A landmark national trial (DMIST), published in the New England Journal of Medicine in 2005, screened nearly 43,000 women at 33 sites across the country, and found that digital mammography is more sensitive than non-digital mammography in women younger than 50 years of age, women with dense breasts and women in the peri-menopausal and pre-menopausal age groups.

Digital technology allows us to use CAD software to assist our radiologists in detecting early breast cancer.  

The American Cancer Society recommends that women have a mammogram annually starting at the age of 40.

A mammogram is an x-ray of the breast, and is considered the best method to detect breast abnormalities. It can detect problems which you or your doctor may not feel. This makes mammography particularly valuable as a screening tool.

When having a mammogram, the patient stands or sits, if needed, beside a machine. The technologist places the breast on a plastic plate. A second piece of plastic is placed on top of the breast and for a few seconds the breast is flattened to get a good, clear picture.

Two pictures are usually taken of each breast. If you need to come back after a screening mammogram, you may have additional x-rays taken and you may also have an ultrasound exam.

When having a mammogram, it is generally a good idea to wear a blouse with a skirt or slacks, since you will need to undress above the waist. It is best not to wear antiperspirants or powder, since they may obscure the picture.

Screening mammograms are interpreted within 48 hours. If a potential abnormality is seen on the screening pictures, additional x-rays may be recommended. A member of the mammography department will contact you directly in the event this occurs. He or she will set up a follow-up appointment so that this can be done.

Diagnostic Mammography

A diagnostic mammogram is performed for patients with a breast problem, such as a lump or pain, or for a patient whose screening mammogram may have been abnormal. During a diagnostic exam, additional views of the breast, and/or an ultrasound may be performed. Diagnostic mammograms are only performed at the Medical Center Campus (link to Practice Sites), and must be done under the direct supervision of a radiologist.  Patients will receive their results at the conclusion of the exam and our radiologists are available at that time to discuss their findings with you, if you so desire.

Breast Ultrasound

Screening ultrasound may be done for women at elevated risk of developing breast cancer. Ultrasound should be used in conjunction with, and never as a replacement for an annual screening mammogram.

Diagnostic ultrasound is used to evaluate a breast problem such as a lump or pain, or to clarify a finding on the mammogram. All breast ultrasounds are performed by specially-trained technologists called sonographers, who are certified by the American Registry of Diagnostic Medical Sonographers (ARDMS) in breast ultrasound. The ultrasound exam will then be interpreted by one of our breast imaging radiologists, and you will be informed of the results before you leave.

The ultrasound department at Fletcher Allen is fully accredited by the American Institute of Ultrasound in Medicine. This accreditation includes the subspecialties of Diagnostic Breast Ultrasound and Interventional Breast Ultrasound.

Breast ultrasounds are performed only in the Breast Care Center, which is located on the Medical Center Campus at Fletcher Allen.

A breast MRI may be ordered for screening purposes in women who are at elevated risk for developing breast cancer, either because of a family history of breast cancer or because they carry a gene mutation.  A "diagnostic" MRI may be helpful in determining the extent of a newly diagnosed cancer, and in planning surgery.  It can also be helpful in determining whether a cancer has recurred at the site of prior surgery.

We are one of only a few institutions in the United States that offers Breast MRI on a 3.0 Tesla magnet, which is the latest in MRI technology.  The ACS currently recommends annual screening MRI to complement annual mammography for patients at higher risk of developing breast cancer.  You may be at increased risk depending on family history or prior radiation treatment. 

Image-Guided Breast Biopsies

If a need for a biopsy arises, our staff members are able to perform a biopsy using stereotactic mammography, ultrasound, or MRI guidance. These are non-invasive techniques using a specialized needle and local anesthesia to guide the biopsy needle to the area of concern. This process is extremely accurate and virtually pain free. We also provide needle localizations for patients having breast surgery.