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Mammograms

by Karl Loren

Ultrasound & Heart Disease

What is a mammogram?
A mammogram is a safe, low-dose x-ray picture of the breast. The x-ray can find small breast cancer lumps which you can't feel with your fingers.

There are two kinds of mammograms. One is called a screening mammogram. The second type is called a diagnostic mammogram.

This booklet can help you learn more about getting the best possible screening mammogram.

Screening mammograms
A screening mammogram is a quick, safe and easy way to find problems in a woman's breast. Two x-ray pictures are taken of each breast. A doctor with special training (radiologist) will look at these x-ray pictures to decide if the problem may be breast cancer.

For most women, the x-ray pictures will show no signs of a problem. The woman will have what is called a normal result.

Diagnostic mammograms
A diagnostic mammogram is used if there is a breast problem. This kind of mammogram takes a little more time than a screening mammogram because special x-ray pictures have to be taken. A radiologist will sometimes check your x-rays while you wait.A diagnostic mammogram may also be used if you have had a breast implant or if your doctor feels that this type of x-ray is better for you because of a special circumstance.

At what age should you have a mammogram?
You should have a mammogram as often as your doctor says you should or as recommended in the Breast Health Screening Guidelines shown on the back cover. A mammogram can show lumps and other changes in your breast long before you can feel them with your fingers.

• 50 years old or more
  Experts agree that women who are 50 years old and over should go for a mammogram at least once every two years. Women who follow this advice can benefit from early detection of a breast problem. When a cancer is found while it is still small, it is usually easier to remove and treat.
• Under 50 years old
  If you are a woman under 50 years old, your doctor may send you for your first mammogram. This is called a baseline mammogram. Each time you go for a mammogram after your baseline, the new x-rays will be compared to the old ones. These x-ray pictures help the radiologist and your doctor look for changes in your breasts.

What do you do when you go for a mammogram?
You will stand in front of a special x-ray machine. The technologist will place your breast on a plate which has the x-ray film. This plate can be raised or lowered to match your height. A second plate will slowly be pushed down to make the breast flat. By doing so, the technologist is able to get a full picture of your breast with the lowest dose of radiation. You will feel some pressure on your breast but only for a few seconds while the x-ray picture is being taken. This is not harmful. Four x-ray pictures will be taken, two of each breast.

Some women find the pressure uncomfortable. Try to relax. If the pressure becomes painful, ask the technologist to stop. For most women, their breasts are tender and sensitive to touch the week right before and after their period. Don't book your mammogram for this time.

Where should you go for a mammogram?
When you go for a mammogram, choose a place that has been accredited by the Canadian Association of Radiologists (CAR). To get accredited, a facility must show proof that the people who take the x-ray pictures (radiological technologists), the radiologist, and the people who keep the equipment in top working order have all had special training. They must be working as a team to make sure you get the best mammogram possible.

You have the right to ask if a facility is CAR-accredited. To find out whether it is, please call the Canadian Breast Cancer Foundation toll-free at 1-800-387-9816.

Where are the best places to go in Canada for a mammogram?
Some of the best places are the special provincial screening centres. At these centres it is possible to have a mammogram, as well as a physical breast examination and in some centres, learn how to do your own breast examination. These centres may be found in shopping malls, community centres, hospitals and offices. In the northern parts of some provinces, the mammogram unit is put inside a van which travels from town to town.

Services at these centres are usually for women who are 50 years old and over. Some provinces provide service to women who are over the age of 40. It is quite easy to make an appointment. Your doctor does not need to refer you. You can call to book an appointment on your own.

Many of these screening centres are accredited by the Canadian Association of Radiologists (CAR).

After your first visit, some centres send a letter to remind you that it will soon be time to return for your next mammogram.

			To find out which centre is closest to you, please call the number shown for your province or call the Cancer Information Service toll-free at 1-888-939-3333.
Alberta			1-800-667-0604		If you are not going to one of the provincial centres, ask your doctor to refer you to a CAR-accredited facility. Remember, you have the right to ask if the facility you are going to is CAR-accredited.
British Columbia			1-800-663-9203
Manitoba			1-800-903-9290
Newfoundland			1-800-414-3443
New Brunswick			1-888-762-8700
Northwest Territories			1-800-667-0604
Nova Scotia			1-800-565-0548
Ontario			1-800-668-9304
Saskatchewan			1-800-667-0017
Yukon Territory			1-403-668-6252

What is the Ontario Breast Screening Program?
The Ontario Breast Screening Program (OBSP) is a program of Cancer Care Ontario dedicated to providing top quality breast screening services for women 50 years old and over.

At the OBSP, your care and comfort are very important. The staff are experts in mammography.

There are over 30 OBSP locations in Ontario. To find out about a location which is close to you, please call toll-free 1-800-668-9304.

What information will you need to make an appointment?

If you have any other questions, ask them now. If you think of questions later, ask the technologist who is taking the mammogram.

What should you do to prepare for your mammogram?
Wear a two-piece outfit so that you will only have to remove your top. Do not use deodorant, talcum powder, or lotion under your arms or near your breasts. These products can show up on the x-ray picture.

If you have trouble with your hearing or if you feel you need help understanding information, you may want to ask a family member or friend to come to the appointment with you. Some women find it easier to come for a mammogram as part of a group. You may be able to arrange for a group appointment at one of the special breast screening centres in your neighbourhood.

Where will your exam results go?
Your doctor will be sent your results. If you have gone to one of the special breast screening centres in your neighbourhood, both you and your doctor will receive a copy of your results.

Do not assume that just because you have not received the results, they are normal. If you have not received your results within 10 days, call your doctor or the facility where you had your mammogram.

What do you do if your results are not normal?
If your mammogram shows anything unusual, talk to your doctor as soon as possible. Your doctor may schedule a diagnostic mammogram or refer you for other tests.

If you have not been able to understand your results, ask questions until you are satisfied that you understand them. If you do have a breast problem, find out what to do next.

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