Breast Imaging

A mammogram is an X-ray picture of the breast. A Mammogram is a simple way for doctors to look for early signs of breast cancer and other health concerns. Regular mammograms are the best way to find breast cancer early, in some cases up to three years before it can be felt. 

A medical imaging technologist will guide you through the process. You’ll be asked to stand in front of a special type of X-ray machine. 

The technologist will help you place one breast on a smooth plastic plate. Another plate will gently press your breast from above. This helps flatten the breast and keep it still so the X-ray can be taken clearly. You may feel some pressure, but taking the image only takes a moment.

After the pictures are taken, you’ll be asked to wait briefly while the technologist checks them. They’ll let you know when the exam is complete.

There are no side effects from the X-rays.

A specially trained doctor, called a radiologist, will review your mammogram. They will look closely at the images for any changes in your breast tissue. 

How a mammogram feels can depend on how sensitive your breasts are. For many, the discomfort is mild. Your breasts may feel more sensitive just before or during your period.

Most people find a mammogram a little uncomfortable. The pressure on your breasts needs to be firm to create clear X-ray images.

The exam only takes a few moments, and any discomfort will pass quickly. 

A specially trained Medical Radiation Technologist (MRT) will perform your mammogram. The MRT and the radiologist work together to provide high-quality breast imaging and coordinated care.

Try to avoid scheduling your mammogram during the week before or during your period. Your breasts may be more tender or swollen at these times, which can make the exam less comfortable.

On the day of your appointment, please do not wear deodorant, perfume or lotion on your chest or underarms. These products can affect the quality of the images.

You’ll need to undress from the waist up for the X-rays, so wearing a two-piece outfit like pants and a top may be more convenient than a dress. 

Once your X-ray images are complete, a radiologist (a specially trained doctor who oversees and interprets medical imaging exams) will carefully review them and send a signed report to your doctor. Normally your results will go to your doctor within one week of your mammogram.

Your doctor will discuss the results with you.

In some cases, the radiologist may choose to speak with you directly about your results. 

Once your X-ray images are complete, a radiologist will review them and send the results to you or your doctor. Most results are sent to your doctor within one week of your appointment.

If the radiologist needs more tests to clarify the images, the mammography facility will contact you.

If you haven’t received your results within 30 days, contact your doctor or the facility to follow up. 

You and your doctor can decide how often you should have a mammogram based on your health and medical history.

Mammograms are a reliable way to monitor breast health. They work best when current images can be compared with previous ones. This helps the radiologist look for any changes in your breast tissue over time. 

An abnormal result does not always mean you have cancer.

It’s common for the radiologist to request a follow-up test, such as another mammogram, an ultrasound or an MRI, to get a clearer view of your breast tissue.

You may also be referred to a breast specialist or surgeon. This does not necessarily mean you have cancer or need surgery. These doctors are experts in diagnosing breast conditions and may recommend more procedures to better understand your breast health. 

Digital tomosynthesis (pronounced toh-moh-SIN-thah-sis) creates a three-dimensional picture of the breast using X-rays.

For this test, your breast is positioned the same way as during a mammogram. Only light pressure is applied—just enough to keep the breast still while the images are taken. The X-ray tube moves in an arc above your breast, capturing many pictures.

These images are sent to a computer and combined to create a three-dimensional view of your breast tissue.

This 3D imaging helps the radiologist see through layers of tissue and examine unclear areas from different angles. 

Breast tomosynthesis can:

• Help detect small breast cancers that may be hidden on a standard mammogram.
• Improve accuracy in identifying the size, shape and location of abnormalities.
• Reduce the need for unnecessary biopsies or follow-up tests.
• Increase the chance of finding multiple tumors, which occurs in about 15 per cent of breast cancer cases.
• Provides clearer images of dense breast tissue.

A breast biopsy is a test that removes tissue or sometimes fluid from an area of your breast that your doctor is interested in. The removed cells are examined under a microscope and further tested to check for the presence of breast cancer. A biopsy is the only diagnostic procedure that can definitely determine if a breast area of concern is cancerous. The good news is that 80 per cent of women who have a breast biopsy do not have breast cancer.

There are three types of biopsies:

• Fine-needle aspiration.
• Core-needle biopsy.  
• Surgical biopsy.

f a lump is found in your breast—either during a self-exam or on a screening mammogram—your doctor may recommend a fine needle aspiration (FNA), especially if the lump appears to be filled with fluid.

This procedure involves inserting a thin needle into the lump to draw out the fluid. If the lump is a fluid-filled cyst, it will usually collapse once the fluid is removed. Sometimes, an ultrasound is used to guide the needle to the exact location. The ultrasound uses sound waves to create an image of the inside of your breast.

If the lump does not go away or if more information is needed, your doctor may recommend a fine needle aspiration biopsy (FNABx). This is a similar procedure, but instead of removing fluid, the needle collects cells from the lump for closer examination.

These procedures help your care team better understand your breast health and decide on next steps. 

A core needle biopsy is used to remove a small sample of breast tissue using a hollow needle. To make the procedure more comfortable, a small amount of numbing medicine is injected into the area.

During the biopsy, the doctor may place a tiny marker inside your breast to mark the location. If surgery is needed later, this marker helps the surgeon find the area more easily.

Special imaging tools, such as ultrasound or X-ray, may be used to guide the needle. If ultrasound is used, the doctor will place a probe against your breast to help direct the needle. If a stereotactic-guided biopsy is chosen, X-ray equipment and a computer are used to guide the needle to the right spot.

You may be asked to lie on your stomach on a special table with an opening for your breast, or sit upright depending on the equipment used. Your breast will be gently compressed, similar to a mammogram, to keep it still during the procedure. 

After your biopsy, a specially trained doctor called a pathologist examines the tissue or fluid samples under a microscope to look for abnormal or cancerous cells.

The results are shared in a pathology report, which usually takes one to two weeks to complete. This report is sent to your doctor, who will review it with you.

If no cancer cells are found, the report will say the lump is benign, meaning it is not cancer. Even if the results are benign, your doctor may still recommend follow-up or treatment.

If cancer cells are found, the report will provide important details to help guide your next steps. Your doctor will talk with you about your treatment options.

Waiting for results can be difficult, but the information in the report is essential for understanding your breast health and planning your care.