Frequently Asked Questions
How do mammograms interact with the COVID-19 vaccine?
Screening mammograms and COVID-19 vaccines are both very important for your health.
Some women who receive the COVID-19 vaccine develop swollen lymph nodes under their arm on the same side as their vaccine injection. This is a normal reaction that subsides after a few days to weeks. However, since swollen lymph nodes under one arm can be seen on a mammogram and be a sign of breast cancer, you may want to schedule your mammogram before your first vaccine or wait at least four weeks after your second/last dose.
Depending on your medical history and when you received your vaccine, your NRC breast radiologist may recommend that you return to the breast center for an ultrasound of your underarm area and they also may recommend a follow up exam to show that the lymph nodes have returned to normal size. If you are already overdue for your mammogram, please don’t postpone it because of your vaccine.
Why is a mammogram performed?
Our board-certified radiologists use the mammogram to help find abnormalities that are much too small for you or your doctor to feel on physical examination. With annual mammography, many breast tumors are detected early, before they have a chance to spread. This provides the best chance for complete cure.
The American Cancer Society, the American College of Radiology, and the American Medical Association recommend the following guidelines for screening mammography:
• Get a baseline mammogram between ages 35 and 40.
• After age 40, get a screening mammogram annually.
These are only guidelines, and they may change based on your clinical history. Monthly breast self-examination is an adjunct tool that may be helpful for women age 20 and older.
If you have a first-degree relative (a mother, sister, or grandmother) who developed breast cancer prior to menopause, we recommend that you have your first mammogram 10 years prior to the age at which that person developed breast cancer, but no earlier than at age 25, and every year thereafter, with the option to alternate with breast MRI.
What is 3D screening mammography?
A screening 3D mammogram is an x-ray examination of the breasts in a person who has no complaints or symptoms of breast disease. The goal of screening is to find breast cancers, which are too small to feel, before they spread. Early detection improves a patient's chance for successful treatment, if a breast cancer is found. Early detection can save lives. Mammography can detect 85-90% of breast cancers, and can detect a lump up to two years before it can be felt.
NRC uses advanced 3D mammography technology for our screening mammograms. A 3D mammography unit takes multiple images of the breast and uses computer reconstruction to create 3D images of the breast. The breast is compressed between a clear plastic paddle and an imaging detector, and the x-ray tube moves in an arc over the breast, capturing different angles. Our radiologists then can scroll through all the images much like a book (one page at a time) or a movie (one frame at a time) to perform a more detailed evaluation of the structures inside your breast.
Benefits of 3D mammography technology include:
• Better breast cancer detection: 3D mammography has up to a 41% higher detection rate for invasive breast cancer.
• Fewer callbacks: Because 3D mammography provided a more detailed exam, fewer women are called back for additional imaging exams, resulting in less expense and anxiety for the patient.
• Comparable radiation dose and time: The dosage is comparable to the older 2D exam, and the exam just takes a few more seconds.
• Insurance coverage: Coverage is required for insurance companies operating in the state of Connecticut. It is also covered by Medicare.
What is 3D diagnostic mammography?
A 3D diagnostic mammogram is an x-ray of the breast in a person with breast symptoms. For example, if the patient has a lump or a mass, a discharge from the nipple, or breast pain, the mammogram examination will be specifically tailored to that complaint. In a diagnostic examination, several additional views may be obtained, in addition to the routine views. In some instances, ultrasound will also be used to obtain further diagnostic information.
Why should I have my mammogram performed at Norwalk Radiology Consultants?
The physicians at NRC have proudly and faithfully served the radiology needs of the community for over 40 years. We are the group that started, developed, and cared for patients at Norwalk Radiology and Mammography Center since 1985. However, we parted with that facility in April 2021 and are starting a new chapter in our history as a physician-owned-and-operated imaging center.
We have brought the expertise of our physicians to the new practice, along with the best and brightest of the staff. Our Board Certified Radiologists have all been trained at the premier hospitals and programs around the country, and many of our physicians have been selected as Castle Connolly Top Doctors.
What can I expect during a mammogram?
You will be asked to undress from the waist up and change into a gown. A specially trained female technologist will then position you for the exam.
In a typical screening mammogram, each breast is examined separately, with two views of each breast:
• From above (a cranio-caudal or CC view); and
• From the side (a medio-lateral oblique or MLO view)
During a mammogram, the breast is compressed between two plastic plates, which may cause temporary discomfort in some patients. The compression lasts no more than a few seconds and does not harm the breast. Compression is necessary for the following reasons:
• Compression makes a mammogram more accurate, by reducing motion, and allowing the x-ray beam to pass more uniformly through the breast.
• Compression makes a mammogram safer, by reducing the amount of radiation required for an accurate interpretation.
How long will my 3D mammogram take?
A routine screening exam generally takes 15 minutes or less.
When and why is an ultrasound used?
Breast ultrasound uses sound waves, rather than x-rays, to image the breast. If a mammogram film shows a mass, or if there is a palpable lump on the breast, this study is performed to determine if the mass is cystic or solid. Sometimes, an ultrasound can help suggest whether or not a mass is suspicious.
Ultrasound does not use radiation. It is often the first breast-imaging test in patients under the age of 35 with a palpable finding. Ultrasound may also be helpful in assessing breast pain.
Ultrasound does not replace mammography, but can be used in conjunction with mammography to obtain additional diagnostic information.
Is 3D mammography safe?
Yes, but be sure to have your mammogram at a fully accredited facility that uses low dose technology, like we do at NRC. The benefit of an accurate diagnosis far outweighs the risk of this small amount of radiation. Get more information from radiologyinfo.org.
It is possible that you will get a “false positive,” since 5-15% of screening mammograms require more testing, such as special mammogram images or ultrasound. Most of these exams show normal results. If there is an abnormal finding, you may need a biopsy for further diagnosis.
Patients must always let the mammography technologist know if they are pregnant. It is recommended that these patients wait until after pregnancy to have a screening mammogram. An alternate screening such as ultrasound may be recommended.
Do I need a referral or prescription?
Although most patients are referred by their physician, you may schedule a mammogram without a referral or prescription. Please be aware that this is subject to the requirements of your insurance carrier or HMO, so check with them first to verify the applicable rules and coverage. The results of your exam will be sent to your physician.
Why do you need my old mammograms?
Just as a person’s fingerprints are unique, so too are a person’s breasts. What is normal in one person may be abnormal in another. The best way for the radiologist to know that a mammogram is normal is to confirm stability from year to year.
If you have had mammograms in the past at any other facility, it is recommended that we obtain them on your behalf to ensure they will be available at the time of your appointment. We simply require a signed release. Alternatively, you may bring the films with you to your scheduled exam.
When will I know my mammography results?
Once your screening mammogram is complete, a radiologist will carefully evaluate the images and meticulously compare your current mammogram with prior exams in looking for any subtle change. If you mammogram is normal, a written report will be sent to your medical provider within three working days, although the vast majority will be available within 24 hours. You will receive a letter within 10 working days. We will also provide optional appointments for real-time results.
Should you need any additional imaging to clarify a finding on your screening mammogram, we will call you within three business days of your mammogram to schedule a follow-up appointment. At the follow-up appointment, the radiologist will ensure that all necessary studies are performed to develop a conclusion, and we will discuss the findings with you before you leave. The results will also be given to you in writing, and your physician will receive a written report.
Diagnostic mammogram results will be available during your appointment and your physician will receive the written report. If a biopsy is recommended, a radiologist will consult with you and you will speak with one of our breast biopsy schedulers to make an appointment before leaving the facility.
Why would my radiologist order a follow-up mammogram in just six months, rather than in a year?
If you have a condition that appears benign, our radiologists may recommend a six-month follow-up examination to more closely monitor the condition and to confirm stability.
Does a mammogram find all breast cancer?
Mammography is the best test available, but it is not perfect. Between 10-15% of breast cancers may not show up on a mammogram (but 85-90% do!). This makes breast self-examination very important. If you have any questions, do not hesitate to ask us, or ask your doctor. The best way to detect breast cancer early is with combination of tests: your self-examination, your doctor’s examination, and annual screening mammography.
What does "dense breast tissue" mean?
Some people have what’s called "dense breast tissue." In fact, about half of all women over age 40 have dense breast tissue. In general, if your breasts have a lot of dense glandular and connective tissue and not much fatty tissue, your breasts may be considered to be dense. A person's breast density can change through their life.
For a definitive evaluation of breast tissue, you need to have a mammogram. There are four types of breast density, from most to least dense.
• Extremely dense
• Heterogeneously dense
• Scattered fibroglandular density
• Almost entirely fatty breast tissue
Dense breasts (extremely dense and heterogeneously dense) may benefit from additional screening breast ultrasound or MRI.
What are breast microcalcifications?
Microcalcifications are tiny deposits of calcium in the breast, usually of varying shape, size, and location. Although breast calcifications are usually benign, changes in the pattern, or new calcifications may indicate the presence of a small or developing breast cancer, or even a pre-cancerous condition. If calcifications are stable from year to year, or clearly benign, no biopsy is necessary. In other cases, a radiologist may recommend a biopsy to determine the cause of the calcifications.
What is a solid lump or nodule?
A solid lump or nodule refers to a mass within the breast that contains solid tissue. A lump or nodule could represent a rounded clump of normal tissue, a fibroadenoma (a benign tumor), or possibly a malignancy. These conditions often require further evaluation, such as ultrasound or biopsy.
What if I find a lump while pregnant?
If you find a lump or a mass, do not ignore it. See your physician. Often an ultrasound (which uses harmless sound waves, rather than x-rays) can be performed for initial evaluation. If a mammogram is necessary, it is usually safe for the fetus, especially after the 14th week of pregnancy, with the abdomen shielded by a lead apron.
Can I have a mammogram while I am nursing?
If you have a breast lump or other problem, it is recommended you have a mammogram or an ultrasound during lactation/nursing to evaluate the problem. Otherwise, if you are just scheduled for a routine or screening examination, it is best to wait approximately six months after terminating nursing. This allows the changes in the breast from pregnancy and nursing to resolve.
What if I have breast implants?
According to the latest literature, breast implants neither increase nor decrease a person's risk of breast cancer. Patients with implants should obtain a mammogram, according to the same recommendations as those without breast augmentation. Patients who have implants do require specialized views, called Eklund or displacement views, where the implants are gently pushed back to visualize as much breast tissue as possible. The risk of rupturing the implant is minimal.
When and why is a breast biopsy used?
A breast biopsy means removing breast tissue for examination under the microscope. It is the only definitive way to diagnose the nature of a breast mass/lump or calcification. Approximately 80% of breast biopsies are benign.
A biopsy may require surgery (excisional biopsy), however, most breast biopsies can be accurately performed by placing a specially designed needle into the suspicious area (stereotactic core needle biopsy).
There are several ways to perform a breast biopsy. If you need a breast biopsy, we can help you find a breast specialist who can advise you on which method is the best for your individual condition.
How should I prepare for my mammogram?
No specific preparation is required. Please do not use powders, talc, lotion or deodorant on the breast and in the underarm area. For your comfort and convenience, two piece outfits are recommended.
If you have had mammograms in the past at any other facility, you will be asked to sign a release to have us request your prior exams on your behalf, or you can bring the films with you to your scheduled exam.