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Mammography

FMH is the first healthcare provider in Frederick County to offer digital mammography with the addition of thre  Lorad® SeleniaTM digital mammography systems.

"Digital mammography definitely has advantages for the patient," said radiologist Dr. Greg Lavanier. "Many women including young woman and those choosing hormone replacement therapy have dense breasts. For them, screening with digital mammography provides better visualization of the breast tissue, which translates into better patient care."

The radiologist can view and manipulate the images on high-resolution computer monitors that enhance visualization of the structures within the breast tissue. They can also adjust brightness and contrast, and zoom in on specific areas to help detect small calcifications, masses and other changes that may be signs of early cancer, which may alleviate the need for additional imaging and more exposure to radiation.

"Women will notice little difference when going for a digital mammogram," said Dr. Lavanier. "The procedure is the same as traditional film mammography, but less time consuming. Both use x-rays to generate images of the breast. However, instead of using film to capture and record the image, a digital mammogram uses a special detector to capture and convert x-ray energy into a digital image."

Digital mammography offers a number of other practical advantages and patient conveniences. Because digital mammography is filmless, nothing has to be developed - saving time.  At FMH Rose Hill and FMH Crestwood, Monday through Friday, a radiologist reviews the images while the patient waits.  This unique service allows for additional images, or procedures such as a breast ultrasound, to be performed the same day, greatly reducing the need for a return visit.

To supplement this technology, FMH has incorporated digital Computer-Aided Detection (CAD). Digital CAD highlights characteristics commonly associated with breast cancer. When activated, it flags abnormalities to help the radiologist detect early breast cancer. CAD is, in essence, a second set of eyes to support and enhance the radiologist's judgment.

Digital images are easily stored and transferred electronically, eliminating the dependency on one set of original films, which can be misfiled or lost in transit.  Of course, hard copies can always be produced if needed.

 

The Importance of Mammograms & Self Breast Exams 

FMH Radiologist Dr. Peter Kremers visited WHAG-TV to discuss the importance of mammograms for women ages 40+ and self breast exams for all women. Interested in 3D mammography? Dr. Kremers describes it here:

What is Mammography?

Mammography is a specific type of imaging that uses a low-dose x-ray system for examination of the breasts. The images of the breasts can be viewed on film at a view box or as soft copy on a digital mammography work station. Most medical experts agree that successful treatment of breast cancer often is linked to early diagnosis. Mammography plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40.

The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening.

A mammogram is a low-dose x-ray used to examine the breasts to detect lumps before they can be felt. The breast is placed on a film and gently pressed.  This compression, while briefly uncomfortable, greatly improves the quality of the image. 

Mammography at the hospital, FMH Crestwood and FMH Rose Hill is performed in a discrete area of the imaging department that provides for patient privacy.

All FMH Imaging facilities are now offering a Softer Mammogram, which uses a soft foam cushion called a MammoPad to make the experience more comfortable. Learn more about the MammoPad.

 

What are some common uses of the procedure?

Mammography is used to aid in the diagnosis of breast diseases in women. Screening mammography can assist your physician in the detection of disease even if you have no complaints or symptoms.  Initial mammographic images themselves are not always enough to determine the existence of a benign or malignant disease with certainty. If a finding or spot seems suspicious, your radiologist may recommend further diagnostic studies.

How should I prepare for the procedure?

Before scheduling a mammogram, discuss 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.

Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time. The best time is one week following your period. Always inform your doctor or x-ray technologist if there is any possibility that you are pregnant.

We recommend that you:

  • Do not wear deodorant, talcum powder, or lotion under your arms or on your breasts on the day of the exam. These can appear on the x-ray film as calcium spots.
  • Describe any breast symptoms or problems to the technologist performing the exam.
  • Obtain prior mammograms and make them available to the radiologist at the time of the current exam.
  • Ask when your results will be available; do not assume the results are normal if you do not hear from your doctor or the mammography facility.

Before the examination, you will be asked to remove all jewelry and clothing above the waist and you will be given a gown or loose-fitting material that opens in the front.

What does the equipment look like?

A mammography unit is a rectangular box that houses the tube in which x-rays are produced. The unit is dedicated equipment, because it is used exclusively for x-ray exam of the breast with special accessories that allow only the breast to be exposed to the x-rays. Attached to the unit is a device that holds and compresses the breast and positions it so images can be obtained at different angles.


 


How does the procedure work?

 The breast is exposed to a small dose of radiation to produce an image of internal breast tissue. The image of the breast is produced as a result of some of the x-rays being absorbed (attenuation) while others pass through the breast to expose film. The exposed film is placed in a developing machine, producing images much like the negatives from a 35mm camera.

How is the procedure performed?

During mammography, a specially qualified radiologic technologist will position you to image your breast. The breast is first placed on a special platform and compressed with a paddle.

Breast compression is necessary in order to:

  • even out the breast thickness so that all of the tissue can be visualized;
  • spread out the tissue so that small abnormalities won't be obscured by overlying breast tissue;
  • allow the use of a lower x-ray dose since a thinner amount of breast tissue is being imaged;
  • hold the breast still in order to eliminate blurring of the image caused by motion;
  • reduce x-ray scatter to increase sharpness of picture.

The technologist will go behind a glass shield while making the x-ray exposure, which will send a beam of x-rays through the breast to the film behind the plate, thus exposing the film.

You will be asked to change positions slightly between images. The routine views are a top-to-bottom view and a side view. The process is repeated for the other breast.

The examination process should take about half an hour. When the mammography is completed you will be asked to wait until the technologist examines the images to determine if more are needed.

What will I experience during the procedure?

You will feel pressure on the breast as it is squeezed by the breast paddle. Some women with sensitive breasts may experience discomfort. If this is the case, schedule the procedure when your breasts are least tender. The technologist will apply compression in gradations. Be sure to inform the technologist if pain occurs as compression is increased.

Who interprets the results and how do I get them?

Our goal is to provide the women of Frederick County with the most thorough, accurate and prompt evaluation possible. In most cases, a radiologist -- a physician experienced in mammography and other x-ray examinations -- will be onsite reading mammograms in real time. Most women who have normal mammograms will leave their exam with a letter that says no suspicious areas were found and encouraging them to return for another mammogram in a year's time.

If the radiologist notes something on the mammogram that needs a closer look, the patient will be introduced to our Navigator who will explain the next steps involved. Based on the radiologist's recommendation and with the permission of the patient's primary care provider, follow-up imaging and even biopsies can often be scheduled for the same day. Results from those procedures are typically available in a few days.

 

                   

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