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
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
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
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
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
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!"
Email suggestions for future House Calls columns to Beth Liles at
Sutter Coast Hospital, firstname.lastname@example.org