Film & Digital Mammography

Mammography is the most important tool in the diagnosis of breast cancer. A mammogram uses a low dose x-ray to take an image of the breast while the breast is compressed. These images can be digital (on a computer) or on film. Digital and film mammography finds abnormalities that cannot be seen or felt by you or your doctor. Most of these abnormalities are not cancer, but they must be further evaluated by a radiologist.

While mammograms don’t prevent breast cancer, they help a doctor find it much earlier, while it is more treatable. A mammogram can identify a lump up to two years before it will become large enough for you to feel it. When breast cancer is found early, the five year survival rate is greater than 95%. Additionally, finding breast cancer early enables more women to select treatment options that allow them to keep their breasts.

Like many medical exams, mammograms are not 100% accurate, but they are the best imaging method available today for screening the population and finding breast cancer early. The American Cancer Society, The American Medical Association, and the American College of Radiology recommend that women age 40 and over have screening mammograms every year. Mammograms should be part of a comprehensive routine for checking for breast cancer that also includes monthly breast self examinations and annual clinical breast examinations.

This page contains the following information about mammography:

Types of Mammograms

There are two types of mammograms: screening and diagnostic.

A screening mammogram is used to check for breast abnormalities in women who are asymptomatic, or currently not experiencing any symptoms of an abnormality. This type of mammogram is used for the majority of women. Two images of each breast are taken from different angles to look for abnormalities.

A diagnostic mammogram is performed when an abnormality was seen on a screening mammogram or a woman has a complaint or symptom, such as a breast lump, nipple discharge or focal breast pain.  Someone with a personal history of breast cancer may have diagnostic mammograms for the first few years following lumpectomy/breast conservation surgery. With a diagnostic mammogram, more images are taken to determine the exact size and location of the abnormality and to better examine the surrounding tissue.

Diagnostic exams are only performed at specific Sally Jobe/INVISION locations where a radiologist is on site. Consequently, if you require a diagnostic mammogram, you may not be able to have it at the same location where you had your screening mammogram.

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Reasons for Having a Mammogram

A screening mammogram can save your life by finding breast cancer significantly earlier than it would be found without a mammogram. By finding breast cancer early, a woman’s chances of survival are higher and she may have more treatment options available to her.

The risk of breast cancer increases as a woman ages. Consequently, it is important for women who are age forty or older to have a mammogram annually. Women at high risk for breast cancer (mother or sister with pre-menopausal breast cancer, personal history of breast cancer, you carry the breast cancer gene, previous biopsy with high risk lesion, previous chest radiation for lymphoma) should consider starting yearly mammograms at a younger age.

A diagnostic mammogram is done to investigate an abnormality that has been found in the breast, either in the screening mammogram or during a breast self exam (BSE) by the woman or during the clinical breast exam (CBE) by the clinician. This type of mammogram may help a radiologist exclude a problem, diagnose an abnormality or determine subsequent evaluations.

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Digital Mammography vs. Film Mammography

Digital and film mammograms both use x-rays to create images of the breast. They differ in the type of image that is created.

Film Mammography

With film mammography, the x-ray image of the breast is created directly on a film which is then studied by a radiologist. This method has been in use for 35 years. Film mammography is very good; however, it is less sensitive for women with dense breasts. Additionally, the film itself is a major limitation of film mammography. The film cannot be altered to improve its quality.

Digital Mammography

With digital mammography, an electronic image of the breast is taken and stored on a computer. The image can be enhanced if necessary and radiologists can use software to help interpret the images. This software is referred to as a computer-aided detection (CAD) system.

Digital vs. Film Mammography

The American College of Radiology Imaging Network (ACRIN) recently released the results of one of the largest breast cancer screening studies ever performed. The purpose of the ACRIN Digital Mammographic Imaging Screening Trial (DMIST) was to compare the effectiveness of digital mammography and film mammography in breast cancer screening.

The primary finding of the study was that, for the entire population of women studied (49,528 women), digital and film mammography had very similar screening accuracy.

It also determined that there is a group of women who would benefit from digital screening mammograms over film mammograms. That group includes women who meet any of the following criteria:

Women who meet all three of the following criteria will not benefit more from a digital mammogram over a film mammogram:

Digital mammography is an important new technology in detecting breast cancer. Speak with your doctor to determine if a digital mammogram would be more beneficial for you.

You can read more about the ACRIN DMIST results in an article published on September 16, 2005 by the New England Journal of Medicine.

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Risks Involved in a Mammogram

There is the risk of x-ray exposure; however, it is well below the level that causes adverse affects.

Since mammograms, like many medical exams, are not 100% accurate, there is the risk that the breast cancer may not be visualized on the mammogram.

Conditions to Let Our Doctor Know About

In advance of your exam, let your INVISION radiologist or technologist know if any of the following circumstances apply to you:

Insurance Coverage for This Exam

In the state of Colorado, most insurance plans cover screening mammography on an annual basis at age 40 and over. Please check with your insurance carrier to be sure.

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Exam Locations

Screening mammograms are preformed at the following INVISION/Sally Jobe breast centers in the Denver, Colorado area:

If there is some irregularity found on the screening mammogram, you may be called back for further evaluation. This may include a diagnostic mammogram and/or a breast ultrasound.  We perform diagnostic breast exams at the INVISION Sally Jobe Comprehensive Breast Center at the Centrum.

Scheduling Your Exam

To schedule a mammogram, call 720-493-3700. The scheduler can help you identify the INVISION/Sally Jobe breast center closest to you.

Preparation Guidelines

Following are the preparation guidelines for a mammogram. Please contact us at 720-493-3700 if you have any questions.

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What to Expect During Your Mammogram

When it is time for your exam, you will need to undress from the waist up. A specially trained technologist will position your breast on a platform and then compress the breast with a paddle.  This will even out the breast so that all of the breast tissue can be visualized. For a screening mammogram, generally two views of each breast are obtained. If you are undergoing a diagnostic mammogram, additional images will be taken. If you brought images from previous mammograms, a radiologist may compare the older images to the new ones to check for changes in your breasts.

A screening mammogram generally takes less than 15 minutes. A diagnostic mammogram may take up to 30 minutes.

Recovering from Your Exam

You can return to your normal activities immediately after your mammogram.

Getting Your Exam Results

Trained and experienced radiologists interpret all mammography exams. Screening mammogram results are sent by mail and you will receive them within 7-10 days. Diagnostic mammography results are given the day of the exam.

Additional Information

The information on this page was taken in part from some of the following web sites. Visit these sites for additional information on mammography.

Sources

Additional Information

A screening mammogram can save your life by finding breast cancer significantly earlier than it would be found without a mammogram. Film and digital mammography use a low dose x-ray to take an image of the breast while the breast is compressed.