Medical Imaging: Breast Imaging - What To Expect

Breast assessment

When a potential abnormality in the breast is found, patients are referred to the Breast Care Program at St. Joseph’s Hospital for assessment (diagnosis).  The unique, specially-designed Norton and Lucille Wolf Breast Care Centre is the main hub of St. Joseph’s Breast Care Program. Here, patients undergo clinical assessment and participate in the development of a treatment plan with their care team.

What patients can expect

When a patient comes to the Norton and Lucille Wolf Breast Care Centre for assessment (diagnosis), he or she will be registered and asked to fill out a questionnaire. A nurse will then review the questionnaire with the patient, who is then seen by team members working with the surgeon, including advanced practice nurses. Since St. Joseph’s is a teaching hospital, patients may also be seen by residents and medical students.

Breast investigations include mammogram and/or ultrasound of the breast. Please be aware that most abnormalities found by these tests are BENIGN. For the radiologist to be certain about any finding on imaging, he/she may offer the patient a biopsy AT THE SAME APPOINTMENT. 

As a result, the patient may be at the hospital for a lengthy period of time and should make appropriate work and parking arrangements.
 
In addition, patients offered a biopsy will be asked to participate in research by having additional biopsy samples taken at the same time and donating them for research.

The breast care program provides:

• Highly specialized clinical care
• Education and support
• Coordination of care, from diagnosis through surgery
• Information about and referrals to community resources
• Follow up

Mammograms

A mammogram is a set of x-rays of your breast tissue. It can detect problems in the breast when they are still too small to be felt. A mammogram uses a very small amount of radiation that does not harm you. At St. Joseph’s, three types of mammogram exams are available:

• Traditional 2-D mammogram
• Contrast mammogram (a mammogram done with the addition of contrast dye injected into a vein in the arm)
• Tomosynthesis (3-D mammogram)

How to prepare for a mammogram

Do not use any creams, oils, talcum, baby powder or deodorant on your underarm or breasts. These products cause problems getting a clear picture. You may want to bring these items with you to use after your mammogram.

Wear a shirt, blouse or top that you can take off easily, as you will need to get undressed above the waist for this test.

What happens during a mammogram?

Regular mammogram

You will put on a hospital gown and the technologist will ask you a few questions about your medical history. The technologist will then position you in front of the machine. Most women stand up for this test. If you are not able to stand, the technologist will help you get into a comfortable position.

The technologist will then compress one of your breasts between 2 plastic plates. This helps the machine get a clear picture of the inside of your breast. The pressure from the plates is uncomfortable but should not be painful. After a picture is taken, the plates are released. You will have 2 or more pictures taken of each breast.

The entire examination will probably take about 30 minutes. If you have any questions, you can plan to be here a bit longer.

After the mammogram has been taken, you will be asked to wait while the technologist checks to make sure the images are clear. The radiologist then interprets the mammogram and may also want other tests done, such as extra views and/or an ultrasound, to get a better look.

This test is safe and does not damage the breast in any way. You should not feel any pain or discomfort after the test.

Tomosynthesis and 3D views

With tomosynthesis or 3D mammography multiple images of each breast are taken from different angles. The breast is placed and compressed the same way as for a regular routine mammogram. The x-ray tube moves in a semicircle across the breast and takes about the same amount of time as a regular mammogram.

The x-rays are sent to a computer where they are viewed by the radiologist. The radiologist can scroll through the images similar to looking at the pages of a book, with each page being a different layer of the breast.

Contrast mammography

With contrast mammography, contrast dye will be injected into a vein in your arm. Patients should drink a few glasses of water before the appointment because it is easier to find a vein when you are well hydrated. If you are over 70 or have any kidney problems, you may need to have a creatinine blood test before having a contrast mammography.

A regular mammogram is performed 2 minutes from the start of the contrast injection. Special computer software is applied to the mammogram that allows the radiologist to look for signs of an abnormality.

You can expect to be in the department for about 1 hour.

When do I find out the results?

The radiologist will send a report to the doctor who sent you for the test.

He/she will give you the results.

What else I should know?

A mammogram is only one test used to find abnormalities in a breast. Your doctor may want you to have other tests as well. All women should do a breast self-exam each month and visit their doctor for routine check-ups.

For more free information or help on breast self-examination, please call your doctor or:

• Canadian Breast Cancer Foundation
  519 691-0969
  Outside London: call 1-866-373-6313
• Canadian Cancer Society
  519 432-1137
  Outside London: call 1-800-268-8874