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Mammography and Breast Imaging FAQs

What is a breast imaging exam?

A breast imaging exam is used to detect and diagnose breast cancer. At Penn Medicine, we offer mammography (tomosynthesis or 3D mammography), ultrasound, MRI and nuclear medicine imaging to view the breasts and related areas. If cancer is detected, these tests can also help determine the type, stage and location of the cancer. Learn about the breast imaging services available at Penn Medicine.

What is mammography?

A mammogram is an x-ray that takes pictures of your breasts using a very small amount of radiation. Digital mammography uses electronics, instead of film, to record and store breast images, so that pictures may viewed on a computer. Special software can detect abnormal areas on digital mammograms. At Penn Medicine, all of our mammograms are 3D mammograms.

Why is mammography done?

Mammograms can be used for both screening and diagnostic purposes.

If you have no signs or symptoms of breast abnormalities, screening mammography may be used to proactively monitor for any changes to your breasts. The goal of screening mammography is to detect cancer before signs or symptoms are noticeable.

Diagnostic mammography is used to examine breast changes, including breast lumps, breast pain and nipple discharge. It can also be used to further evaluate the findings of a screening mammogram.

How do you prepare for a mammogram?

When having a mammogram, do not use deodorant, talcum powder or lotion on your breasts or underarms that day. These substances may interfere with the imaging.

You'll also be asked to remove jewelry, including any piercings, as well as clothing above the waist.

What happens during a mammogram?

During the test, the mammography unit compresses the breast for a few seconds as images are taken. Breast compression can be uncomfortable, but it is necessary to help ensure accurate images.

A technologist will help position your breast and make the study as comfortable as possible.

How early can a mammogram detect breast cancer?

Screening mammograms may detect breast cancer in women with no symptoms, or diagnose other breast diseases. About 10 percent of screening mammograms need additional imaging with either mammography or ultrasound. Those follow-up images usually turn out to be normal.

Diagnostic mammograms are used to evaluate a condition such as a breast lump or discharge.

How long does a mammogram take?

A mammogram usually lasts between 10 and 15 minutes.

How much does a mammogram cost?

The cost of a mammogram will depend on your insurance plan and provider. The Penn Medicine Breast Health Initiative offers free mammograms to uninsured or underinsured women who are 40 or older.

Is a 3D mammogram better for dense breasts?

Studies have shown that dense breasts are more likely to develop cancer than those that aren’t dense. Breast density also may affect how breast cancer is detected by mammogram.

With traditional mammography images, fatty tissue looks dark, which makes it easier to spot cancer, which appears white. Dense breast tissue may also appear white, making the cancer harder to spot.

A study published in JAMA Oncology found that combining 3D mammography or breast ultrasound with regular screening mammograms can better detect cancer in dense breasts.

Is a 3D mammogram painful?

A 3D mammogram offers several benefits to traditional mammography, including increased comfort. During your mammogram, pressure will be applied to your breast for a few seconds to spread out your breast tissue. This makes it easier to spot abnormalities. While it may be uncomfortable, flexible plates on our 3D mammography machines help ensure less pain during compression. If you are in pain, please alert your technician.

Do 3D mammograms give false positives?

Mammography using 3D imaging (or tomosynthesis) has been shown to improve breast cancer detection and reduce the number of false positives when compared with traditional mammography.

Can an ultrasound detect breast cancer?

Ultrasound is used in conjunction with other tests screen for breast cancer.

If an abnormality is seen on mammography or felt by physical exam, you may have an ultrasound to determine if the abnormality is solid or fluid-filled.

However, the ultrasound will not be able to determine if the abnormality is cancer. A breast biopsy may be used to determine whether cancer is present.

What does a breast MRI detect?

If you've recently been diagnosed with breast cancer, you may have a breast MRI to better determine the cancer's size and stage.

If you are at a high risk for developing breast carcinoma, you may also benefit from pairing breast MRI with mammography screening. If breast cancer is detected early, it can mean less chemotherapy and fewer or no breast cancer-related surgeries.

Breast MRI is sometimes used to evaluate uncertain findings on either a mammogram or ultrasound to help determine whether a biopsy is needed.

What are image-guided breast biopsies?

Sometimes, it is necessary to remove tissue or cells to test for the presence of cancer. This procedure, known as a biopsy, may be performed surgically or using image guidance.

Image-guided breast biopsies, which are, less-invasive procedures using only a needle to sample cells, are conducted by radiologists, uses ultrasound, MRI or mammography for guidance.

Who reads and evaluates the breast images?

A breast imaging radiologist, a physician trained in interpreting breast exams, will analyze the images and report findings to you and your doctor.

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