House Calls runs every four weeks. Today’s column is written by Wendi Workinger, supervisor of diagnostic imaging at Sutter Coast Hospital.
I have been doing mammography since 1999. I learned from the master of mammography in Del Norte County, Susan.
That same year I was sitting with a close family member and we were discussing my work. I asked her if she had a mammogram yet. She answered “No,” and I was kind of surprised. Here was a smart woman in her 50s and she had yet to go in for her first baseline mammogram?
Her father was a doctor and she was well versed in medical issues. It didn’t make sense to me. I asked her, “Are you afraid of the test?” She said, “No, I am afraid of the results.” I convinced her that she needed to make an appointment with her doctor and discuss getting a mammogram.
A few days after her mammogram appointment I called her to ask how it went. She was a little frustrated in her tone and she told me that the technologist must have made a mistake because the facility where she went has asked her to come back for more images.
I told her that in fact the technologist had not made any mistakes. I explained that there is a basic set of images that we as technologists do across the United States for a complete screening mammography exam. The job of the technologist is to ensure that the images are good quality.
It is the job of the radiologist (radiology medical doctor) to interpret the mammogram. If the radiologist sees an area of concern the patient is called back for another appointment for additional imaging such as magnified views of the area, a certain area to be compressed instead of the entire breast, or possibly an ultrasound.
She went to her “callback” appointment; there the radiologist suggested she had a biopsy. She called me to tell me about her appointment for the surgical biopsy, I told her I would be there to support her.
When we arrived on the day of her biopsy she went straight to the mammography department. The radiologist localized the area for the surgeon to biopsy. When the radiologist felt he was in the correct area, the mammography technologist took another image for confirmation.
The mammogram film came back with my family member so I had a brief chance to look at it. I held it up to the light and if the area hadn’t been circled I would have never seen it. A lot of people assume that we as technologists can see everything on X-rays, but our training is to take the X-ray, not to read them. The radiologists have gone to many years of training to interpret the images. In that instant I felt very lucky that the radiologist was able to diagnose such a small area as being possibly cancer. It was a humbling moment.
Her biopsy came back as being the very early stages of breast cancer. She went onto radiation treatments for six weeks and had follow-up mammograms every year. I am happy to say that was over 11 years ago and she is still cancer-free.
Imagine though if I hadn’t talked her into getting that first mammogram. What would have happened?
The year I turned 40 I had my first mammogram. And guess what? I had to come back for additional imaging. There was an area of concern on the first set of images that the technologist had to compress and magnify for the radiologist. Fortunately for me the area did not look concerning after the additional views were obtained. Approximately 3 percent of screening mammograms have to come back for additional imaging. Less than 10 percent of those “callback” patients are diagnosed with breast cancer.
My husband had a lump develop in his left breast (yes, a small percentage of breast cancer is in males) and he had to have a mammogram. Susan and I did the images together.
Now ladies I know you think mammograms are uncomfortable but imagine a hairy chest too. We giggled our way through it. The radiologist suggested a biopsy for him as well. Fortunately the results were negative. If any changes occur in your breasts, please make an appointment with your health care provider whether you are male or female.
October is Breast Cancer Awareness Month. If you haven’t had your mammogram this year I urge you to make an appointment with your health-care provider and discuss whether you need to have a mammogram. The American Cancer Society still recommends a yearly mammogram for all women over the age of 40, but that is a decision you need to make with your doctor.
The day of the appointment remember not to wear any deodorant — most deodorant has aluminum in it which will show up on the X-ray. Wear a two-piece outfit as we will be asking you to take everything off from the waste up.
Try to schedule your mammogram during your cycle when your breasts are not tender. We have to compress the breast for the images but the compression is only applied for a few moments while we take the X-ray.
The American Cancer Society reports that only two to four mammograms of every 1,000 lead to a diagnosis of breast cancer. But what if it is you, a friend or a family member that are the two to four in 1,000?
A woman asked a fellow mammographer one day, “How do you do this job every day?” She answered, “It’s a great job and I get to save lives!”