Ask The Experts: Robert E. Wold, M.D.

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Red Bank Radiologists, PA, has provided quality imaging services to Monmouth and the surrounding counties for more than 40 years. Board Certified by the American College of Radiology, with extensive experience and advanced specialty training, our skilled team of advanced licensed technologists and a dedicated clerical staff coordinate efforts to provide comprehensive care and support in a caring and professional environment. Red Bank Radiologists is committed to expand and improve the scope of the diagnostic services we provide.

What is mammography?

Mammography is a specific type of imaging that uses a low-dose X-ray system to examine breasts, and is used for early detection and diagnosis of breast diseases in women. An X-ray is a noninvasive test that produces images to help diagnose and treat medical conditions. Two recent advances include digital mammography and computer-aided detection. Digital mammography is a system that converts X-rays into electrical signals, similar to those found in digital cameras. These signals produce images of the breast that can be seen on a computer screen or printed on special film. Computer-aided detection (CAD) systems use a digitized image that can be obtained from either a conventional film or digitally acquired mammogram. The computer software searches for abnormal areas of density, mass, or calcification that may indicate the presence of cancer. The CAD system highlights these areas, alerting the radiologist to the need for further analysis.

What are some common uses of the procedure?

Mammograms are used as screening tools for early detection of breast cancer in women experiencing no symptoms, and to detect and diagnose breast disease in women experiencing symptoms such as a lump, pain, or nipple discharge. A screening mammography plays a central part in early detection because it can show changes in the breast up to 2 years before a patient or physician can feel them. Current guidelines from the U.S. Department of Health and Human Services, the American Cancer Society (ACS), the American Medical Association, and the American College of Radiology recommend a screening mammography every year for women,beginning at age 40. Annual mammograms lead to early detection of breast cancers, when they are most curable. The National Cancer Institute adds that women who have had breast cancer and those at increased risk should seek expert medical advice regarding screening before age 40, as well as screening frequency. Diagnostic mammography is used to evaluate abnormal clinical findings, such as a breast lump or lumps; they may also be done after an abnormal screening mammography in order to evaluate the area of concern.

How should I prepare?

Before scheduling a mammogram, the ACS (and other relevant organizations) recommends discussing any new findings or problems in your breasts with your doctor. In addition, inform your doctor of any prior surgeries, hormone use, and family or personal history of breast cancer. The best time to schedule a mammogram is 1 week after your period, and always inform your doctor or X-ray technologist if there’s a possibility that you are pregnant. Do not wear deodorant, talcum powder, or lotion under your arms or on your breasts the day of the exam, as these can appear as calcium spots. Describe any symptoms or problems to the technologist performing the exam. If possible, obtain prior mammograms and make them available at the time of your exam. Ask when your results will be available, and don’t assume results are normal if you don’t hear from your doctor or the facility.

How is the procedure performed?

Mammography is performed on an outpatient basis. Your breast is positioned in the mammography unit, placed on a special platform, and compressed with a clear Plexiglas paddle. Your breast is gradually compressed; this evens out breast thickness for easier visualization of the tissue; it also spreads out the tissue so that small abnormalities are less likely to be obscured, allows the use of a lower X-ray dose, holds the breast still to minimize blurring of the image, and increases the sharpness of picture. The process is repeated for the other breast and takes about 30 minutes. When the exam is complete you will be asked to wait to make sure all the necessary images have been obtained.

What will I experience during and after the procedure?

You will feel pressure on your breast as it is squeezed by the compression paddle. Some women experience some discomfort. Be sure to inform the technologist if pain occurs as compression is increased. If discomfort is significant, less compression will be used.

Who interprets the results, and how do I get them?

A radiologist will analyze the images and send a signed report to your primary care or referring physician, who, in turn, will discuss your results with you. You should also be notified of the results by the mammography facility.