Digital Mammography

A New Ally In The Fight Against Breast Cancer
Breast cancer will affect an average of one in eight women sometime in their lifetime. It is the second most common cause of cancer-related deaths in women. Numerous studies prove that early detection is a vital component in the successful treatment of breast cancer. Mammograms play a central part in the early detection of breast cancer because they can detect changes in the breast that may be early signs of cancer, but are too small or subtle to be felt. The use of mammography has greatly enhanced the ability to detect breast cancers at earlier stages. A new technology called full field digital mammography shows great promise in the fight against breast cancer.

Because our primary goal has always been to deliver the highest quality care to our patients, we are pleased to announce the addition of full field digital mammography to our women’s health imaging services.

A Letter To Our Patients
Clinical Indications For Screening And Diagnostic Mammography
What Is Full Field Digital Mammography?
What Are The Benefits Of Digital Mammography?
How Accurate Is Mammography?
What's Right For Me: A Screening Mammogram Or A Diagnostic Mammogram?
What is CAD And Why Is It Important?
What Are Some Of The Possible Abnormalities A Radiologist Looks For When Interpreting A Mammogram?
What Happens If The Radiologist  Finds Something Suspicious?
Why Do I Need A Clinical Breast Exam If I'm Having A Mammogram?
Scheduling An Appointment


What Is Full Field Digital Mammography?
Digital mammography uses computers and specially designed digital detectors to produce an image that can be displayed on a high-resolution computer monitor, and transmitted and stored just like computer files. From a patient’s point of view, having a digital mammogram is very much like having a conventional screenfilm mammogram. Both film-based and digital mammography use compression and x-rays to create clear images of the inside of the breast. During all mammography exams, the technologist positions the patient to image the breast from different angles and compresses the breast with a paddle to obtain optimal image quality. Unlike film-based mammography, digital mammograms produce images that appear on the technologist’s monitor in a matter of seconds. There is no waiting for film to develop, which can mean a shorter time spent in the breast imaging suite.




What Are The Benefits Of Digital Mammography?
Unlike other parts of the body, the breast is composed mainly of soft tissue. When breast tissue is x-rayed, it creates an image that looks something like a smoky haze, making it difficult to see tiny “spots,” called microcalcifications, and other subtle signs of early cancer.

With digital mammography, the radiologist reviews electronic images of the breast using special high resolution monitors. The physician can adjust the brightness, change contrast, and zoom in for close-ups of specific areas of interest. Being able to manipulate images is one of the main benefits of digital technology. Another convenience of digital mammography over film-based systems is it can greatly reduce the need for retakes due to over or under exposure. This potentially saves additional time and reduces your exposure to x-rays.




How Accurate Is Mammography?
Like all medical tests, mammography is not a perfect test—it cannot always detect breast cancer, and is not 100% accurate. Screening mammography can detect about 85% of breast cancers. It will also show areas that may appear to be abnormal, but are actually due to a benign (noncancerous) change in the tissues of the breast. This may nevertheless lead to a biopsy (removal of tissue from the breast) in order to determine whether the abnormality is due to breast cancer.




What's Right For Me: A Screening Mammogram Or A Diagnostic Mammogram?
Screening mammography is performed on women who have no sign or symptom of breast cancer. It can detect many cancers at their earliest stage, before physical symptoms develop, and up to two years before cancer is large enough to be felt as a lump. In fact, 40% of breast cancers that are detected by screening mammography are “in situ”, meaning they are at the earliest stage, and are not invading through the ducts of the breast. The size of a cancer and how far it has spread are key predictors of health outcome from the disease. When disease is localized in the breast, survival is greater than 90%. Detection of breast cancer using screening mammography therefore helps detect breast cancer at its earliest stage and is crucial to the goal of curing breast cancer.

Washington Radiology also offers diagnostic (or problem-solving) mammography. A diagnostic study is ordered for patients who have a personal history of breast cancer, or have a specific symptom or problem that could indicate breast cancer. Some of these symptoms may include lumps, discharge or breast pain. Please alert your health care provider if you have these symptoms to ensure that you are scheduled for a diagnostic study.

What is CAD And Why Is It Important?
Computer-Aided Detection (CAD) acts as a second pair of eyes by analyzing patterns in the mammogram and marking areas for the radiologist to review in more detail. The radiologist then makes a final assessment of the images to determine whether studies have shown that there is anything that is truly of concern, or may require additional assessment. Studies have shown that the use of CAD with mammography can increase the detection rate of cancer.




What Are Some Of The Possible Abnormalities A Radiologist Looks For When Interpreting A Mammogram?
About 10% of screening patients return for further evaluation of calcifications (calcium deposits), masses (abnormal growths of tissue) and asymmetries (abnormal patterns of tissue).

There are two types of calcifications: microcalcifications (tiny) and macrocalcifications (large). Macrocalcifications indicate a benign condition and do not require a biopsy. Microcalcifications are tiny specks of calcium that may appear alone or in clusters. An area of microcalcification does not always mean that cancer is present. In fact, the majority of microcalcifications are benign. In some cases, the radiologist will determine that the calcifications have a benign type of appearance, but should be followed closely with another mammogram in 4 to 6 months to ensure that they do not change. In other cases, the calcifications may have an uncertain or suspicious appearance, and a biopsy will be ordered.

Masses and asymmetries in the breast can be cancerous or noncancerous. Noncancerous masses can be due to a fluid-filled cyst or tissue mass, such as a fibroadenoma. Masses are evaluated by obtaining additional specialized mammography pictures, by using ultrasound of the breast, or with an MRI scan of the breast. After masses have been fully evaluated, some can be carefully monitored with a repeat mammogram or breast ultrasound in 4 to 6 months, while others may require a biopsy. (For more information about a biopsy, click here.)




What Happens If The Radiologist Finds Something Suspicious?
The majority of screening mammograms are normal and do not require additional testing. However, after a screening mammogram, about 10% of patients will have to return to the mammography facility for additional testing, which may include more mammography images, breast ultrasound, biopsy, or MRI (magnetic resonance imaging) of the breast. Even when a potential abnormality is detected on a screening mammogram, the additional imaging that is performed when the patient returns will often show that the area in question on the screening mammogram is normal or represents noncancerous changes.

Why Do I Need A Clinical Breast Exam If I'm Having A Mammogram?
It is important for your physician or health care provider to perform a clinical breast exam before you have your screening mammogram. If she or he finds a lump or other area that looks or feels abnormal, then you will be scheduled for a diagnostic mammogram to evaluate the problem. A limited examination of a palpable area in the breast which might be performed in this office does not substitute for a clinical breast exam. Remember that if you have a lump, a negative or normal mammogram is very reassuring, but does not definitely exclude the possibility that there is cancer in the breast. Your health care provider may still suggest further testing or consultation with a breast specialist. Also, you should be aware that if a lump develops even after you have had a normal screening mammogram, it should be promptly evaluated and you should not wait until the time of your next screening mammogram.




Scheduling An Appointment:
Washington Radiology offers mammography services in DC at 2141 K Street NW (near Washington Circle), at our two Virginia clinical offices in Sterling and Fairfax, and at our two Maryland offices in Bethesda and Chevy Chase. Patients are seen by appointment and a written order from a referring physician is required. To schedule a mammogram at WRA, please have your physician order handy and call Centralized Scheduling at (703) 280-9800.