Name of the Procedure:

Diagnostic Mammography, including Computer-Aided Detection (CAD) when performed; Unilateral

Summary

A diagnostic mammography is an advanced type of breast imaging that uses low-dose X-rays to examine the breast. With the addition of computer-aided detection (CAD), the radiologist has the aid of computer algorithms that highlight potential areas of concern, which helps in identifying abnormalities more accurately. This procedure specifically evaluates only one breast (unilateral).

Purpose

Diagnostic mammography is utilized to investigate suspicious breast changes such as lumps, pain, or unusual findings from a routine screening mammogram. The goal is to accurately detect and diagnose conditions such as breast cancer or benign breast diseases early, facilitating timely and appropriate treatment.

Indications

• A new lump or mass in the breast.
• Unusual nipple discharge or changes.
• Pain in one breast.
• History of breast abnormalities or breast cancer.
• Follow-up on an abnormal screening mammogram.

Preparation

• Wear comfortable clothing and be ready to remove garments from the upper body.
• Avoid using deodorants, powders, or lotions on your underarms or breasts on the day of the exam as these can interfere with the mammogram.
• Inform the healthcare provider if you are pregnant or breastfeeding.
• Provide a thorough medical history, including past breast surgeries, biopsies, or family history of breast diseases.

Procedure Description

1. The patient is positioned and one breast is placed on a flat imaging plate.
2. Another plate firmly compresses the breast to spread out the tissue for a clearer image.
3. Several X-ray images are taken from different angles.
4. CAD software analyzes the images and highlights any areas that should be reviewed by the radiologist.
5. The entire process is repeated for the other breast if needed or focused only on the symptomatic breast for a unilateral exam.

Duration

The procedure typically takes about 30 minutes.

Setting

Diagnostic mammography is performed in a radiology or imaging center, often within a hospital or outpatient clinic.

Personnel

• Radiologic Technologist: Performs the mammography and operates the CAD system.
• Radiologist: Interprets the mammography images and CAD highlights to diagnose any abnormalities.

Risks and Complications

• Exposure to small amounts of radiation.
• Potential false positives/negatives requiring further testing.
• Discomfort or pain due to breast compression.
• Very rare risk of an allergic reaction to contrast material if used.

Benefits

• Early and accurate detection of breast abnormalities.
• Enhanced evaluation with CAD, potentially leading to early detection of cancers.
• Non-invasive and relatively quick.

Recovery

• No specific recovery time; patients can resume normal activities immediately.
• Some minor breast soreness or bruising may occur.
• Follow-up appointments may be scheduled if abnormalities are found.

Alternatives

• Ultrasound: Useful for further evaluation of abnormal mammogram findings or for dense breast tissue.
• Magnetic Resonance Imaging (MRI): Provides detailed images and is useful for high-risk patients.
• Clinical breast exam: Physical examination by a healthcare provider.

Each alternative varies in terms of accuracy, comfort, cost, and radiation exposure. Discuss with a healthcare provider to choose the most suitable option.

Patient Experience

During the procedure, the patient might feel temporary discomfort due to the compression of the breast. After the procedure, some minor soreness may persist. Results are typically communicated after the radiologist has reviewed the images and CAD findings, often within a few days.