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Frequently Asked Questions About Mammography and Breast Cancer

What is a Baseline Mammogram?

A baseline mammogram is the set of images used as the basis for comparison in later tests. It is usually a patient's first screening mammogram, unless those films are unavailable. Patients should always try to keep track or when and where they have had each mammogram. Previous mammograms are necessary to assist the interpretation of current or future mammograms. Patients who do not have a baseline mammogram are more likely to need extra views, follow up exams and biopsies. If prior mammograms are available for comparison, less additional study and examination is needed.

How Long do Mammography Examinations Take?

This can vary from center to center, but once patients are called, screening mammography usually takes less than 15 minutes. Diagnostic mammography takes roughly twice as long (approximately 30 minutes). Breast biopsy procedures usually take about an hour.

What is a Cleavage View?

A cleavage view (also called "valley view") is a mammogram view that images the most medial (central) portions of the breasts. This is the portion of breast tissue "in the valley" between the two breasts. When one breast is imaged and the other breast is left out of the compression field, some of the breast being imaged may get pulled or left out too. To get as much medial tissue as possible, the mammogram technologist will place both breasts on the plate at the same time to image the medial half of both breasts.

A cleavage view may be performed when there is a questionable density on the medial edge of the mammogram film and the radiologist needs to see more of this density (if possible). A cleavage view may also be performed if the radiologist sees something suspicious in the mediolateral-oblique (MLO) mammogram view and cannot find the area on the cranial-caudal view (CC) view. Learn more about views taken during mammography.

Do I Need a Mammogram if I have Breast Implants?

Yes, women with breast implants should follow the same ACR program of recommended screening mammograms as women without breast implants. However, due to the implant, several special views must be taken to allow visualization of both the breast tissue and the implant. For this reason, diagnostic mammography is always performed on patients with breast implants. Patients with implants should always inform the physician and the technologist performing the exam that they have implants. MR imaging can also be used to image breast tissue and implants, and MR is useful for checking the condition of implants. MR imaging is the imaging method of choice to evaluate the implant itself (to check for ruptures) while mammography is still the best test for evaluating breast tissue. Mammography does not cause implant rupture.

The x-rays used for mammographic imaging of the breasts cannot penetrate silicone or saline implants well enough to image the overlying or underlying breast tissue. Therefore, some breast tissue will not be seen on the mammogram, as it will be covered up by the implant. In order to visualize as much breast tissue as possible, women with implants undergo four additional views as well as the four standard images taken during diagnostic mammography. In these additional x-ray pictures, called implant displacement (ID) views, the implant is pushed back against the chest wall and the breast is pulled forward over it. This allows better imaging of the forward most part of each breast. The implant displacement views are not as successful in women who have contractures (formation of hard scar tissue around the implants). The ID views are easiest to obtain in a women whose implants are placed underneath (behind) the chest muscle.

Can X-ray Mammograms Cause Cancer?

Modern mammography uses the lowest possible dose of x-rays. Scientific data has shown that doses 100-1000 times greater those used for mammography are required to show any statistical increase in breast cancer frequency. There is no significant risk of radiation damage to breast tissue from mammography and the potential risk is greatly outweighed by the benefit of getting regular mammograms. The MQSA (Mammography Quality Standards Act) was created by the American College of Radiology (ACR) and passed by Congress to mandate rigorous guidelines for x-ray safety during mammography. Patients should make sure they are being imaged at an ACR accredited facility using modern mammography systems.

Where Can I Find a Mammography Facility?

To date, over 11,000 mammography facilities have been accredited by the American College of Radiology (ACR) in the U.S. The Center for Devices and Radiological Health of the US Food and Drug Administration (FDA) maintains a Mammography Site Database that lists mammography locations within the fifty U.S. states and Puerto Rico. Users may search for a nearby facility by entering the first three digits of their zip code.

How Much does a Mammogram Cost?

The average cost of a mammogram is approximately $100. Most insurance plans cover the cost of screening mammograms, and many facilities offer low-cost or financial assistance for those who qualify.

How Often Should I Receive a Mammogram?

The National Cancer Institute recommends women 40 years of age receive a screening mammogram every one to two years. Begininning at age 50, mammography should be performed every year. Women at a very high risk of breast cancer (such as those have tested positive for mutations of the BRCA1 or BRCA2 breast cancer genes) should speak with their physician about beginning annual mammograms as early as age 25.