THINK PINK: Questions and answers with Merit Health mammographer Jewel Lee – The Vicksburg Post

Breast cancer is the second leading cause of death in women. To draw attention to this disease, October has been declared the month of fighting breast cancer.

According to the Centers for Disease Control, 42,211 women will die from breast cancer in 2022.

However, survival rates are higher if breast cancer is detected before it spreads to other parts of the body, so regular mammograms are essential.

But some women may hesitate or fear screening because they don’t know what to expect. To provide information about screenings and what they can predict, Merit Health River Region mammography technician Julie Lee answered questions posed by The Vicksburg Post reporter Terry Cowart Frazier in an effort to educate and inform women about the importance of getting mammograms.

Q and A

At what age should a woman start doing mammography?

According to the recommendations of the American Cancer Society, women should start screening before the age of 40.

What type of screening/imaging does River Region offer?

We offer screening and diagnostic mammography, as well as diagnostic ultrasound.

Can you explain the differences and how each is performed?

If the patient has no problems, it is considered a screening mammography — regardless of whether it is their first or annual exam. The mammary gland is placed on the mammogram in such a way that the ribs touch it. We pull enough breast tissue forward to reach from the nipple to the chest wall in the image. The compression paddle is then lowered down to straighten the breast tissue. The way I like to describe it to my patients is, “Your breasts are like a bag of balls, so we try to spread out the ‘balls’ like on a cookie sheet so that the breast tissue is clearly visible.” We squeeze the chest so that the “balls” do not collide with each other, as this can simulate a mass. Compression is very important because you can be withdrawn if there isn’t enough pressure on your chest to push the fabric apart. We take four pictures or more if the breasts are larger. And during the procedure, the patient literally stops breathing for a few seconds while the irradiation takes place. This is necessary to ensure a clear image, as breathing can blur the image due to movement. Each exposure lasts approximately six seconds. After the technologist checks all the images for motion and is satisfied that the image has all the necessary anatomy, the patient gets dressed and leaves.

If the patient experiences a lump, a lump, any pain or tenderness, nipple discharge, or her doctor feels something during a clinical breast exam, diagnostic mammography should be performed After a screening mammogram, the radiologist may recommend further testing to evaluate areas such as calcifications, cysts, lymph nodes, or general dense areas of breast tissue. After that, the patient plans to return for a diagnostic mammogram at a later date. At this appointment, additional pictures are taken, which may differ slightly from those taken during the screening. These images give the radiologist more information about the problem area. With areas of dense breast tissue, sometimes just more compression can clear up the questionable area. As mentioned earlier, this is why proper compression is so important during mammography. In the case of calcification, a magnified image is taken to see the size, shape, number of calcifications and then whether they are layered. This information determines whether there is a need for a biopsy compared to the next six-month interval. If there is a suspicious tumor or cyst, an ultrasound is performed at the same time to show whether the problem area is a solid or fluid-filled cyst, a lymph node, or simply an area of ​​dense tissue that does not compress clearly on screening. The radiologist will determine at this stage whether a biopsy of the area or a follow-up in six months is needed.

When will the patient receive the results?

The test is read on a different day (than the day of the screening) and a letter with the results is sent to the patient within 7-10 days. The ordering provider will receive a faxed copy of the report as soon as it is dictated and transcribed the same day it is read by the radiologist.

I understand that sometimes a woman who is having a mammogram for the first time may be called in for additional screening to better access the baseline.

Not everyone is called from the first viewing. However, you usually get a call back because the radiologist reading the study has never seen the tissue before and may see some questionable areas that they think need further study and there are no comparative studies to confirm if anything was there.

Should the patient be worried if they call him back?

Worrying about something will not change the result and is a waste of precious time. I want people to know that it doesn’t necessarily mean it’s a bad thing. Just something that needs to be considered a little more carefully.

If someone in the family has had breast cancer, should they be screened earlier? If so, why?

Depending on how close the family history is to the patient, people are advised to screen early. For example, if your mother was diagnosed in her 40s, the patient should consider getting tested starting in her 30s..

Do you ever get too old to have a mammogram, and if so, why and at what age?

This is a painful topic for me. I get this question all the time. I’ve seen breast cancer in patients in their 20s, and I’ve seen it diagnosed at 86. My honest answer is, as long as you’re taking care of yourself, you can go to the doctor, get a mammogram. Cancer has no age limits and time when it can appear.

What would you say to a woman who is afraid to have a mammogram?

Every day I hear women say that for years they were afraid to come in and say when it was all done, “I can’t believe I waited so long. It wasn’t as bad as I thought it would be.” It really isn’t. Machines have improved significantly since the first mammogram. The exam is more comfortable. You still have compression, but it shouldn’t be painful, just a slight pressure that we monitor all the time. The techs won’t put more pressure than you can handle, so communication is key because we don’t know if something will hurt you if you don’t say something.

How important are breast self-exams?

Breast self-examination is crucial because not all providers perform it. The main thing is to check how your breasts feel every month. Use the pads of your fingers and follow a pattern like a circular pattern to cover the entire breast. Never simply squeeze a group of breast tissue together because you are collecting these “balls” and may mistakenly think there is something there. It is best to do this in the shower with soap, but you can also lie in bed with your hand raised. The more familiar you are with the feel of your breasts, the easier it is to notice the difference.

If a woman finds something suspicious or her breasts start to hurt, what should she do?

Call your doctor immediately. Never take your breast problems lightly.