Breast cancer is the second most common cancer among all women in the United States and is the most common cancer among African American women.

Annually, approximately 128 of every 100,000 women will be diagnosed with breast cancer and about 19 in every 100,000 women will die of breast cancer. Early detection is critical for life-saving care, and the mammogram is the most effective screening tool to identify a potentially malignant tumor at its earliest stage.

With this is mind, we sat down with WakeMed Clinical Breast Imaging Navigator, Adrienne Jackson, BS, RT(R)(M)(BD)CN-BI, to learn more about breast imaging and why it is so important for women to get their annual mammogram.

When to Start Breast Mammograms

The American College of Radiology (ACR) suggests that women at average risk for breast cancer begin yearly breast cancer screenings between the ages of 40 and 44. Women 45 to 54 should schedule a yearly mammogram. And, women 55 and older may elect to stick with their yearly schedule or switch to a mammogram every other year. Women with a family history of breast cancer, should consult their primary care provider or gynecologist who may suggest beginning mammograms as early as age 35 — This will vary depending on whether an immediate relative (mother) had breast cancer versus an extended relative (aunt, grandmother, cousin, etc.) had breast cancer.

Men and transgendered individuals are also at risk for breast cancer. According to Susan G. Komen, there are different screening recommendations for men at higher risk and transgender people.

Breast Mammogram Safety

Unfortunately, misinformation is ongoing when it comes to breast mammography. Some believe that mammograms are not safe and may lead to cancer or hormonal issues, but this is not true. Breast mammograms do not cause cancer. Neither do they impact the functioning of the thyroid. Mammogram radiation is very minimal and exposes women to significantly less radiation than even a chest X-ray. Plus, since it is typically performed once per year — as opposed to on an ongoing basis throughout the year — it is relatively harmless.

Others believe the mammogram is extremely painful. While patients should feel pressure, the mammogram should not cause stinging or burning pain. If this occurs, the technician may need to readjust the patient on the machine. Each picture only takes about 30 seconds to capture, so the pressure does not last long.

The benefits of the breast mammogram, undoubtedly, outweigh any potential discomfort.

Equipment

At WakeMed Outpatient Imaging locations, we utilize the highest standard equipment for mammography — as do our imaging partners, Raleigh Radiology. At WakeMed, all of our machines are three-dimensional (3D) tomosynthesis mammography units manufactured by Hologic. They are FDA-approved and considered the “BMW” of mammography units. Our friends at Raleigh Radiology also offer 3D tomosynthesis scans at each of their locations.

Our 3D mammogram machines take images through layers of breast tissue, including very dense breast tissue, to ensure no cancerous lesions are hiding out of sight. This is significant in that the two-dimensional (2D) mammography units only produce a flat image that does not see through the layers of the breasts. Providers, in this case, can only see what is clearly evident, so the 3D breast image is far superior.

Effectiveness

A mammogram is 87% effective at detecting cancer, and it is the most effective means available to detect breast cancer.

The 3D mammogram can detect breast cancer before a patient has any symptoms or feels a lump. Studies have shown that 3D mammograms are more effective than 2D mammograms at detecting early-stage breast cancer.

Along with a mammogram, women should go to their annual primary care/gynecological appointments for a clinical breast exam and should also perform monthly breast self-exams. Even if the clinical breast exam and self-exam do not raise concerns, women should always get their annual mammogram since it is the most effective means to detect breast cancer at its earliest stage.

Length of the Mammogram

The entire procedure takes between just five and seven minutes. A woman will receive two images on each breast. These include a craniocaudal view which is a top to bottom breast image and a medial lateral view which is a side image. Additional images may be taken for women with large breasts or if additional side images are needed.

Results

At WakeMed, we pride ourselves in delivering fast results. We realize that waiting can be nerve-racking. The faster the primary care physician receives imaging test results, the faster patients can begin treatment and get on the road to recovery. We make every effort to streamline this process.

A Normal Reading

If the mammogram is normal, the referring provider (primary care or OB/GYN) will receive a notification of these results so s/he can update the patient. The patient will also receive a letter in the mail with a request to return for an annual mammogram in a year.

If a woman with dense breast tissue has a normal reading, she will also receive a notification of these findings. The letter will caution that the results were a little more challenging to see since the patient has dense breast tissue. Women with dense breast tissue can be more likely to develop breast cancer, but they are not more likely to die of breast cancer.

Test results for patients seen at WakeMed Outpatient Imaging locations will also be shared via the patient’s WakeMed MyChart account.

An Abnormal Reading

If the mammogram results are abnormal, the patient will be contacted by phone for a follow-up diagnostic mammogram. Since North Carolina is a right-to-know state, all results — including abnormal readings — are shared just as they would be for a normal reading.

Because letters are sent quickly, a woman may receive the results before the care team can call to schedule a diagnostic mammogram. In that case, she is welcome to make that follow-up appointment herself. Either way, patients can directly schedule, or they will receive a call from the breast care navigator to schedule the diagnostic appointment.

All women with an abnormal reading are scheduled for a diagnostic exam.

As with a normal mammogram, all test results for patients seen at WakeMed Outpatient Imaging locations will also be shared via the patient’s WakeMed MyChart account.

Statistically, 12% of patients who come in for a mammogram are called back. Of that 12%, just one in 10 are diagnosed with breast cancer.

At WakeMed, we are cautious and thorough, so if a woman’s image has a change from her prior mammograms or a spot stands out on an image, she will be called in for a diagnostic exam to rule out any possibility that she has an area that is suspicious. Even a slight difference will result in a call back for additional imaging because we want to make sure a biopsy is not necessary.

Diagnostic Mammograms

There are three outcomes following a diagnostic mammogram.

Outcome 1

If follow-up diagnostic imaging is normal, we will tell the patient to come back in a year either as a diagnostic or a regular screener depending on what was detected on the mammogram.

Outcome 2

If a patient’s diagnostic exam does not look suspicious enough to biopsy, we will schedule a six-month follow up. The patient will then come back in six-months time to repeat a mammogram in the area of concern. If nothing has changed, we will tell the patient to come back again in six months as a diagnostic to complete a year follow up. Sometimes the radiologist will follow up for two years. If a change has occurred within those six months, a biopsy will be recommended. The biopsy will be scheduled by the breast care navigator before the patient leaves.

Outcome 3

If the diagnostic imaging does look suspicious or we are not 100% certain the abnormal reading is benign, we will biopsy the breast tissue. When a biopsy is warranted, the breast care navigator will schedule this appointment before the patient leaves the diagnostic exam.

Why Choose WakeMed

Patients should turn to WakeMed for all their breast mammography needs because we provide the highest caliber in 3D standard-of-care imaging; ACR accreditation; exceptional care through our top-notch, credentialed team; and a caring, patient-first focus.

At WakeMed, we have the best 3D mammography equipment currently available, and our state-of-the-art mammography machines are available at every location. Our machines are inspected annually per the guidelines of the Mammography Quality Standards Act, so our standards are also of the highest quality.

WakeMed Breast Imaging Services is ACR-accredited in 3D Mammography, Breast Ultrasound and Stereotactic Breast Biopsy. The ACR accreditation is a peer-reviewed, educationally focused evaluation process to help ensure patients receive the highest level of image quality and safety. ACR accreditation is considered the “gold standard” of breast care.

Our expert care team is among the best and brightest. WakeMed breast imaging radiologists are board certified, licensed and solely dedicated in breast imaging. Our certified technologists are compassionate and committed to excellence in their work and care of their patients.

We realize that our team greatly impacts the patient experience. Patients come to get breast mammograms sometimes scared and full of anxiety. An empathetic technologist can make all the difference. Our goal is always to work collaboratively as a team to ease anxiety and fear from the moment a patient walks through our doors and throughout her entire care experience. And, while we hope that no one ever hears the words, “You have breast cancer,” if a patient is diagnosed, our WakeMed Hematology & Medical Oncology and Breast Surgery teams are ready and waiting to deliver exceptional and compassionate care.

About Adrienne Jackson BS, RT(R)(M)(BD)CN-BI

Adrienne is a Breast Care Navigator and mammography technologist for WakeMed. She earned her bachelor’s degree in Radiologic Science from UNC Chapel Hill and is certified in Breast Care Navigation through the National Consortium of Breast Centers. She is also certified in mammography, X-ray and bone densitometry through the American Registry of Radiologic Technologists. Adrienne has passionately served her patients and our community at WakeMed for over 19 years.

As a Breast Care Navigator, Adrienne’s mission is to deliver the highest quality care to her patients. Her job is to help decrease anxiety and fear while answering any questions a patient may have prior to their appointment. When a patient is recommended for a biopsy following a diagnostic exam, Adrienne schedules their appointment prior to them leaving the Imaging office. There, she’s able to explain the upcoming procedure, what to expect, and answer any questions the patient (and family) might have. If needed, Adrienne can also make an appointment for patients with WakeMed’s Breast Surgery team as well. Adrienne aims to be the familiar face that is there to answer questions, reinforce patient education and try to decrease any barriers that may impede care. After having two aunts diagnosed with breast cancer, she takes her job very seriously and wants to create a safe place for patients so that they will continue to go for their yearly screening mammogram every year without anxiety or fear.

In her spare time, Adrienne enjoys family time with her husband and two boys. They enjoy spending time in the North Carolina mountains. Adrienne also does bootcamp almost every day — and finds it’s a great way to release stress.

About WakeMed Breast Imaging

When it comes to fighting breast cancer, early detection is the best defense. WakeMed Breast Imaging Services offers comprehensive breast imaging and related testing to help physicians find and treat breast cancer at its earliest stage.

WakeMed Raleigh, WakeMed Cary Hospital and WakeMed North Hospital are all designated as Breast Imaging Centers of Excellence locations with the American College of Radiology.

Digital Mammography

Advanced screening and diagnostic mammography are conveniently available in WakeMed locations across Wake and Johnston Counties.

3D Digital mammography decreases the need for additional imaging, detects more breast cancer, and improves detection of breast cancer in dense breast tissue. Breast images are immediately sent to a radiologist and viewed for diagnosis on a high-resolution monitor.

Learn more about preparing for a mammogram.

Locations

Imaging locations in partnership with Raleigh Radiology:

Sources

American College of Radiology
Susan G Komen
American Cancer Society