with the implants moved out of the way. It’s important to have your mammogram performed at a center where the technologists are expert at obtaining push-backs.

An exciting development for those with breast implants is breast CT. With breast CT, no compression or push-back views are required. Each patient is positioned for the exam so that the entire implant and breast can be imaged – all the way back to the ribs. Breast CT can be used in combination with other types of imaging to gain the greatest amount of information on what’s going on with a woman’s breasts.

HOW DO I KNOW IF MY IMPLANT IS RUPTURED?

Breast implants aren’t made to last a lifetime. Each year, the risk of rupture increases. Saline implant rupture is usually obvious to a patient – the affected breast will be noticeably smaller than the non-ruptured side. With silicone implants, however, it might be very difficult to tell a rupture has occurred. Talk to your doctor if you are feeling any changes, such as a difference in the contour or size of your breast, pain or swelling. Implant ruptures can sometimes be detected on annual mammography, but additional testing is often necessary. Many insurance companies require patients to have an ultrasound for questions of implant rupture, but ultrasound may not be definitive with certain implant ruptures. If this is the case, MRI is recommended.

IS AN IMPLANT RUPTURE AN EMERGENCY?

A ruptured implant is rarely an emergency. Many women are walking around right now with ruptured implants and don’t even know it. However, if the size of one breast increases significantly in a short period of time (such as overnight or over the course of a week), your breast is swollen, painful, or discolored, or the skin becomes hard and shiny, call your doctor. You should be evaluated on a more urgent basis.

HOW LONG DO I HAVE TO WAIT TO HAVE A MAMMOGRAM AFTER BREAST REDUCTION SURGERY?

Ask your surgeon. In general, most surgeons ask patients to wait 6-12 months between reduction surgery and a screening mammogram. Many plastic surgeons will have patients get a screening mammogram right before having a breast reduction so this examination remains current. This is important to determine if a cancer is present before having surgery, and also so that you won’t need another mammogram for a full year.

WHY SHOULD I SKIP DEODORANT/ANTIPERSPIRANT ON THE DAY OF MY MAMMOGRAM?

Most deodorants and antiperspirants contain aluminum, which is a metal. Calcium is also a metal, and aluminum and calcium can look alike on a mammogram.

WHY IS THAT A PROBLEM?

Calcium deposits, or calcifications, are one of the main things radiologists look for on mammograms. So, if you have traces of aluminum on the skin of your underarms, you might get called back from your screening mammogram for a second look.

WHAT ARE THE RISKS OF MAMMOGRAPHY?

Many women are rightfully concerned about the radiation they receive from radiology tests like mammograms. In reality, the radiation dose from a mammogram is very low.

No medical test is perfect, and it’s possible a mammogram misses a breast cancer due to overlapping tissue. It’s also possible a radiologist suspects something abnormal on your annual mammogram when in reality there’s nothing there, leading to additional testing and follow-up, and maybe even a biopsy.

Learn more from a reputable website on this subject: https://www.breastcancer.org/screening-testing/mammograms/benefits-risks

HOW MUCH RADIATION WILL I RECEIVE WITH A MAMMOGRAM?

The total radiation dose for a mammogram is typically quoted at about 0.4 mSv per breast. That’s considerably lower than the amount of radiation the average American is exposed to by their natural surroundings – approximately 3 mSv per year. It’s true that repeated exposure to medical x-rays can increase the risk of cancers over time. However, scientific studies show the risks are small, and the benefits of breast cancer screening with mammograms outweighs the risks posed by x-rays. Learn more on this subject from a reputable website: https://www.iaea.org/resources/rpop/health-professionals/radiology/mammography/radiation-doses

I DON’T HAVE A FAMILY HISTORY OF BREAST CANCER. DO I STILL NEED A MAMMOGRAM?

According to the American Cancer Society, aside from skin cancer, breast cancer is the most common type of cancer affecting women. It’s estimated that 1 in 8 women will develop breast cancer in their lifetime. Only a minority of women develop breast cancer that’s “inherited” – related to a known cancer-associated gene.

WHAT ARE THE MOST COMMON FORMS OF CANCER AFFECTING WOMEN?

Colorectal – Start regular screening beginning at age 45

Endometrial – There are currently no screening tests for endometrial cancer. Because of this, it’s important to report any new vaginal discharge, bleeding, or abnormal spotting to your doctor.

Lung – Women at higher risk for lung cancer, either because they smoke or have a significant past smoking history, may be eligible for lung cancer screening with a low dose CT scan. Most of our area hospitals have established lung cancer screening programs. Talk to your doctor to see if you qualify for this life-saving test.

Cervical – Excellent screening tests are available for cervical cancer. Talk to your doctor about getting tested for human papillomavirus (HPV), which is linked to many cervical cancers, as well as how often you should undergo a pelvic exam and PAP smear (this usually depends on your HPV status and other history, such as if you’ve had an abnormal PAP before).

Ovarian – There are currently no screening tests for ovarian cancer. Because of this, it’s important to undergo regular physicals, including a pelvic exam. Report any changes in your health to your doctor, such as abdominal swelling and pain, and digestive problems like bloating.

Find out more from a reputable site:

https://www.cancer.org/healthy/cancer-facts/cancer-facts-for-women.html