I’m looking for info on how mammography works (X-ray? Ultra-sound?) and what, specifically, it’s designed to detect. A preliminary run through search engines revealed plenty of sites but I’m somewhat leary of getting medical info from sites I’m unfamiliar with. Can anyone here give me a brief explanation and point me in the direction of trustworthy web resources? Keep in mind that I’m not a medical scientist so anything aimed at the layman would be a bonus.
Thanks,
Hodge
Mammograms are a type of X-ray of the breasts.
After looking it over, I think that your other questions will be answered here, especially the internal links entitled “Background Information” and “What Women Should Know” (and, as I’ve said before, any site from the NIH or NCI is usually good).
It’s an x-ray that (hopefully) shows tumors ‘n’ such. Search for it on WebMD
Simple answer. It’s an x-ray. The breast is flattened and a x-ray taken of it. In a normal breast, all the soft tissue (no pun intended) inside of it is the same density and shows up as the same color on the x-ray film. If there is a lump of stuff (tumor, cancer, cysts, anything different) inside the breast, then it shows up because it is different from the surrounding tissue.
What mammograms do is pick up lumps of stuff that are too small to be detected by the hand (SBEs).
Mammograms are indeed a type of very low-dose xray as stated previously. They are designed to detect any abnormalities. Many women come in because they are feeling a lump. Mammos can determine if it has cystic qualities. Ultrasound (which uses sound waves, no radiation involved) can help confirm this. Ultrasound determines if the nodule or nodules are fluid filled or if they are solid. Solid being more likely to be malignant. However some fluid filled nodules can be malignant too. One of the most important things that mammos pick up is calcifications within the breast. Imagine 10 or so granules of powder. They look like white specks on film. (So small in fact, that radiologists use special magnifiers to read the films) Anyway, calcifications (calcs) alone are nothing to worry about, however they are generally watched to see how they cluster and if they increase in size. There are generally 4 pictures taken during a mammogram (2 per breast). Top to bottom (Craniocaudal or CC view) and one taken at a 40 degree to 60 degree angle called MLO or the Medio-Lateral Oblique.
To put in perspective how low dose mammo is think about this. Mammo uses 26-30 KV for the picture. A chest x-ray is shot at 110-125 KV. So as common as chest xrays are, mammos are generally nothing to worry about when it comes to dosage. Some people think they may get cancer just from having it done.
All done. I hope I didn’t overdo it. I just wanted you to know all the little stuff that hopefully you will find interesting.
Most of what’s been posted I’ve been aware of, but one thing that I don’t really understand.
Why is it necessary to basically squish a woman’s breast to perform one? If you’re doing time to botom as well as side to side x-rays, don’t you get a full view?
(Or is this just a myth perpetuated by sitcoms and female stand up comedians?)
-Doug
is it true that they hurt like hell?..I would’nt know, being a guy 
The breasts are flattened as much as possible to get the clearest reading. And it does get pretty…uncomfortable. I’ve had a few (I had a small lump removed a few years ago) and the techs will generally try to get the breast as flat as they can. I always let the tech know when I’m at my limit, and they have always respected that.
Incidentally, I’ve had both male and female techs do my mammograms, and both seem to be equally competent.
If you go in for one, be SURE not to use deodorant beforehand. Apparently, the aluminum crystals in many deodorants will mess up the reading, and you do NOT want to have to retake readings, not from the exposure standpoint, but from the squishing standpoint.
Evnglion, or any male who’s curious…to empathize, get a vise. Now put the most sensitive body part you own into that vise, and have someone else tighten it. Or put that body part next to a tire, and let someone roll the car onto that part. It feels just like that.
Yes, it is true that SOME techs get the breast as flat as possible. But…NOT ALL of us. The main thing is to keep the breast still and in compression enough to where the tissue is “taut” (sp?). The deodorant thing is for the fact that the powdery white excess can look like calcium deposits that can indicate the need for a biopsy. Who wants to have one of those if the calcs are just excess deodorant?
I honestly think that most women are surprised at how painless it is. I am NOT saying it is comfortable, but itcertainly should not be excruciating pain. There have been so many jokes for so long that most women are expecting the absolute worst. People that have been in the field longer do use more compression from what I have heard from my patients. I think that is because the old adage was “the tighter, the better”. However, we have since learned that tighter doesn’t mean a better picture. Also, as my friend used to say, We are not the breast police, don’t overdo it. I can also say that women with cystic breasts tend to be much more sensitive to the compression. Same with women having mammograms at certain time of the month, and women that have just started taking hormones.
Lynn…
You must have been up north to have men doing the exams.
I am from the deep, deep south and I don’t know any males in the field nor do any of my coworkers. However I have heard from patients that men in this field is common in other areas of the US. Down here, we don’t have males do the breast ultrasound without a chaperone, if we can possibly help it.
roseyray, I live in Fort Worth, Texas, and I’ve had all my mammograms here. I don’t know if this is “Deep South” to you or not…I consider FW to be more Southwest than South. I was told I could have a male tech NOW, or wait for a female tech. Since I’m basically a nudist when circumstances permit, I opted for the male tech. Hanging out in radiology labs is boring for me. As for the squish factor, I wear a FF or FFF cup size, when I bother to wear a bra at all. So there’s plenty of tissue on me to flatten. Perhaps I have just been getting techs who haven’t heard that it’s not necessary to squish to be effective.
so what do they do about women who are A cup and there isn’t enough there to photograph?
Howardsims…
Well, we do mammos on men, so it is possible to get something out of nothing. However it is an artform. You kind of pinch the skin with your hands until you get enough tissue to make a picture. It sounds alot worse than it is. You just have to kind of “create a breast”. Maybe I could market this technique and go live in Fiji for the next 100 years…Hmmm I have to go see about that, after all isn’t that the lifelong quest of 60 percent of American women especially? Gotta go the patent office is fixing to close.
To Lynn…
Size may definitely be the pain factor for you. See, an average woman up to maybe full D gets 4 pictures. Anything larger gets extra pictures to include the entire breast. So you may have alot of extra pictures that other women just don’t have to deal with. The more pictures, the more squishing, the more discomfort.
Sorry Roseyray
The US government just issued advisories to Americans in Fiji concerning possible election violence. Guess you will have to keep working.
Thanks for the responses everyone, especially roseyray. It’s nice to hear from someone with direct experience.
Now a follow-up question: What does a biopsy entail?
Thanks again,
Hodge
Ah…The dreaded biopsy. Well, if there is an area that is questionable the patient is usually referred to a gerneral surgeon. They do most of them, however there are some general surgeons that do strictly breasts. The surgeon then decides the next step. If the area is extremely large, the patient will go to surgery, have it removed and then have it analyzed for pathology. I’ll venture to say that 75% (posssibly more) patients have a needle localization directly before the biopsy. This is where mammograms come in. You hook up a different type of paddle to the machine that either has several holes and a grid or one large hole and a grid that shows up on xray. Then you put the breast in compression and hopefully the area in question is under a hole. If so, the radiologist then comes in cleans the area, numbs the area with lidocaine, then puts a catheter with a needle inside into the area of concern. The holes and the grid in the paddle are great for this, because after the needle is in place, you have to let the paddle up without moving the needle. This is needed to be able to take another view 90 degrees from the 1st view. If all is well the radiologist removes the catheter and leave the needle in place. The patient is sent directly to surgery and the general surgeon then removes the area that was localized. Then several hours later you get that back as a specimen and it is xrayed in the same manner to ensure that they got the right area. This is done with the patient under anesthesia in OR with a courier bringing the mammo tech the specimen. Freaky, huh?
If all goes well the radiologist calls the surgeon and its over. Sometimes, if they are sure by the borders of the looks of it that it is cancer they will go ahead and put a port a cath or mediport in the patient while they are in surgery. Sometimes, they don’t just take the lump, sometimes they do a total mastectomy and you don’t get a specimen. The worst part of the whole thing is that the patient has to stay in compression while you run and check your film, so it is much worse than a regular mammo. And the film takes twice as long as regular xray film to develop because of the developer time settings. So, there you go…the total and complete history of the dreaded breast biopsy.
And Hodge thanks for ruining my Fiji vacation. I guess I’ll have to settle. My annual vacation is next month in Hawaii for 10 days, so I’ll just have to take second best.
Sorry Hodge it was howardsims who deserved the blame for taking Fiji away from me. Just kidding!!! Thanks howardsims!!