Saskatoon Medical Imaging/Saskatoon Women's Imaging
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Services Provided: The clinic is a Canadian Association of Radiology (CAR) Accredited Mammography centre. We provide general mammography imaging. Mammography Forms: There are two forms that we will have you complete upon your arrival at the clinic. If you wish to read them before hand or download them, print them and complete prior to your visit please access the links below. MEDICAL QUESTIONNAIRE PRIOR TO MAMMOGRAPHY SMI/SWI MAMMOGRAPHY RELEASE OF INFORMATION CONSENT FORM Mammography uses low-dose x-rays for imaging of the breast. The image of the breast is produced as a result of some of the x-rays being absorbed while others pass through the breast to expose an x-ray film. The exposed film is placed in a developing machine, producing images much like the negatives from a 35 mm camera. The resulting x-ray films of the breasts are reviewed at a viewing console. Digital mammography is a possibility in the future and x-ray film may be replaced by computer work stations for reviewing the images. However, digital mammography is not a widely available technology at present. Screening mammography can assist your physician in the detection of disease even if you have no signs or symptoms. Screening programs evaluate asymptomatic individuals to determine if they have subclinical breast diseases. If an abnormality is seen on screening mammography this usually leads to other mammographic images or breast ultrasound at an imaging centre such as Saskatoon Women's Imaging. Diagnostic mammography is used to evaluate a patient with abnormal clinical findings, such as a breast lump or lumps, nipple discharge, etc., that have been detected by the woman or her doctor. Most medical experts agree that in order to maximize the potential for cure of a patient's breast cancer, early diagnosis plays an important role. Mammography plays a central part in the early detection of breast cancer because it can show changes in the breast that are suspicious for cancer before a patient or physician can feel them or see them. How should I prepare for Mammography? Before scheduling a mammogram, the American Cancer Society (ACS), and other specialty organizations, recommend that you discuss any new findings or problems in your breasts with your doctor. In addition, inform your doctor of any prior surgeries, hormone use, and family or personal history of breast cancer. Do not schedule your mammogram for the week before your menstrual period, especially if your breasts are usually tender during that time. The best time to book a mammogram is one week following your menstrual period. Always inform your doctor or x-ray technologist if there is any possibility that you may be pregnant. The ACS also recommends you:
Before the examination, you will be asked to remove all jewelry and clothing above the waist and you will be given a gown or loose-fitting top that opens in the front. Avoid caffeinated beverages 3 - 4 days prior to your examination. There is a suggestion that this may decrease the discomfort associated with this test. What does the Mammography equipment look like? A mammography unit is an apparatus that houses the tube in which x-rays are produced. The unit is dedicated equipment, with special accessories, and it is used exclusively for x-ray exams of the breast. Attached to the unit is a device that positions and compresses the breast. It is quite versatile allowing it to adapt to each different patient, and to obtain images at different angles, if required. Most machines are designed to have the patient sitting, or standing, beside the imaging unit to have the mammograms performed.
How is the procedure performed? During mammography, a specially qualified radiologic technologist will position you to image your breast. The breast is first placed on a special platter and compressed by rounded plates (often made of clear Plexiglas or other plastic). Breast compression is necessary in order to:
The technologist will go behind a glass shield during the x-ray exposure. You will be asked to change positions slightly between images. The routine views are a top-to-bottom view and a side view. The process is duplicated for each breast. The examination process should take about fifteen minutes to half an hour. When the mammography images are developed they will be reviewed by the technologist and the radiologist to determine if any additional images are required. Additional images may be done due to uncertainty about an area requiring more detailed views or may be due to the need to reposition the breast for the best assessment. You may also have a breast ultrasound performed on the same visit to our centre if the radiologist feels that it will contribute to a better understanding of the current status of your breasts. What will I experience during the procedure? You will feel pressure on the breast as it is squeezed by the compression system. Some women with sensitive breasts may experience discomfort. If this is the case, schedule the procedure when your breasts are least tender. The technologist will apply compression in gradually Inform the technologist if pain occurs as the compression is increased. If discomfort is significant, less compression will be used. What are the current recommendations for mammography? The Canadian Cancer Society states: "Many women are alive and well today because their breast cancer was detected and treated early. While breast self-examination (BSE) helps you learn what is normal for your breasts, increasing the likelihood that you will notice any changes, mammography and clinical breast examinations are the most reliable methods of finding breast cancer. The Canadian Cancer Society recommends that: If you are 70 or older, you should talk to your doctor about a screening program for you. If you are between 50 and 69, have a mammogram every 2 years. If you are between 40 and 49, discuss with your doctor your risk of breast cancer, along with the benefits and risks of mammography. For a pdf discussing the issue surrounding screening examinations for women age 40 - 49, click here. Current guidelines from the U.S. Department of Health and Human Services (USDHHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40. The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk, related to a family history of breast cancer, should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening thereafter. We encourage you to discuss your situation with your referring physician and establish a frequency of mammographic tailored to your particular circumstances. What are the benefits vs. risks? Benefits * Imaging of the breast improves our ability to detect breast tumors, some too small to detect clinically. Early detection increases the likelihood being cured. * The use of screening mammography increases the detection of small tumors confined to the milk ducts in the breast, called ductal carcinoma in situ (DCIS). Complete cure is more likely if tumors are removed at this stage. Mammography is the only proven method to reliably detect these types of tumors. Risks * The radiation exposure from a mammogram is about 0.7 mSv, which is about the radiation received from background radiation sources in three months. The mammography units are maintained and checked regularly to ensure that the radiation levels are acceptable. It is important to remember that the radiation source is not constantly emitting x-rays but is only on for milliseconds when the technologist exposes each image. * Women should always inform their doctor or x-ray technologist if there is any possibility that they are pregnant as the fetus should not be exposed to radiation if at all possible. * False Positive Mammograms. Five to 10 percent of screening mammogram results are abnormal and require more testing (more mammograms, fine needle aspiration, ultrasound or biopsy). Most of the follow-up tests resulting from this confirm that no cancer was present. This is called a false positive mammogram. It is estimated that a woman who has yearly mammograms between ages 40 and 49 would have about a 25 - 30 percent chance of having a false-positive mammogram at some point in that decade. What are the limitations of Mammography? Interpretations of mammograms can be challenging in some circumstances, this is particularly true for women who have very dense breast tissue. Not all cancers of the breast can be seen on mammography. Previous mammograms to be used to compare to recent mammograms can be very helpful in most situations. If previous films are not available it is more difficult to determine if a subtle abnormality is a new finding or something that has been present before i.e. not of concern. Breast implants can also diminish the accuracy of mammography readings as the implants are not transparent on x-rays and can obscure breast tissue. This is more likely a problem if the implant has been placed in front of, rather than beneath, the chest muscles (pectoralis major). Experienced mammography technologists know how to carefully compress the breasts to improve the diagnostic quality of the mammograms without rupturing the implant. When making an appointment for a mammogram, women with implants should ask if the facility uses special techniques, and has technologist who are appropriately trained to accommodate them. Before the mammogram is taken, the technologist should be informed of the presence of implants to ensure that care is taken to avoid implant disruption. Sample Images
Breast Cancer Detection/Screening The Canadian Cancer Society states: "Many women are alive and well today because their breast cancer was detected and treated early. While breast self-examination (BSE) helps you learn what is normal for your breasts and increases your ability to detect any changes, mammography and clinical breast examinations are the most reliable methods of finding breast cancer. The Canadian Cancer Society recommends that: If you are 70 or older, talk to your doctor about a screening program for you. If you are between 50 and 69, have a mammogram every 2 years. If you are between 40 and 49, discuss with your doctor your risk of breast cancer, along with the benefits and risks of mammography. For a pdf discussing the issue surrounding screening examinations for women age 40 - 49, click here. Current guidelines from the U.S. Department of Health and Human Services (USDHHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40. The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk, related to a family history of breast cancer, should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening thereafter. We encourage you to discuss your situation with your referring physician and establish a frequency of mammographic tailored to your particular circumstances. Breast Self-examination You may consider doing breast self-examination and report any changes you find to your doctor. It is suggested that you perform breast self-examination monthly, after your menstrual cycle has ended. Self-examination should be performed consistently, at roughly the same phase of your menstrual cycle. This helps to minimize the effects of the normal variation in breast tissue caused by variable hormone levels associated with the normal menstrual cycle. After menopause perform a breast self-exam on a set day of each month, for example, the first day of each month. The two major elements of the breast self-exam are palpation (feeling) and observation (viewing). For a pdf describing Breast Self-examination click here. Palpation: This should be performed standing and lying down. While standing, raise one arm. With fingers flat, touch every part of each breast and the area around it, gently feeling for a lump or changes under the skin. Use your right hand to examine your left breast, your left hand for your right breast. Additionally, with your arm extended horizontally and resting on a firm surface, use the same method to examine the underarm area. This is breast tissue also. Both vertical and circular motion can be used for the examination or you may prefer to employ only one of these techniques. Palpate the breast in vertical lines or small circles, starting under your arm, and move in toward the nipple. Be sure to cover your entire breast area. While lying down, place a towel or pillow under your right shoulder and rest your right hand on your forehead - palm up. Examine your right breast with your left hand by touching gently but firmly. If at any time you notice changes see your physician right away. Observation: Before a mirror: Place your arms at your sides, on your hips, then raise your hands above your head, look carefully for changes in the size, shape and contour of each breast. Look for puckering, dimpling, or changes in skin texture. Turn to left and right and repeat. “This self-exam is not a substitute for periodic examinations by a qualified physician. Clinical Breast Examination This should be performed as part of your regular health assessment process. If you are over the age of 40, have a clinical breast examination by a trained health professional at least every 2 years. Mammography Mammography is done in a imaging department, imaging clinic or screening centre. It uses small amounts of x-rays to acquire images of the soft tissue inside the breast. A mammogram also gives you and your doctor information about changes to your breasts that you may have found during breast self-examination or that a health professional finds during a clinical breast examination. You should discuss the risks and benefits of mammography with your doctor. Women between 50–69 years should have a mammogram every 2 years. If you are under age 50 or over 69 and are at a higher risk for breast cancer, you should discuss with your doctor when mammography may be appropriate for you. Breast Screening Program Breast screening programs vary between provinces. All provinces have breast cancer screening programs for women age 50–69. You can make an appointment at a screening centre without a doctor’s referral. To find out more about breast screening centres in your province, call the number below or visit the Canadian Association of Radiologists (CAR) web site for a list of accredited facilities. In Saskatchewan you can call 1-800-567-7271 for information. To link to the Saskatchewan Breast Cancer Screening web site click here. Sample Images
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| ©2006 Saskatoon Medical Imaging/Saskatoon Women's Imaging | Web Site contact: Dr. B. Burbridge |
