Common Questions About Breast Screening

Mayfair • Sep 16, 2020

As a medical imaging provider, Mayfair Diagnostics specializes in providing our patients with the very best imaging experience. This includes answering our patients’ questions. Below are some common breast screening questions and our answers.

What are the benefits of screening mammography?

Mammography is a type of X-ray exam that takes an image of the inside of the breasts – called a mammogram. It provides a detailed look at the internal structure of breast tissue in both men and women and can reveal changes that are too small for you or your doctor to feel. All Mayfair Diagnostics’ mammography clinics use technology that provides traditional 2D images of the breast, as well as 3D images of the breast that can then be viewed in slices (tomosynthesis). This provides a greater level of detail and a clearer view of the breast tissue with a very small dose of radiation.

Breast cancer will affect one in eight women in Canada, but if you find it early, there are more ways to treat it and the chances are better you will survive it. The best way to detect breast cancer early is by having regular screening mammograms. Having a mammogram every year, or every two years (based on your risk factors), makes it easier for a radiologist to compare your images and see changes or areas of concern. If you wait until you feel pain or notice something different about your breasts, the breast cancer might be bigger and harder to fight.

When should I start screening?

Mayfair Diagnostics recommends that you have a mammogram every year from age 40 to 49. After that we recommend a mammogram every two years from age 50 to 75, unless you have pain or concerns with your breasts, or if you have spoken with your doctor and your medical history suggests a mammogram each year is beneficial. As part of the Alberta Breast Screening program, women 50 years and older don’t need a referral from a doctor to have a screening mammogram. After age 75, screening frequency will depend on your medical history and should be discussed with your doctor. It’s also important to be aware of your breasts and report any changes in their look and feel, such as pain, lumps, or nipple discharge, to your doctor.

Is a mammogram safe?

The exposure to radiation from mammography is similar to standard X-rays, equivalent to a chest X-ray, but the associated risk is still small. For example, the radiation levels involved are comparable to the exposure from the earth's natural background radiation from living in Calgary over six months. In most cases, the benefits of a mammogram, such as the early detection of a serious illness, outweigh the small increased risk from radiation exposure.

Are mammograms painful?

During a mammogram, two X-ray plate surfaces slowly move together, compressing the breast for a short time. This compression is necessary to get the clearest image of breast tissue using the least amount of radiation. Everyone’s pain threshold is different, but there may some discomfort during the very short interval when the breast tissue is being compressed.

Mayfair Diagnostic also uses the latest mammography technology – the GE Senographe Pristina Dueta mammography system – at four Calgary locations. This system is designed to increase patient comfort and reduce anxiety. With Pristina the patient is offered the option to use a handheld wireless remote control – called patient-assisted compression – to adjust the level of compression to what’s comfortable for her, under the guidance of a technologist. This is important because the more relaxed the patient, the easier it is to position and compress the breast, resulting in less radiation from the X-rays and a clearer image. A positive experience also makes patients more likely to return for regular screening, which is the most effective way to catch breast cancer early.

What’s the difference between screening and diagnostic mammograms?

Screening is different from diagnostic medical imaging. A diagnostic mammogram is performed when you have symptoms, to identify a cause, or if your doctor has discovered an abnormality. For example, it might be ordered to investigate pain, lumps, or nipple discharge.

A screening mammogram, on the other hand, is performed to help detect diseases early, before they cause symptoms. Typically, a screening exam is performed at a regular interval, such as annually, to look for subtle changes in your breast tissue which may reflect an early cancer.

Why might I be called back after my screening mammogram?

During a screening mammogram, four images are taken. Occasionally you may be asked to return for additional breast imaging, such as a diagnostic mammogram and/or diagnostic breast ultrasound. This is done to get a more detailed look at any areas of concern and ensure you have received a complete breast exam.

Why might I need a breast ultrasound?

A diagnostic breast ultrasound uses high frequency sound waves to see the internal structure of your breast. It is often requested to investigate symptoms, like pain or lumps, or to examine a specific area of concern.

A diagnostic breast ultrasound or an automated breast ultrasound may be booked as a supplement to a screening mammography for patients with extremely dense breast tissue (Volpara D score) or patients who have a high risk factor for breast cancer (first-degree relative diagnosed with breast cancer) combined with heterogeneously dense breast tissue (Volpara C score).

Dense breast tissue is a clinical diagnosis that can only be assessed by mammography. Dense breasts have less fat and more glandular and connective tissue, which make a mammogram harder to read so smaller cancers may be hidden. Very dense breast tissue can also increase breast cancer risk. Using both ultrasound and X-ray technology (mammography) together helps provide a more complete picture of the dense breast tissue.

Breast Health, Disease Prevention