During the Procedure

The mammogram is quick and easy and takes only a few seconds.

• You will be asked to remove all clothing above the waist including jewelry and metal objects from around the neck.
  
  
• Then you will simply stand in front of an x-ray machine. The radiology technician places the breast between 2 plastic plates. The plates lightly press the breast and make it flat just enough so breast tissue can best be seen on the mammogram. This compression may be uncomfortable for a few seconds, but it helps to improve the quality of the mammographic image. Pressing the breasts for a few seconds is not harmful and minimizes the necessary x-ray dose.
  
  
• The technician will take 2 x-rays of each breast (and reposition you) for a complete view of the entire gland. Each breast has a double scan. In the craniocaudal projection, the x-rays beam from above toward the radiologic film positioned under the breast. In the mediolateral projection, x-rays come from the inner side toward the outside of the breast.

Women without a history of breast problems usually have a screening mammogram performed. For women with a history of breast problems, a targeted mammogram may be performed to better evaluate a particular area of the breast. Sometimes special mammograms may be requested by your doctor.

• Ductogram: If additional views are needed for specific reasons, such as bloody discharge from the nipple, the doctor may request a ductogram. It consists of mammography performed after a fine plastic tube is placed into the opening of the duct into the nipple and administration of a small amount of dye.
  
  
• Pneumocystography: This mammography is performed after a cyst is emptied with fine-needle aspiration and core biopsy, usually after the cyst has been seen on an ultrasound or if the cyst can be felt.
  
  
• Stereotactic mammography: Based on mammograms taken from 2 angles, a computerized map shows the precise location of masses or calcifications. This technique allows, after local anesthesia, a metallic wire with a little hook at the end to be inserted into a breast lump that cannot be felt. The wire then guides the surgeon during surgery to remove the tumor and the surrounding healthy tissue completely. After removal, a new film of the breast is taken to ensure that all the suspicious tissue has been removed. However, a stereotactic biopsy may be performed in which a small computer-controlled system guides the placement of a needle into the lesion or lump for sampling in a laboratory.
  
  
• Two new instruments have been developed to obtain stereotactic breast biopsies: the mammotome and the advanced breast biopsy instrument (ABBI). Both instruments use a rotating knife that cuts the tissue samples from the rest of the breast. Each type of biopsy has distinct advantages and disadvantages, but their accuracy is similar if well performed.