Name of the Procedure:

Mammogram Assessment Category of Suspicious, Documented (RAD) Common name(s): Suspicious Mammogram, Breast Imaging Reporting and Data System (BI-RADS) 4 or 5 Assessment

Summary

A mammogram assessment categorized as suspicious involves detailed imaging of the breast to investigate areas that might indicate cancer. This could lead to further diagnostic testing, like a biopsy, to determine if the suspicious area is malignant.

Purpose

This procedure addresses potential breast cancer detection. The goal is to identify and evaluate suspicious areas seen on a mammogram to intervene early if cancer is present.

Indications

• Detection of abnormal areas in a screening mammogram
• Presence of symptoms like a palpable lump
• Previous mammograms showing areas of concern
• Family history of breast cancer

Preparation

• Patients should avoid applying deodorant, powder, or lotion on the day of the procedure.
• They need to inform the healthcare provider about any breast symptoms or problems.
• Previous mammograms and medical records should be forwarded to the radiologist.
• No fasting or medication adjustments are generally required.

Procedure Description

1. The patient stands in front of the mammography machine.
2. The technician places one breast at a time on a flat support plate.
3. A compression plate presses the breast to flatten the tissue for clear images.
4. Two X-ray images, typically from different angles, are taken of each breast.
5. Additional images may be taken to further evaluate suspicious areas.

Tools and equipment used:

• Mammography machine
• Compression plates

The procedure uses very minimal, if any, anesthesia or sedation.

Duration

The procedure typically takes about 20 to 30 minutes.

Setting

The procedure is performed in a hospital radiology department or an outpatient imaging clinic.

Personnel

• Radiologic technologist
• Radiologist (interprets the images)

Risks and Complications

• Exposure to a low level of radiation
• Discomfort or pain from breast compression
• Need for additional testing if suspicious areas are found

Benefits

• Early detection of breast cancer
• Detailed examination of suspicious areas
• Helps guide the need for further testing or biopsy

Recovery

• No specific post-procedure care is usually needed.
• Patients can return to normal activities immediately.
• Follow-up may include additional imaging or a biopsy if suspicious areas are identified.

Alternatives

• Ultrasound: Useful for detailed imaging, especially in dense breast tissues.
• MRI: Provides a more detailed contrast of breast tissue, but is more costly and less available.
• Clinical breast exam: Involves physical examination by a healthcare provider but is less precise than imaging modalities.

Patient Experience

• The patient might experience discomfort from the breast compression during the mammogram.
• Any pain or tenderness post-procedure is typically minimal and temporary.
• The radiologist will discuss the results and next steps, which may include a biopsy if an area is highly suspicious.

Pain management:

• Over-the-counter pain relievers can help if discomfort persists.

Comfort measures:

• Technicians are trained to minimize discomfort, and they can take breaks if needed.