Bay Radiology Breast Imaging Center
537 Baltimore Annapolis Boulevard
Severna Park, MD 21146
Screening For Breast Cancer
Radiologists have many ways to image body parts, including the breasts. Mammography is the only imaging screening tool that has been proven to reduce mortality from breast cancer. Mammography is an xray of the breasts, using specialized equipment designed for this purpose only. The newest mammography technology available is digital mammography which captures images electronically instead of on film. A digital mammogram will feel the same as the old film mammogram, since compression is still necessary (compression is the most important factor in obtaining high quality images and in reducing radiation exposure). Digital mammography offers significant technical advantages over film mammography, including 1) mammograms can be completed more quickly, 2) there are fewer repeat exposures due to computerized technology, 3) images can be optimized electronically to allow diagnosis of small tumors, 4) radiation exposure to the patient is reduced by up to 40%.
A recent multicenter breast cancer screening trial (DMIST) compared digital mammography with film mammography in 49,528 women. Digital mammography was found to be significantly superior to film mammography for breast cancer detection in women under age 50, perimenopausal women and in women with dense breasts.
The American Cancer Society and the American College of Radiology recommend that all women undergo yearly mammography screening beginning at age 40. It is most effective when performed annually, since breast tumors tend to grow more quickly in younger women.
Mammography screening for women at “high risk” includes personal history of breast cancer, personal history of atypical hyperplasia or lobular neoplasia, having a first degree relative who developed premenopausal breast cancer, having multiple relatives with breast or ovarian cancer, having a BRCA gene mutation and having a history of radiation to the chest between ages 10 and 30. If a woman is under age 40 and at “high risk”, we will recommend yearly mammography screening before age 40. When to begin screening young women at high risk will be decided on a case by case basis. For those with BRCA mutations, screening is recommended to begin between ages 25-30. Breast MRI is usually recommended in addition to mammography in those at high risk. MRI has been found to be more sensitive than mammography for demonstrating breast cancers. Neither breast MRI nor mammography is 100% effective for breast cancer detection, and we recommend that they be used together for women in the high risk category.
Screening mammography is for women without a new breast symptom, such as a lump or other change in breast exam. The goal of screening is to find breast cancer before it is large enough to be felt. Women with any breast problem should have a “diagnostic mammogram”, which is a “problem-solving” study.
All mammography facilities are required to be federally qualified and registered (MQSA). The manner in which the mammography equipment is used varies tremendously from site to site. Mammography quality is best when performed by technologists with subspecialized training, working under the direct supervision of a radiologist who specializes in mammography.