Diagnostic mammography imaging is required under certain circumstances:
- In women with breast implants
- In women with severe fibrocystic disease
- After surgery for early breast cancer that did not remove the entire breast
- After an abnormal finding on a screening mammogram (e.g., change in a mass)
- After a new finding during clinical breast examination (e.g., lump, nipple discharge)
Types of imaging used for diagnosis include special mammographic views, mammographic views taken from different angles, and ultrasound. If the findings obtained from additional studies indicate that there is a solid lesion, a biopsy is recommended.
Special mammographic views include magnification and spot compression. Magnification produces an enlarged image of a portion of the breast that contains small calcifications or small masses.
Spot compression applies more pressure to a small region in the breast. This thins out an area of dense tissue so that the x-rays produce a clearer image, making it easier for the radiologist to see if the tissue is normal or abnormal.
Sometimes views of the breast from different angles are required to see a questionable area. Typical additional views include:
- Cleavage viewBoth breasts are compressed between a set of panels at the same time and a top-to-bottom view of a suspicious finding in tissue between the breasts.
- Rolled viewThe breast is rolled to the right or left, compressed, and a top-to-bottom view is taken of a questionable area located in dense tissue.
- Mediolateral viewThis image is taken from the center of the chest to the outer side of the breast.
- Lateromedial viewThis image is taken from the outer side of the breast to the center of the chest.
Ultrasound is used to determine if a mass is a cyst or a possible cancer. Ultrasound is performed with a small, handheld device called a transducer. First, a gel is spread on the skin of the breast. The radiologist passes the transducer over the breast, which directs sound waves through the skin into the body. The sound waves create an image of the breast on a computer monitor.