Mammography

Definition

• Mammography is a radiographic technique used to detect breast cysts or tumors, especially those not palpable on physical examination. In xeromammography, a specially charged plate records the radiographic images and transfers them to a special paper. Biopsy of suspicious areas may be required to confirm malignancy. Although 90% to 95% of malignant breast tumors can be detected by mammography, this test produces many false positive results. Mammography may follow such screening procedures as ultrasonography or thermography.

Purpose

• To screen for malignant breast tumors.
• To investigate breast masses, breast pain, or nipple discharge.
• To differentiate between benign breast disease and malignant tumors.
• To monitor patients with breast cancer who are treated with breast-conserving surgery and radiation.

Procedure

Patient Preparation

1. Instruct the patient to avoid using underarm deodorant or powder the day of the exam.
2. Explain that the test takes about 15 minutes.
3. Explain to the patient that she may be asked to wait while the films are checked.
4. When scheduling the test, inform the staff if patient has breast implants.
5. Make sure the patient has signed an appropriate consent form.
6. Note and report all allergies.

Implementation

1. The patient rests one breast on a table above the X-ray cassette.
2. The compressor is placed on the breast.
3. The patient holds her breath until the X-ray is taken and she’s told to breathe again.
4. An X-ray of the cranicaudal view is taken.
5. The machine is rotated, and the breast is compressed again.
6. An X-ray of the lateral view is taken.
7. The procedure is repeated for the other breast.
8. The film is developed and checked for quality.

Nursing Intervention

1. Answer the patient’s questions about the test.
2. Encourage the patient to deep breathe to alleviate fear and anxiety.
3. Make the patient feel comfortable after the procedure.
4. Prepare to educate the patient about her diagnosis.
5. Prepare the patient for further testing or surgery, as indicated.

Interpretation

Normal Results

• The test reveals normal ducts, glandular tissue, and fat architecture.
• No abnormal masses or calcifications are present.

Abnormal Results

• Irregular, poorly outlined, opaque areas suggest malignant tumors, especially if solitary and unilateral.
• Well-outlined, regular, clear spots may be benign, especially if bilateral.

Interfering Factors

• Powders, deodorants, or salves on the breast and axilla that may cause false positive results.
• Failure to remove jewelry and clothing (possible false-positive results or poor imaging).
• Glandualr breasts that are common in patients younger than age 30, active lactation and previous breast surgery (possible poor imaging).
• Breast implants (possible hindrance in detecting masses).

Complications

• Vasovagal reaction during compression.

image coutesy of : http://www.cancer.gov