Name of the Procedure:

Screening Mammography, Bilateral (2-view study of each breast), including Computer-Aided Detection (CAD) when performed

Summary

A bilateral screening mammography is an imaging test that takes X-ray pictures of both breasts. It is done to check for breast cancer in women who have no symptoms. The procedure uses computer-aided detection (CAD) to help radiologists identify any abnormal areas more accurately.

Purpose

Screening mammography aims to detect breast cancer early, before any symptoms appear. The goal is to find cancer when it is most treatable and to reduce breast cancer mortality.

Indications

• Routine screening for breast cancer, typically recommended for women aged 40 and older.
• Patients with a family history of breast cancer.
• Women with genetic predispositions (e.g., BRCA1 or BRCA2 mutations).
• Individuals with previous breast cancer or precancerous conditions.

Preparation

• Patients should avoid using deodorants, perfumes, powders, or lotions under their arms or on their breasts on the day of the exam, as these can interfere with the images.
• Wear a two-piece outfit to make it easier to undress from the waist up.
• Inform the technician if you are pregnant or breastfeeding.
• Bring any previous mammogram images for comparison if performed at a different facility.

Procedure Description

1. The patient will stand in front of a specialized X-ray machine.
2. Each breast is placed one at a time on a flat surface and gently compressed with a paddle to spread the tissue for a clearer image.
3. Two views of each breast are taken: top-to-bottom and side-to-side (mediolateral oblique).
4. The computer-aided detection (CAD) system scans the mammograms for any suspicious areas that may require closer examination.

Duration

The entire procedure typically takes around 20-30 minutes.

Setting

This procedure is performed in a radiology department of a hospital, an outpatient imaging center, or a specialized breast clinic.

Personnel

• Radiologic Technologist (performs the mammogram)
• Radiologist (interprets the images)
• Occasionally, a computer-aided detection (CAD) system as an adjunct to assist the radiologist

Risks and Complications

• Exposure to a low level of radiation, though minimal.
• Potential for false positives, leading to unnecessary worry and additional testing.
• False negatives where the mammogram may miss cancer.
• Discomfort or pain due to breast compression, although briefly.

Benefits

• Early detection of breast cancer, which can lead to a higher chance of successful treatment.
• CAD can increase the accuracy by highlighting areas of concern for the radiologist.
• Increased peace of mind with a normal result and early intervention if abnormalities are detected.

Recovery

• There is no recovery time needed; patients can return to normal activities immediately.
• Slight tenderness or bruising may occur but should resolve quickly.
• Follow-up appointments may be scheduled if any abnormalities are found.

Alternatives

• Breast Ultrasound: Good for further evaluation of abnormalities seen on mammograms, especially in dense breast tissue.
• Breast MRI: More sensitive than mammograms and used in high-risk patients, but also more expensive and time-consuming.
• Clinical Breast Exam (CBE): Physical examination by a healthcare provider; less accurate without imaging.
• Self Breast Exam (SBE): Regular self-checks, not a substitute for mammograms but useful for personal awareness.

Patient Experience

• Patients typically feel pressure and compression during the mammography but it is brief.
• Any discomfort from the compression plate is usually mild and temporary.
• Anxiety may be present around the results, but this can be mitigated by understanding the procedure's benefits and discussing concerns with healthcare providers.