Experience Matters: Who is Reading Your Mammogram?

Mar 31, 2021




Whether you have had a mammogram before or whether it’s a new experience, let’s discuss what you and your imaging center can do ahead of time to be prepared. The purpose of the x-ray is to distinguish normal structures that are components of the breast such as glandular and fatty tissue from abnormal lesions. Subtle differences in the cellular structure of the tissue such as distortion, breast masses, or extremely small white spots (as small as grains of salt) called cluster microcalcifications may be hard to visualize without the best radiology imaging and interpretation. We need to obtain the best pictures of the breast to have the best opportunity to find an abnormality early. The clearer the mammogram, the better the ability of the radiologist to visualize small cancers before they can be felt. Although most findings prove to be benign lesions such as breast cysts or fibroadenomas, we perform regular annual or biennial mammograms to look for abnormalities that may represent the earliest signs of breast cancer. 

When scheduling your mammogram, be sure to tell the receptionists why you are having the exam such as “it’s my annual mammogram” or “I have a breast lump”. This is the first step in ensuring that the proper exams will be scheduled. A screening mammogram typically consists of two standard high-resolution low x-ray images of each breast while a diagnostic mammogram for a breast problem like a “lump” may involve additional images such as spot compression or magnification that are not performed with the regular mammography. Also, the amount of time to expect and any additional studies needed such as ultrasound for a breast complaint may involve a different set of technologists. A Radiologist is involved in real-time monitoring or examining a patient with a breast complaint at any of our Women’s Imaging Centers. 

Tell the scheduler if you have any specific requests such as having your screening mammogram read at the time if you live a long distance away or if you will be having any breast surgery in the near future. If you have breast implants, let us know as the imaging takes additional time. If you have had a personal history of breast cancer or if you have a strong family history of breast cancer, then let the scheduler and the technologist know if you have questions for the radiologist. For many women, this process is a breeze, but for others, it may be nerve-racking. If you are nervous about the exam because it’s your first or are concerned about the potential results, we ask you to please share those concerns so that your Care Team (technologist, medical assistant, radiologist) may be involved. 

The technologist will walk you through the process of what is needed to obtain the best images and ensure you are comfortable with that plan. For everybody type this may be different. Everyday routines such as applying deodorant can interfere with the ability of the mammogram to distinguish aluminum artifacts (found in most deodorants) from microcalcifications (also known as cluster calcifications) which may be the earliest sign of best cancer before a mass develops. Wear a two-piece outfit if possible because you will be changing into a gown so that the mammography technologist has the best access to perform the exam. The technologist will position each breast onto a somewhat rectangular gently curved paddle and then apply gentle pressure. The amount of pressure needed for the correct exposure is based on experience and the parameters of the machine pre-exposure. 

We want to keep the breast in the same position, avoiding slight motion that may cause blurriness of the image so the mammogram technologist will ask you to hold your breath for a few seconds while she obtains the exposure. There are typically two views of each breast obtained, so you will be repositioned four times (once for each view of each breast). If you have breast implants, four views will be obtained for each breast for a total of eight images. Our technologists are highly experienced in performing these exams and are adept at recognizing possible barriers to follow through such as language barrier or disability and will involve the radiologist at the time for closure of care.

The Breast Radiologist at The Women’s Imaging Center then interprets the image to determine if there are any mass or suspicious findings that suggest breast cancer. If previous mammograms are needed, the radiologist may need to compare them before an opinion is rendered. If you have a breast problem such as a breast lump, please bring it to the technologist’s and women’s imaging radiologist’s attention when scheduling so that the appropriate variations in imaging can be made. For some breast problems, a minimally invasive breast biopsy can be performed in the office. If that is indicated, then results will typically be available within one to two days (at any of our four locations Denver, Highlands Ranch, Lakewood, Westminster). If further action is required, a breast MRI can be performed on-site to determine additional imaging characteristics. Breast MRI is also often used as an additional screening tool for women with strong family history, but this needs to be approved by your insurance company in advance. We will perform that authorization process upon recommendation of your referring clinician or in the continuity of care following the National Cancer Coalition Network (NCCN) guidelines or the American Cancer Society (ACS) recommendations. 

Know who is reading your mammogram as this may be the most important exam you have. Our radiologists are all fellowship-trained specialists in breast imaging and non-invasive breast biopsy, far exceeding the community standards. Make sure that your radiologist is accessible or responsive to your needs and concerns. When selecting the optimal imaging center for you, know that experience matters. The Women’s Imaging Center and our Care Teams have been serving women throughout Colorado for over 25 years, receiving the highest commendations and awards for excellence in our field. The facility you choose should be recommended by your clinician based on reputation and experience, not just convenience. Remember that most mammography findings are benign (noncancerous) or variations in the breast tissue that prove to be normal. However, it takes fellowship-trained specialists proven in their field of Women’s Imaging to spot the earliest signs of breast cancer. 

Author Dr. Kelly McAleese

Medical Director, The Women’s Imaging Center AKA Women’s Imaging-Denver/Cherry Creek, Women’s Imaging-South/Highlands Ranch, Women’s Imaging-West/Lakewood, Women’s Imaging-North/Westminster

The Women’s Imaging Center uses the highest-rated digital mammography systems made by Hologic Dimensions and Selenia. We offer 3D mammograms, breast ultrasound, pelvic ultrasound, abdominal ultrasound, breast MRI, pelvic MRI, shoulder MRI, Knee MRI, brain MRI, spine MRI, thyroid ultrasound, thyroid fine needed biopsy, nonsurgical breast biopsy, stereotactic breast biopsy, ultrasound-guided breast biopsy, breast cyst aspiration, and other imaging services at affordable out-patient cost dedicated Women’s Imaging Centers in Denver/Cherry Creek, West/Lakewood, South/Highlands Ranch, and North/Westminster.


Call 303-321-CARE (2273) to schedule an appointment or make an online appointment request:    Scheduling@thewomensimagingcenter.net

Kelly McAleese
by Kelly McAleese