PHYSICS

MAMMOGRAPHY

• A mammogram is an X-ray examination of the breast. It is used to detect and diagnose breast disease in women who either have breast problems, such as a lump, pain, or nipple discharge, as well as for women who have no breast complaints. The procedure allows detection of breast cancers, benign tumors, and cysts before they can be detected by palpation (touch).

PROCEDURE

• Client will be asked to remove any clothing, jewelry, or other objects that might interfere with the procedure. Client will be asked to remove clothing from the waist up, and will be given a gown to wear. The technologist will ask if client has noticed any lumps or other changes in either breast. If so, an adhesive marker will be placed on the spot(s) prior to the procedure

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• Client will stand in front of a mammography machine and 1 breast will be placed on the X-ray plate. In order to position the breast for optimal imaging, the technologist may examine and/or palpate the breast before placing it on the plate. An adhesive marker may be applied to any moles, scars, or other spots that might interfere with the breast image. A separate flat plate, often made of plastic, will be brought down on top of the breast to compress it gently against the X-ray plate. Compression of the breast is required in order to minimize the amount of radiation used and to ensure optimal visualization of the breast tissue. Client may feel some discomfort during this time.

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• Client will be asked to hold your breath while the image is being taken. The radiologic technologist will step behind a protective window while the image is taken. Two pictures at different angles will be taken of each breast, requiring the breasts to be repositioned between pictures.

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• After the X-rays have been taken, client will be asked to wait while the films are examined by the radiologist to ensure that the films are clear and that no additional films are needed. If there is a question about any of the films, client may be asked to have additional films taken. The examination process takes approximately 20 to 30 minutes.

TYPES OF MAMMOGRAM

• Diagnostic mammogram. A diagnostic mammogram is an X-ray of the breast used to diagnose unusual breast changes, such as a lump, pain, nipple thickening or discharge, or a change in breast size or shape. A diagnostic mammogram is also used to evaluate abnormalities detected on a screening mammogram. It is a basic medical tool and is appropriate in the workup of breast changes, regardless of a woman's age.

TYPES OF MAMMOGRAM

• Screening mammogram. A screening mammogram is an X-ray of the breast used to detect breast changes in women who have no signs or symptoms of breast cancer. It usually involves 2 X-rays of each breast. Using a mammogram, it is possible to detect a tumor that cannot be felt.

Principle
X-rays are made by using external radiation to produce images of the body, its organs, and other internal structures for diagnostic purposes. X-rays pass through body structures onto specially-treated plates (similar to camera film) and a "negative" type picture is made (the more solid a structure is, the whiter it appears on the film).

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• NURSING RESPONSIBILITIES: Before scheduling a mammogram, ask the patient for any new findings or problems in her breasts. Ask the patient if she has undergone any recent surgeries, hormone use. Obtain a family or personal history of breast cancer.

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• Do not schedule mammogram for the week before the patient's period if her breasts are usually tender during this time. The best time for a mammogram is one week following period. Ask the patient if there are any possibilities that she is pregnant. Recommend patient not wear deodorant, talcum powder or lotion under her arms or on breasts on the day of the exam. These can appear on the mammogram as calcium spots.

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• If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam. Inform patient that she will feel pressure on her breast as it is squeezed by the compression paddle. Some women with sensitive breasts may experience discomfort. If this is the case, schedule the procedure when her breasts are least tender. Be sure to inform the nurse or the technologist if pain occurs as compression is increased. If discomfort is significant, less compression will be used.