Many a joke has been made about the discomfort of a round breast being squeezed flat like a pancake during a mammogram, but it turns out there is sound reasoning behind it.
"The breast has to be taut," explains Carla Montgomery, a mammography technologist at The Rose. "The more pressure we use, the less 'give' there is in the breast and the more the breast tissue is spread apart.”
This, says Montgomery, means the radiologist – the physician whose specialty is “reading” mammograms – can see through the mass with no overlapping breast tissue getting in the way.
At The Rose, a Houston-area nonprofit breast cancer screening organization, women who don't care much for that temporary flattening effect can feel great about this: Every time their insurance pays for a mammogram, they have helped cover the cost of a mammogram for other women who are not insured or don’t have the ability to pay.
Women can also feel great about The Rose Galleria, says the center’s radiologist. Dr. Daniel Roubein. “There is not another medical facility in the Houston area that can claim superior technology to our new The Rose Galleria.” The newest mammography technology is digital.
Before digital mammograms, analog mammography was the standard. What is the difference between analog and digital?
Roubein explains: "Analog mammograms are similar to photographs developed from film. You can't change the color of the picture and you can't magnify it or rotate it to get a different view. With digital images like those we obtain at The Rose Galleria, we can glean more information. This means the patient may be less likely to be called back for additional imaging.”
Another advantage says Roubein, is that the information can be shared electronically if a patient’s record needs to be sent elsewhere."
Roubein reads and interprets the digital images – the mammogram – from a computer screen, but it's a team effort.
If a radiologist can't count on his mammography technologists to do the job right, he says, there's nothing to work with. Skilled technologists, says Roubein, generate diagnostic images that are meaningful and useful.
To earn these skills, Montgomery says she and other technologists must complete a two-year
X-ray college program, followed by 40 hours of mammography specialization, plus 25 mammograms.
The goal is for patients to get an experienced technologist from the get-go, she says.
Montgomery brings special knowledge to the job. At only 38, she has already had several mammograms herself, because she volunteered to be the class "guinea pig” as a student.
"I wanted to know what it was like so I could tell my patients 'this is how it's going to feel, this is how long it's going to take,’" she says.
Bedside manner cannot be taught in a classroom, but it is important. That’s why Montgomery tells women that yes, mammograms are uncomfortable, but it shouldn't take more than 10 minutes to get two images per breast.
Women tend to be nervous the first time they have a mammogram, she says. A woman’s first breast screening is called a baseline mammogram.
Baseline mammograms are important, says Roubein.
"They are the starting point for interpretation. We can interpret without a baseline if one is not available for some reason, but making comparisons between breast tissue today and breast tissue from two or three years ago is an ideal way to determine if something is benign without having to do a biopsy. "
Baseline mammograms can be a woman's first mammogram ever, or her first mammogram after surgery for breast cancer or breast implants.
So when should a woman have that first mammogram?
At age 40, or even younger if a problem pops up, Roubein says. These are not the guidelines set out in a recent study conducted by the United States Preventative Services Task Force, which recommended eliminating screening for women aged 40-49. The study said women 50-74 should be screened every other year.
Roubein says the controversial study is just not correct. "The study did not accurately portray the value of mammography. There is no arbitrary age at which breast cancer begins."
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The Rose, which last year delivered more than 68,000 medical and educational services to both uninsured and insured Houston-area women, won the Winner of Distinction Award for Excellence presented by the Greater Houston and South Texas chapter of the Better Business Bureau (BBB).
