> What is mammography and how does it work?
> What is it like to have a mammogram?
> How do I prepare for a mammogram?
> What is digital mammography?
> Where does CHA offer mammography services?
> How do I make an appointment?
> What happens if something is found on my mammogram?
> What is breast ultrasound imaging?
> What is breast MRI?
> What special procedures are performed in breast imaging?

> Referral information for physicians
> Additional information on Mammography
> Visit the Cambridge Breast Center

What is mammography and how does it work?

Breast imaging, or mammography, uses x-rays to create an image of tissue inside the breast. Mammography is used to spot lumps, tumors and other abnormalities that are too small to be found by feeling them. There are two basic types of mammograms, depending on why the test is being done:

• Screening mammograms. This is a routine test to look at breast tissue. It is used to look for changes in breast tissue in women with no signs of breast cancer. Your first exam will be the "baseline" mammogram that will be used to compare the results in future years and see changes.

• Diagnostic mammograms. If your doctor wants to check a lump that was found when you were examined or if you have symptoms of breast cancer, he or she will send you for a diagnostic mammogram to get a better look.

  If you have had recent breast surgery for any reason, you should schedule a diagnostic mammogram, since the scarring from surgery may need special attention at the time of the study.

What is it like to have a mammogram?

When you arrive for your appointment, you will be taken into a private changing room and will remove your clothing from the waist up and put on a gown. You will then be brought to a separate waiting area and taken in to the mammography room.

The entire appointment takes less than 30 minutes. When you come into the room, the technologist, who is a woman, will help you stand in the right position and set the machine. She will place your breast on the mammography machine, and use a clear plastic plate to keep it in place. This may be uncomfortable, but is generally not painful. She will need to take a couple of different images, one from above and one from the side and will move the machine to get the pictures she needs. She may need to move you as well.

If you have any questions, you can ask the technologist. She will be happy to answer them and to try and make you as comfortable as possible.

How do I prepare for a mammogram?

You will need to give your doctor and the technologist information about your medical history and any family members who have had breast problems. You will be asked about past problems with your breasts, surgeries you have had, if you have breast implants, if you have had hormone therapy, or if you have been pregnant and nursed a baby.

If possible, you should schedule your test for the week after your period, and not just before or during your period, since your breasts may be tender.

The day of the test, don't put perfume, powder, or deodorant on your underarms or breasts. You may want to bring deodorant with you to put on after the test. You will be asked to remove jewelry around your neck, so you may want to leave it at home.

What is digital mammography and why is it important?

Digital mammography is done the same way as traditional film mammograms, but the image goes directly to a computer, instead of on film. A recent study in the New England Journal of Medicine showed that a digital mammogram was better for finding breast cancer in women younger than 50, women with dense breasts, and women who were pre-menopausal or peri-menopausal.

While only about 19% of breast imaging centers in the US offer digital mammograms, all 3 CHA hospital campuses are proud to offer this state-of-the-art equipment!

Where does CHA offer mammography services?

CHA offers next-day mammography appointments in 3 locations. the Cambridge Hospital campus (1493 Cambridge St., Cambridge), Somerville Hospital campus (230 Highland Ave., Somerville), and Whidden Hospital campus (96 Garland St., Everett).

How do I make an appointment?

You, or your doctor's office, can make an appointment by calling our central scheduling office at 617-665-1298. To schedule an appointment, you must have a referral order from a primary care physician.

Important note:

If you have had mammograms at an institution outside of Cambridge Health Alliance, you should try to arrange to bring those films with you at the time of your appointment. Comparison to prior studies is extremely helpful in allowing the radiologist to detect any changes in your mammogram.

What happens if something is found on my mammogram?

You will receive a letter within 30 days if the mammogram is normal. If the doctor sees something they want to look at further, you will be called within 5 days. The doctor may order a breast ultrasound and, if needed, a biopsy.

A breast ultrasound uses sound waves to make an image of an area of the breast. If you need to have one, it simply means the doctor wants to look at something further. If needed, a biopsy is used to get tissue or fluid for closer examination. In a stereotactic biopsy, which is offered within Breast Imaging in Radiology, x-rays are used to carefully guide a needle to the site.

What is Breast Ultrasound Imaging (ultrasonography)?

Ultrasonography is the technique of using sound waves to create an image of part of the body without the use of radiation. Ultrasound is used to further evaluate abnormalities seen on the mammogram or abnormal clinical breast exam. It can differentiate a solid mass from a cyst. Ultrasound is also used to provide guidance for biopsies and other interventions.

Preparation For Your Exam: There is no preparation for a breast ultrasound exam.
During the exam, you lie on a stretcher and a small amount of gel is placed on the part of the breast to be examined. A small device called a "transducer" is then used to carefully examine the area. Several images are usually taken to document the findings. When the technologist has finished the examination, the images are shown to the radiologist who may also perform a brief ultrasound scan to confirm the findings. The exam takes approximately half an hour.

After the exam you will be informed of the results of your mammogram by the radiologist and/or your physician.

What is Breast MRI?

Breast Magnetic Resonance Imaging (MRI) utilizes a magnetic field and radio waves to create images of the body or specific parts of it. Breast MRI is not a substitute for mammography, and your primary care provider can help determine if breast MRI may be appropriate for you.

What Special Procedures may be Performed in Breast Imaging?

Biopsy - A biopsy is currently the only way to achieve an accurate diagnosis. A percutaneous (through the skin) biopsy uses a needle to remove cells (Fine needle aspiration) or pieces of tissue (Core biopsy). Approximately 1 million breast biopsies are performed every year; 80% of them are benign.

Stereotactic Breast Biopsy - Stereotactic breast biopsy is a procedure that uses mammography to assist in removing suspicious calcifications or tissue from your breast. The entire procedure is done through a small cut in the skin.

MR-Guided Breast Biopsy - Magnetic resonance imaging (MRI) uses magnetic fields to evaluate breast tissue. Certain tissue characteristics that are not easily seen on ultrasound or mammography can be detected by MRI. The radiologist uses MR images to locate suspicious regions of breast tissue and visually assist in taking samples.

Ultrasound-Guided Breast Aspiration and Core Biopsy - Ultrasound-guided core breast biopsy and cyst aspiration are procedures that use sound waves (ultrasound) to assist in removing tissue from your breast or fluid from a cyst in your breast.

Referral information for physicians

You can make a referral for your patients by calling Central Scheduling at 617-665-1298.