The mammography procedure used to detect breast cancer

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The definition of a mammogram is a radiograph of the breast tissue (refer to the attached copy of a mammogram). It is an effective non-invasive means of examining the breast, commonly searching for breast cancer. Cancer is not preventable, but early detection leads to a much higher chance of recovery and lowers the mortality rate from this disease. Breast tissue composition varies with age and hormone levels in a woman. Generally, a younger woman has denser or fibro-glandular breasts. Her mammogram will look very white or "cloudy" (Figure 8-dense breast) and the middle-aged women have a mixture of fibrous and glandular tissues (Figure 8-50-50 breast). Their mammograms look black and white. In a mature breast, most of the fibrous tissue is replaced with fatty tissue. The mammograms tend to look black or gray.

Mammography Procedure

The woman is escorted to the changing room, where she undresses from the waist up and changes into the screening center gowns. She is asked to wipe off any deodorants, perfumes or powders that she may have used that day, as these can mimic micro calcifications on the film. She is taken into the mammography room, where the mammographer or technologist reviews her history sheet. The history sheet has questions pertaining to the woman's previous mammograms, prior surgeries (if any), if she felt any lumps, superficial marks (such as prominent moles, scars from an incision), family history of breast cancer, number of children, her age when the first child was born, and last date of menstruation or post-menopausal (Addendum 2). Then, the mammography procedure is explained. This opens communication channels and the woman feels free to voice her concerns, thus increasing her comfort level. It is important to prepare the woman for the compression that would be used for imaging. This device causes discomfort, but should not hurt the woman. A Compression Paddle, (see Figure 6 and Figure 7) is a device used to compress the breast tissue. This helps to spread out and separate breast tissue, enabling the Radiologist to get an unobscured view of possible pathology. Compression also lowers patient radiation dose and prevents patient motion. The required views are performed and the woman is dismissed with instructions that she might feel sore for a day or so from the compression. Besides that, the mammography equipment has progressed rapidly over the last 10 years. In developed countries, a dedicated mammography unit is used. A whole range of manufacturers make these machines, for example the GE, Bennett, Lorad, Siemens, Fischer, Phillips. They generally have a reciprocating grid to reduce scatter radiation thus avoiding fog and blurry image. The Filter (to make the beam hard and more penetrable) used, is 0.03 mm Molybdenum. Film Processing is done under specific conditions. The two ways to develop an exposed film are firstly Standard Processing and secondly is Extended Processing. The choice depends on the type of film used. The technique used for a mammogram is low Kilo-voltage Peak (KvP) about 24 to 30. The milli-Ampere-seconds (mAs) vary depending on breast tissue density. When the photo timer cells are used, it provides the optimum mAs for the tissue to be imaged. This technique results in mammograms with a high film contrast, making it easier for the Radiologist to read. Besides that, the Films used for mammography are single emulsion fast films to enhance image sharpness by eliminating geometric distortion. Films commonly used are the Kodak Min- RE, Agfa, Fuji, Dupont, and Konica. Then, the screens consist of a rare earth phosphor called terbium activated gadolinium oxysulfide. Screens have to be compatible with the film. The newest film-screen combination is responsible for dose reduction by 30 - 50 %. The markers are used to indicate the side and view demonstrated on that particular film. Markers are placed on the side of the axilla (armpit) of the patient. This acts as a reference point to understand the orientation of the breast, especially in the CC view.

Screening Mammograms

These views are done as a regular screening process to get an overall picture of the breasts and ensure that all is well. The protocol depends on the specific facility. In America, four films are required of the breasts: two views for each breast.

In Europe, most countries do one view (MLO) of each breast and if an area of suspicion is notice, then 15% of the times, additional CC views are taken.

Screening for breast cancer referred to a study to investigate breast individuals who did not show a clear indication of which symptoms. This was done to identify if there are signs emerging in the early stages of breast cancer. Such actions at the beginning will allow medical practitioners to stunt the emergence of the possibility of breast cancer at the level that can harm patients.

There are various methods of breast imaging, such as the Mammography x-ray film, the ultrasound, the magnetic resonance imaging (Magnetic Resonance Imaging), the radionuclide scanning (Radionuclide scans),  the xeromamografi (Xeromammography), the computed Tomography (Computed Tomography), the thermography (Thermography), the transilluminasi (Transillumination) and the elektropotensi (Electropotentials) (for the introduction of pulp / for palpable lesions). New method is computer-based digital mammography and ultrasound 3-D. Despite the discovery of promising new technologies to identify potential breast cancer more effectively, but until now there has not really proven to rival the traditional methods used in the business. This is evident from the Institute of Medicine (IOM) and National Research Council of the National Academies of America reported in a March 2001 report that the method of film mammography is still the gold standard in identifying breast cancer. Now it's up to digest the new technology is the challenge to prove their methods is superior. According to the U.S. Preventive Task Force in the latest recommendations issued in 2002, individuals who reach their 40s women are advised to get mammograms every year or two years. Mammography is not necessarily 100% accurate. It can only be detected only 85% of breast cancer. Accuracy decreased when breast tissue becomes more dense. Small cancers can be hidden by dense tissue can not be seen in a mammogram. Women who have dense breasts that contain milk glands excessive compared with fat tissue. Menopausal women given hormone therapy also had a dense breast tissue. The density of the breast gland has nothing to do with the size, shape and appearance of the breast. Women who do not have a lot of fatty tissue (which has a dense breast) may benefit from an ultrasound examination in addition to a mammogram. Now, a new method using high frequency ultrasound has been reported to detect small tumors or calcification in the breast. However, it can not be recommended as the primary tool for detecting breast cancer. This is because ultrasound can not show the overall features of the breast tissue, can not detect small calcification in the cancer, and it is highly dependent on the ability to guide the machine. Mammography continues to be first choice for screening for breast cancer. Combination of mammography and ultrasound will prove to be important to increase the sensitivity in detecting cancer in dense breasts.

The study is still ongoing on the benefits, risks, costs, and long-term effects on the life of someone who undergo screening using ultrasound alone. At present it is too early to draw conclusions about the ultrasound examination without mammography, including the dense breast.

Are mammograms painful?

While mammography is, the breast tissue is compressed for a moment and feeling sick. The compression process allows mammography performed with low radiation dose and also allows the breast tissue more clearly visible. The compression process is only brief and acceptable to many patients. Many women think the pain is not as expected. Pain depends on the individual. Anxiety and fear of adding further pain. Lack of discussion between the interpreter and the patient's mammography will also add a feeling of pain. Feelings of discomfort during mammography is small compared with the pain during childbirth but the pain during childbirth is acceptable because the excitement and accept parenthood. Pain during mammography may save your life. Mammography equipment now have a modern design of the detection process with optimal compression. Most of them have sensors that will stop the compression of the compression process as soon as make exposure. If you go get a mammogram with an open mind, it would not be a bitter experience for you. Is practice a positive attitude and you will overcome the fear to undergo mammography screening. Mammogram is not harmful. It is wise for us to know about the dangers of radiation, but we may not know about our didedahi radiation. We are exposed to radiation from outer space, the environment, small amounts of food, by exposure at work, out of fuel and medical examination. However, intelligence on the radiation does not mean you are afraid of radiation. Furthermore, we often forget we are always facing threats, such as crossing the road without using pedestrian bridges or we are still smoking cigarettes despite the evident relation to lung cancer. A mammogram the same as soaking up the sun for 2 hours or 2 weeks of exposure to the radiation environment Mammogram center has a staff of skilled and specialized modern equipment for mammograms. The combination of high technology and skills to produce high-quality mammograms with low radiation dose exposure. A mammogram with risk same with the air trip as far as 70 miles, the driving 10 miles,the sucks 1 / 8 sticks and 3minute live at the age of 60 years. Smoking is more dangerous than because a mammogram is a mammogram once a year than smoking that 365 days a year. Cancer risk of 1 death per year in each of the 6,000,000 women who are doing mammograms for 10 years. It is identified after 10 years as the effects of cancer may not arise for at least 10 after exposure.The warning are with the tools now, radiation dose is minimal. Cancer is not detected early is more dangerous than pendehadan low radiation doses.

The main mammographies are not all cancers form a lump and not all cancers can be detected by physical examination or touch except when it becomes large enough. There are types of cancer that can only be felt after one or two years at the rate of growth of the cancer. Although mammograms are not one hundred percent accurate, it can be detect lesions (lesions) in the early stages, detect lesions that can not be felt by hand, detect lesions before they can be felt by hand. Provide important information about breast lumps or changes are detected by you or your doctor. Mammograms are performed should be compared with a previous mammogram to obtain new information that helps radiologists to detect small changes caused by cancer. Mammograms are done on a regular basis to provide a better opportunity to identify cancer at an early stage when compared with the mammogram is done only occasionally.

Differences between diagnostic and screening mammograms should be identified in advance by the patients and medical practitioners who carry on their treatment. This is because the individual women who are symptomatic or at high risk require different methods of experimental investigation against the individual women who undergo a screening mammogram. Although there is no specific hours to undergo mammography terutamnya if symptoms such as clinical signs are first observed (ie, when sufferers show symptoms such as lumps, thickening of skin, the effect of dimples on the skin). Such situations require a diagnostic mammogram should be done as soon as possible. Moreover, if suspected sufferers face cancer, it is better to undergo the examination as soon as possible.

Mammography mammography screening or scanning is for an individual woman who did not show a clear indication that symptom will penghidapan disease. Typically, a total of 4 display scan will be performed on individuals who undergo breast scans are. However, to get satisfaction and certainty, at times several additional methods will be used to track any abnormal signs.

If the method of scanning a whole needs to be done, then the aspect of whether it is necessary or worth the cost in terms of always getting the attention. However, for those aged more than 50 years old or between 40-49 years, it was considered worthwhile, and not relied on the cost aspect. However, this issue continues to be controversial and will be further discussed in the section entitled.

Routine scanning for women aged less than 40 years are generally not recommended for breast glandular tissue density is higher at this age is likely to prevent the display of the tumor (ie not visible) and active in the breast tissue is likely sensitive to the effects of radiation. Although there was no determination of the highest age to undergo mammography scans, but something that must be remembered that the risk of breast cancer.

To undergo mammography procedures are simple, you need not go hungry or empty stomach before undergoing mammography. In terms of appropriate clothing to wear, it is best if you wear clothes based on two sheets (2-piece outfit) as pants with a blouse. Although there are no mandatory dress procedures to follow, but be sure to choose clothing that easily removed, especially in the breast. Avoid the use of powder, perfume, deodorant on one side of your body and also in the armpit. This will result in belaying on your mammogram; it would have an impact on the interpretation of the results of your mammogram scans by radiologists. If you experience pain in the breast, especially during menstruation, then you can schedule a mammography scan again after the end of your period. This is because during the menstrual experience, breasts are in a less gentle or "tense" and more sensitive. For those who had undergone scans a mammogram before, then it is best to take it with you. This will enable radiologists to make a comparison with the previous mammogram results and identify any abnormal development. The ability to make comparisons and research will certainly help them make more accurate reports. Make sure you do not remove or eliminate the long-mammogram. The mammogram is the result of the report is very important to your health. If you have a mammogram, make sure the previous mammograms taken together, it definitely will help radiologists to compare and review the investigation if there is an abnormal growth, particularly in the areas of suspicion and invite maybe tumor or cancer. Do not forget, the advantage of mammography is the detection of breast cancer before you feel or see any symptoms.

The process of imaging x-ray of the breast. And you certainly have heard another term associated with the mammogram mammography. Is actually a film mammogram x-ray images. To implement the imaging / scanning, a device called a mammography machine used. Look at the pictures that show the machine. These machines usually you will find the visit to undergo screening mammography. In Malaysia, the task of doing mammography managed and supervised by a trained female radiographer mammography. Methods and procedures performed during the mammography examination is simple. Firstly, you will be disassembling clothing from the waist. This is to allow the task to check your breast. Scanning for the purpose of this review will normally be taken from two directions. Both the scan to be performed is from the top and sides of that edge. You will then be positioned by the operator of mammography at the appropriate position and comfortable to scan the breast screening. Then, you'll be pressed to obtain the compression; the goal is to flatten the tissue thoroughly. This is to facilitate the process of identifying any abnormalities with a low level of radiation. While performing this task, the operator and the supervisor in charge of women will do with care and caution. They hate to try to make sure you do not experience discomfort when undergoing the process of screening mammography. To obtain a high level of quality screening, the need to create the position of the breast is compressed and over is important. You need not feel anxious or worried about this situation. This can cause you to feel not so comfortable but the implementation of this compression is only an instant. If the filter engine is of a modern and sophisticated, the position of your breasts are compressed and depressed will be released as soon as the scan completed. While mammography scans are taken, the supervisor will always be with you and do not require them to stay out of the room. In fact, they will operate the machines that press the mammography machine to take a scan. Almost the majority of women are often harassed by a misunderstanding of the term pain is pressed and when the breast is compressed. A more appropriate term to use when the breast is compressed is some discomfort. However, it is something that is subjective and each individual has different perceptions about the experience. However, to make sure your screening is in a comfortable situation, you should respect and two-way communication with mammography operators to enable them to customize the scanning of the circumstances and needs your time. It is very important for you to undergo a screening process to ensure the best possible way. Positive outlook will produce more than happy to pass inspection. Remember, screening mammography is able to save your life. If benefits are taken into account, what is "painful" breast is not compressed until some time! If you have a menstrual period, so it is best if you schedule the date for screening mammography performed after dry periods. This is to avoid feeling discomfort in your breasts.

Some women are very concerned to undergo screening mammography if they had undergone treatment of breast implants. They are anxious and worried that the so-called screening mammograms will cause damage to breast implants. This notion is not true, needs to undergo a screening mammogram is dependent on medical advice. It will also take into considerations whether the implants are made that are part of reconstruction surgical treatment for breast cancer. In countries where there is some art groups of people who participate in the screening mammogram, those who had undergone breast implant process are also advised to undergo a screening mammogram, especially if they are of the age group at risk. The United States is an example of countries that adopt such an approach. Before doing mammography screening, the women who underwent mammograms must inform the operator of mammography screening before starting work on the existence of silicone in breast implants. This is because its presence would prevent a clear view of tissues that protect the silicone implant behind. This is more pronounced if the silicon had placed the bows instead of the chest wall muscles in the back. If notified in advance of this situation, the operator of mammography and an experienced radiologist to ensure that the focus be more careful and be given to ensuring silicone implants have not broken or damaged. Besides, different techniques will also be implemented, such as inserting an implant behind the breast tissue and exciting position forward. This is to facilitate efforts to identify any unusual circumstances in the breast tissue. When there is a effect tissue (scar tissue) around the implants or silicone from implants has melted into the tissue, it will be difficult for businesses to identify abnormalities in your breast in a mammogram. "Accuracy" or the ability to find abnormalities in the mammogram is not so satisfactory as to the breast in a "natural." Implants will also "hide" part of the breast tissue, depending on the size of the implant compared with the size of your breasts. Thus, although the implants are not dangerous to your health, it will reduce the accuracy of mammograms to detect signs of cancer. If your mammogram is abnormal is found during the initial examination, further investigation is needed to determine its true or not. If this is true disorder, a biopsy examination is recommended for confirmation. (A biopsy is an investigation in which some breast tissue will be taken for laboratory studies.) Examination of the biopsy can be performed using a fine needle (needle biopsy) or by taking a section of tissue (core biopsy). You do not have to stay in the hospital for examination of a biopsy may be performed as outpatient procedures. It was done at room mammography or ultrasound in the room. This check requires no special preparation, and you can return home after undergoing a biopsy examination. A final diagnosis of breast cancer can only be made by taking a sample of tissue from the breast area of ​​a clot can be detected. This is known as a biopsy. In the case of a lump can be felt clearly, then surgical biopsy performed.