Mammography refers to x-ray examination of the breast and yields information on the interior of the breast. Mammography is used to detect and diagnose breast disease both in women who have breast symptoms (problems such as a lump, pain or nipple discharge) and women who are asymptomatic (no breast complaints).

When you have your mammogram at The Hill Medical Corporation, you will be comfortable knowing that our physicians and support staff are highly experienced and trained. We perform over 20,000 mammograms and 10,000 diagnostic evaluations of women with breast problems a year. We also provide excellent mammogram accuracy thanks to our nationally respected team of breast radiologists and our computer aided detection (CAD) program. It provides secondary interpretations of every mammogram film that our experienced team of radiologists uses as a back-up evaluation. In addition, our physicians, technologists and state-of-the-art equipment are certified and accredited by the American College of radiology and the FDA.

Calcifications are tiny mineral deposits within the breast tissue, which appear as small white spots on the films. Calcifications are divided into two categories, macrocalcifications and microcalcifications. Macrocalcifications are coarse (larger) calcium deposits are associated with benign (non-cancerous) conditions and do not require a biopsy. They most likely represent degenerative changes in the breasts, such as aging of the breast arteries, old injuries, or scarring from other causes. Macrocalcifications are found in about 50% of women over the age of 50, and in about 10% of women under the age of 50.

Microcalcifications are tiny (less than 1/50 of an inch) specks of calcium in the breast that may appear singly or in clusters. An area of microcalcification that is seen on a mammogram does not always mean that cancer is present. The shape and arrangement of microcalcifications help the radiologist judge the likelihood of cancer being present. In some cases, the microcalcifications do not even indicate a need for a biopsy. Instead, a doctor may advise a follow-up mammogram within 3 to 6 months. In other cases, the microcalcifications are more suspicious and a biopsy is recommended to determine if cancer is present.

A mass is an important change seen on mammograms. Masses may occur with or without associated calcifications and can be due to many things, including cysts. A cyst, which is a benign collection of fluid in the breast, cannot be diagnosed by a physical exam alone nor can it be diagnosed by mammography alone. To confirm that a mass is a cyst, either breast ultrasound or aspiration with a needle is required. If a mass is not a cyst, then further imaging may be obtained. As with calcifications, a mass can be caused by benign breast conditions or by breast cancer. Some masses can be monitored with periodic mammography while others may require immediate or delayed biopsy. The size, shape, and margins (edges) of the mass help the radiologist in evaluating the likelihood of cancer. Breast ultrasound is often helpful. Prior mammograms may help show that a mass is unchanged for many years, indicating a benign condition and helping to avoid unnecessary biopsy.

Mammography cannot prove that an abnormal area is cancer. If mammography raises a significant suspicion of cancer, tissue must be removed for examination under the microscope to tell if it is cancer with certainty. This can be done with needle biopsy or open surgical biopsy.

Screening mammography is an x-ray examination of the breast in a woman who is asymptomatic (has no breast complaints). Screening mammography usually involves two views (x-ray pictures) of each breast. For some patients, additional pictures may be needed at screening to include as much breast tissue as possible.

The goal of screening mammography is to detect cancer when it is still too small to be felt by her physician or the woman. Early detection of small breast cancers by screening mammography greatly improves a woman's chances for successful treatment. If you have no symptoms such as a breast lump, pain or nipple discharge, we recommend annual screening mammograms beginning at age 40. The American Cancer Society’s breast cancer detection guidelines include yearly screening mammography for all women 40 years of age and older.

In the United States, one out of eight women will develop breast cancer during her life. The earlier the disease is diagnosed, the higher the chances of a complete cure. Breast cancer takes years to develop. Early in the disease, most cancers of the breast cause no symptoms. When breast cancer is detected in the localized stage without spread to lymph nodes, the five year survival rate is 98%. If the cancer has spread regionally to axillary (underarm) lymph nodes the rate drops to 76%.

Should you experience unusual tenderness, pain, nipple discharge or notice a lump (even if you are in your early twenties), contact your personal physician immediately and come in for a diagnostic evaluation. The best protection against the effects of breast disease is early detection and early treatment.

Diagnostic mammography is an x-ray examination of the breast in a woman who either has a breast complaint (for example, a breast mass, nipple discharge, etc.) or has had an abnormality found during screening mammography. During diagnostic mammography, additional pictures will be taken to carefully evaluate the breast abnormality. In some cases, special images known as cone views with magnification are used to make a small area of altered breast tissue easier to evaluate. Many other types of x-ray pictures can be obtained, depending on the type of abnormality and its location in the breast. These x-rays are tailored to the patient's needs. Although it may not be true of many other breast facilities, our radiologists strongly believe that clinical history and physical examination of the breast are integral parts of the diagnostic mammogram. Our physicians use this information to properly apply mammography and ultrasonography to your problems.

A diagnostic mammography work-up may show that a lesion (area of abnormal tissue) has a high likelihood of being benign (not cancer). For these, it is common to ask the woman to return earlier than usual for a recheck, usually in 4-6 months. On the other hand, a diagnostic mammogram may show that the abnormality is not worrisome at all and the woman can then return to routine yearly screenings.

Finally, the diagnostic work-up may suggest that a biopsy is needed to tell whether or not the lesion is cancer. A recommendation for biopsy does not necessarily mean that the abnormality is cancer. About 70% of all breast lesions that are evaluated with biopsy are found to be benign when evaluated under the microscope. If a biopsy is recommended, the woman should discuss the different types of biopsy with her physician to determine which method of biopsy is best for her.

Mammography cannot find 100% of breast cancers. The American Cancer Society recommends the use of three tests for breast cancer detection in asymptomatic women - mammography, clinical breast exams by a physician or other health care professional, and breast self examination (BSE).

The American Cancer Society guidelines for the detection of breast cancer in asymptomatic women are:

• Women 20 years of age and older should perform breast self-examination every month.
• Women 20-39 should have a physical examination of the breast every three years, performed by health care professional such as a physician, physician assistant, nurse or nurse practitioner.
• Women 40 and older should have a physical examination of the breast every year, performed by a health care professional, such as a physician, physician assistant, nurse or nurse practitioner.
• Women 40 years of age and older should have a mammogram every year.

These guidelines apply only to women at usual risk for breast cancer, who have no symptoms of breast cancer. Women with certain risk factors, such as a family history of breast cancer should discuss their risk factors with their doctor. In some cases, mammography may be started before age 40 and a more vigilant schedule of early detection tests may be appropriate.