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Understanding breast tests

Understanding breast tests

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To finish up Breast Cancer Awareness month, I thought we could take a closer look at some of the tests that might be ordered. I think most of us have heard about the dreaded crushing of the breast in the mammogram. Having a better understanding of all the tests and when or why they would be done can go a long way towards increasing your comfort level with these exams.

Screening mammograms typically start for women at the age of 40. There may be times when you have this done earlier. For me, my first was at age 35 when my mother was diagnosed with breast cancer. It is important to get your mammogram yearly because having those films for comparison purposes down the road can be important in detecting changes in a slow growing tumor.

A screening mammogram is a standard set of pictures that is taken on everyone. There is no variation in the poses or angles from person to person. This gives us the first real view of the breast tissue. If this is negative, you should expect to come back in one year for a repeat. If it is positive, next up is a diagnostic mammogram.

This type of mammogram is a little more hands on. Pictures will be taken of the particular breast in question and viewed by the Radiologist while you are still at your testing site. Additional pictures or different angles could be called for as they really try to hone in on what you may or may not have going on.

It should be noted that the call back rate for first time mammograms is generally a little bit higher, but this is because we don’t want to overlook something if the screening mammogram isn’t clear. Remember, just because you get a call back doesn’t mean there is anything wrong, it just means we want to look a little closer.

If your diagnostic mammogram is negative you would follow the same follow up routine as the screening. If there is an abnormality, an ultrasound would be the next test. A positive ultrasound would result in possibly treatment based on findings (for instance you have an abscess that needs to be treated with antibiotics) or a biopsy. Follow up would be determined based on both findings and treatments. In other words, there is no set schedule. If it is negative, you would follow up in a year.

If the ultrasound doesn’t reveal the abnormality you may then have what is called a stereotactic guided biopsy. This biopsy would be done guided by x-rays and a computer to analyze pictures of the breast and pinpoint where the needle needs to go to remove tissue for evaluation by a pathologist. Again, follow up here would be based on findings.

The final test that could be performed is a breast MRI. This is generally only used in cases of extreme high risk or when there is a need for additional diagnostic images after the other avenues have been explored.

On mammogram day, leave off your deodorant. Most deodorants contain aluminum which can look like calcifications on a mammogram. It should also be noted that while screenings typically start at age 40, if there is any bloody nipple discharge or you feel lumps on self-exam at any time, you should discuss this with your doctor so it can be evaluated.

In South Carolina, there is a law titled “Hope’s Law.” This law is a breast density notification law. Having dense breast tissue is not abnormal, but it does sometimes make it harder to evaluate the results of a mammogram. When you receive your mammogram report, if you have dense breasts, you will also receive notice of this. This is just a tool for you to use to discuss with your doctor your risk and screening options.

Early detection is so important for treatment of breast cancer. At Carolina Pines, we have a great team willing to help get you through your first mammogram or your 21st mammogram. Call our Imaging Department at 843-339-4790 to discuss your mammography needs. Breast health isn’t only important during Breast Cancer Awareness month. We are happy to get you scheduled at any time. Until next time ... live healthy!

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