Mammography and Breast Health

By scheduling a mammogram at Grinnell Regional Medical Center, you have taken an important first step in fighting breast cancer and disease. A mammogram is a very low-level x-ray of the breasts and is not harmful. Although not foolproof, to date this is considered the best method to detect lesions (abnormal growth). It can detect lesions in breast tissue that might otherwise go unnoticed because they are very small or deeply buried and cannot yet be felt during palpation. This makes mammography particularly valuable as a screening tool in detecting early breast cancer.

The GRMC department of radiology will schedule a mammogram when it is most convenient for you. We will do our best to accommodate your request.

The Best Defense: Early Detection

The earlier breast cancer is detected, the easier it is to treat.

The American Cancer Society recommended guidelines for early detection

Risk Factors

Most women who get breast cancer have no family history of the disease or other risk factors. Breast cancer can occur at any age, but it becomes more common as women get older. Although some women are a slightly higher risk – women whose mothers or sisters had breast cancer, women who have never had children, and women who had their first child after age 30 – the biggest risk factor for breast cancer is being a woman. The use of tamoxifen in higher risk women may lower risk of development of breast cancer.

Signs and Symptoms of Breast Cancer

• Lumps in the breast or armpit
• Thickening in the breast
• Dimpling of the breast
• Discharge from the nipple
• Flat, inverted, or retracted nipple
• Ulcers, sores, or surface erosion

One out of eight women in America will develop breast cancer. Fortunately, a high percentage of breast disease conditions (lumps) are harmless and caused by natural changes within the body. Mammography is an important aid in distinguishing normal from abnormal conditions.

Mammography Preparation

Your mammogram will take approximately 30 minutes and will be completed in a private suite. On the day of your exam, please do not use deodorant or powder. Please call the GRMC Department of Radiology at 641-236-2355 if you have any questions or concerns. A professionally trained mammographer will be available for you.

The Importance of Compression

GRMC recently acquired a new mammography unit that was designed by women for women with the intent to minimize discomfort during your exam. However, you may still experience some discomfort during your mammogram due to the compression. We want to assure you that the compression is necessary to produce the highest quality of films possible so if you do have any abnormal tissue, the radiologists can make a correct diagnosis.

There are five primary reasons why compression is necessary during your examination.

1. By decreasing the breast thickness, the amount of radiation is reduced.
2. It prevents patient motion that can cause a blurred image.
3. It separates the breast tissues and allows evaluation of lesions that might otherwise be obscured by other tissue.
4. It increases details by bringing the breast as close as possible to the film.
5. It makes the breast uniform in thickness and allows equal penetration by the x-ray beam.

What Happens if They Find Something??

If a mass is found, a doctor may use a thin needle to remove fluid or a small amount of tissue. This may show whether it’s a fluid-filled cyst, which is not cancerous, or a solid mass, which may or may not be cancerous.

Sometimes the doctor will do a biopsy, which is a minor operation to take out part or all of the suspicious tissue. It is then examined under a microscope by a specialist called a pathologist. A biopsy is the only sure way to know if cancer is present. It’s important to remember that even if you are told you need a biopsy, more than 80 percent of lumps or suspicious areas are not cancer.

If a biopsy shows that there is cancer, you and your physician will discuss treatment options. Early cancer often can be treated by removing the lump or a portion of the breast rather than the whole breast.

Parts of the Breast

The breast consists of five major structures.

Chest Wall
The chest wall is a large group of muscles that fan out beneath the breast over the ribs. These muscles and ribs form the firm background to which the breast attaches.

Lymph Nodes
The soft beam shaped structures form the filtering devices of a microscopic network of tiny channels that drain body tissue fluids. There are two primary lymph nodes chains located under the arm and beneath the chest wall that drain fluids from the breast. They become quite important in breast cancer because these areas are the first regions to which the cancer can spread.

Fibrous Tissue
This tissue extends from under the surface of the skin of the breast to the chest wall to provide support for the breast. It also separates the breast into segments. Younger women have more fibrous tissue and thus firmer breasts.

Mammary Glands
The mammary glands are the part of the breast that produce milk that is transported through ducts to the nipple. There are 7 – 12 separate lobes of breast glands that empty through the ducts into the nipples.

Fat Tissue
The fat tissue forms a covering for the breast and its amount varies according to weight. Age is also a factor in the amount of fat in the breast. After menopause, it replaces the mammary glands and the breasts lose their firmness.

Signs of Breast Cancer

As a cancerous growth occurs in the breast, it may take on any of the following appearances.

• A lump: Usually single, firm, and most often painless
• Inverted nipple: In a previously normal breast
• Skin swelling: A portion of the skin on the breast has the appearance of an orange peel.
• Superficial veins: The skin surface veins on one breast become more prominent than the other.
• Skin dimpling: A depression occurring in a localized area of the breast surface.

Glossary

• Benign: Noncancerous.
• Biopsy: A surgical procedure used to test for cancer by removing a piece of tissue from the breast.
• Breast Cancer: The uncontrolled growth of abnormal breast cells. This is one of the most common kinds of cancer in women. Early detection through regular breast self-exams and a regular program of mammography and physical exams show excellent results in reducing risk of death.
• Breast Disease: Any one of a number of abnormalities of the breast, either non-cancerous fibroadenoma, fibrocystic disease, mammary duct ectasia, ductual papilloma, fat necrosis and others; or cancerous breast cancer. Remember, 75-80 percent of breast diseases are noncancerous.
• Breast Lumps: Any swelling or unusual bump or hardness in the breast. This is an indication of breast disease and a reason to see your doctor. Most are noncancerous.
• Breast Self-Exam: The process, developed by the American Cancer Society, for women to monthly examine their own breasts. This process can reveal breast problems at an early stage.
• Ductal Papillomas: A noncancerous breast disease, occurring most frequently in women, that causes a bloody nipple discharge.
• Estrogen: A hormone that plays an important role in the female reproductive cycle. Also used as a therapy for post-menopausal women.
• Fat Necrosis: A noncancerous breast disease caused by trauma or injury.
• Fibroadenoma: A noncancerous breast disease most common in younger women.
• Fibrocystic Change: A noncancerous breast condition, resulting in painful cysts or lumpy breasts. Seen most often in middle-aged women. Present in some extent in almost all women.
• Malignant: Cancerous tissue.
• Mammary Duct Ectasia: A noncancerous breast disease occurring most often in older perimenopausal women.
• Mammary Glands: The breast glands that form and carry milk to the nipples during pregnancy and nursing.
• Mammogram: An x-ray image of the breast taken to detect the presence of breast disease.
• Menopause: The ending of the normal menstrual cycle in women. It occurs most frequently in the late forties or early fifties.
• Menstrual Cycle: A woman’s normal monthly reproductive cycle caused by hormones produced by the ovaries.
• Metastasize: The process in which cancer can travel from one section of the body to another through the lymphatic system or the bloodstream.
• Needle Aspiration: A process of testing a lump to determine whether it is cystic or not.
• Screening: The process of routine testing of a large number of people for a disease.
• Ultrasound: A sound wave imaging technique used to examine a part of the body. It is sometimes used to further evaluate a breast lump or other abnormality seen in a mammography.