At SRC we understand what it means to be a woman.

It is through this understanding that SRC has established a reputation as the Willamette Valley 's premier provider of women's imaging and breast health services.

When choosing a facility it is important to select an accredited mammography facility that specializes in mammography. At SRC we are proud of our commitment to Women's imaging and being accredited by the American College of Radiology since 1994 and performing over 23,000 mammography procedures per year.

SRC is proud to be an ACR accredited facility for mammography since 1994

DIGITAL MAMMOGRAPHY with "Computerized Second Opinion"

The first step in breast health awareness begins with mammography. There are two types of mammography exams, screening and diagnostic.

Screening mammography is an x-ray examination of the breasts in a woman who has no signs or symptoms of breast cancer. The goal of screening mammography is to detect the occurrence of breast cancer when it is still too small to be felt by a woman or her physician. Early detection of small breast cancers by screening mammography greatly improves a woman's chances for successful treatment. Screening mammography is generally recommended every year for women over 40 years of age.

Diagnostic mammography

Diagnostic mammography is an x-ray examination of the breast in a woman who either has a specific breast concern such as the presence of a breast lump, nipple discharge or has had an abnormality found during screening mammography. Diagnostic mammography is more involved and requires more time than screening mammography because it is used to determine the exact size and location of breast abnormalities and to image the surrounding tissue and lymph nodes.

Typically, several additional views of the breast are imaged and interpreted during diagnostic mammography. At SRC, a physician radiologist with certification as a specialist in the interpretation of breast images will read your diagnostic mammogram immediately following your exam to determine if additional imaging such as an ultrasound or breast MRI is necessary before you leave the facility. If your diagnostic mammogram reveals any area of concern, your physician will be immediately consulted to arrange for a biopsy procedure to be scheduled to obtain a sample of the suspicious breast tissue which will be examined under a microscope to determine whether it contains cancer cells. Women with breast implants or a personal history of breast cancer will usually require the additional views used in diagnostic mammography or magnetic resonance mammography . Click here to learn more about how mammography is performed.

Computerized Second Opinion.

At SRC, we believe each and every mammogram deserves a " computerized second opinion". Using a sophisticated computer analysis system called CAD (computer-aided detection), each mammogram performed at SRC is processed to identify features within the images that are suspicious for cancer.

The system displays your images on a specially designed computer screen and electronically marks any areas with unusual or suspicious densities. After thoroughly reviewing your mammogram films, the radiologist then consults the computerized second opinion before issuing a final report. Clinical studies have demonstrated that when used together in this manner, the early detection of breast cancer is increased by as much as 19%.

Magnetic Resonance Mammography (Breast MRI).

Magnetic resonance mammography is not a substitute for a mammographic examination but is a valuable tool for determining the development of breast cancer disease when this is unclear based on physical examination and other standard imaging techniques. Magnetic resonance mammography is very sensitive for detecting the presence and extent of breast cancer. Cancerous breast neoplasms produce chemical factors which "grow" a new group of blood vessels to supply the tumor.

By administering a contrast agent called gadolinium, these new blood vessels can be detected by the highly sensitive MRI scan. Because the MRI scan is very sensitive it is more susceptible to falsely identify tissue as being cancerous (false positive) when none exists. The risk of a false positive diagnosis is significantly increased when the female is on hormone replacement therapy or is scanned during the 1st or 4th week of the menstrual cycle. This is due to the changes that occur in breast tissue as a result of changes in hormone levels. To reduce this risk, SRC highly recommends that women schedule their breast MRI during the 2 nd or 3 rd week of their menstrual cycle or after discontinuing hormone replacement therapy for a period of 4 weeks. At SRC we understand it can be difficult to delay a diagnosis involving breast cancer; however, it is important that you and your doctor have reliable and accurate information to plan your treatment options.

At SRC we have a unique scanning technique that allows us to image both breasts during a single scan with a single dose of gadolinium contrast. Most facilities scan only the suspicious breast or scan each breast separately which involves two separate scans with two doses of gadolinium contrast. With SRC's unique scanning technique, we will always scan both breasts with the highest level of image quality in half the time and with half the gadolinium dose which we believe sets the highest standard of clinical quality for magnetic resonance mammography.

"American Cancer Society Recommends Breast MRI" The American Cancer Society has updated its guidelines for breast cancer screening and is now recommending that for women who are at an extraordinarily high risk of developing breast cancer in their lifetime, that in addition to annual mammography, they also have an annual MRI performed of both breasts. Women considered to be at extraordinarily high risk would be women who are known carriers of the two breast cancer mutations that are easily testable, which are the BRCA1 and BRCA2 genes. And women who are first-degree relatives of someone with one of those gene abnormalities, but have not yet been tested. Or a woman with a significant family history, who by a breast-cancer risk model, would have a lifetime risk of somewhere between 20 and 25 percent. The American Cancer Society recommends that women in these groups still receive a mammogram because the complement of the mammogram and a breast MRI actually provides the highest pickup rate of early breast cancers. Consistent with the American Cancer Society guidelines, the radiologists at Salem Radiology perform MRI guided biopsy procedures.

Breast Ultrasound is an excellent imaging technique for determining whether a breast mass, identified on physical exam or through mammography, is filled with fluid or is solid. Breast ultrasound is an excellent imaging tool but has specific application for evaluating breast abnormalities after they have been detected by mammography. Breast ultrasound, however, is far less effective at searching the breast tissue for unknown abnormalities and therefore is not a substitute for a mammographic examination.

Ultrasound Guided Breast Biopsy. In some cases, it is not possible to tell from the imaging studies alone whether an abnormality is benign or cancerous. In these cases, ultrasound guided breast biopsy is a highly accurate and minimally invasive way to provide the answer. During this procedure, a specially trained ultrasound technologist and a physician radiologist will place an ultrasound wand on the breast over the site of the breast lump. After applying a local anesthesia to the area the physician radiologist will carefully guide a biopsy needle into the breast mass. The needle is designed to remove a small sample of the suspicious breast tissue that can then be reviewed under a microscope to determine if it is benign or cancerous.

Download the SRC Ultrasound Guided Breast Biopsy Brochure

How is Digital Mammography Performed?

During mammography, the technologist will position the patient and image each breast separately. One at a time, each breast is carefully positioned on a special detector plate and then gently compressed with a paddle (often made of clear Plexiglas or other plastic). This compression flattens the breast so that the maximum amount of tissue can be imaged and examined.

Your mammography technologists may place adhesive markers to the breast skin prior to taking images of the breast. The purpose of the adhesive markers is twofold: first, to identify areas with moles, blemishes or scars so that they are not mistaken for abnormalities, and secondly, to identify areas that may be of concern (e.g. a lump was felt during physical examination). Some centers routinely mark the nipple with a small dot to provide a clear "landmark" for the radiologist on the mammogram images.

To "take" a mammogram, the low dose x-ray source is turned on and x-rays are radiated through the compressed breast and onto a digital sensor located within the shelf that provides support under the breast. The x-rays penetrate the digital sensor to produce a detailed and electronic image of the internal structures of the breast. Highly sensitive digital detectors and special x-rays are used for mammography to create the highest quality images at the lowest exposure.

It is the special energy and wavelength of the x-rays that allow them to pass through the breast and create the image of the internal structures of the breast. As the x-rays pass through the breast, they are attenuated (weakened) by the different tissue densities they encounter. Fibrous Breasts are very dense and absorb or attenuate a great deal of the x-rays. The connective tissue around the breast ducts and fat is less dense and attenuates or absorbs far less x-ray energy. It is these differences in absorption and the corresponding varying degrees of exposure to the digital detector that create the images which can clearly show normal structures such as fat, fibroglandular tissue, breast ducts, and nipples. Further, abnormalities such as microcalcifications (tiny calcium deposits), masses, and cysts are also visible.

The digital image appears on a computer screen within seconds after the exam which allows the technologist to ensure the best possible images of the breast were obtained.The images are then processed through a sophisticated computer analysis system called CAD (computer aided detection) which serves as a computerized second opinion in the review of your images. The images are then interpreted by a radiologist, who compares the new images of a woman's breast to each other and to previous mammograms a woman has had. The radiologist will look for shadows and patterns of tissue density to detect any abnormalities.

A mammogram is like a fingerprint; the appearance of the breast on a mammogram varies tremendously from woman to woman, and no two mammograms are alike. It is extremely helpful for the radiologist to have films (not just the report) available from previous examinations for comparison purposes. This will help the doctor to recognize small changes that occur gradually over time and detect a cancer as early as possible. For this reason, it is important that a woman carefully considers where her mammograms are performed and establishes a mammographic history with an ACR accredited mammography facility.

The breast is made of fat, fibrous tissue and glands. Breast masses (these include benign and cancerous lesions) appear as white regions on mammogram images. Fat appears as black regions on a mammogram image. Everything else (glands, connective tissue, tumors and other significant abnormalities such as microcalcifications) appear as levels of white on a mammogram.

If women have questions about mammography during the procedure, they should feel free to ask the mammography technologist.

Views Taken During Screening and Diagnostic Mammography

For screening mammography each breast is imaged separately:

For diagnostic mammography, each breast is imaged separately:

A cleavage view (also called "valley view") is a mammogram view that images the most medial (central) portions of the breasts. This is the portion of breast tissue "in the valley" between the two breasts. When one breast is imaged and the other breast is left out of the compression field, some of the breast being imaged may get pulled or left out too. To get as much medial tissue as possible, the mammogram technologist will place both breasts on the plate at the same time to image the medial half of both breasts.

A cleavage view may be performed when there is a questionable density on the medial edge of the mammogram film and the radiologist needs to see more of this density (if possible). A cleavage view may also be performed if the radiologist sees something suspicious in the mediolateral-oblique (MLO) mammogram view and cannot find the area on the cranial-caudal view (CC) view.

Breast Compression During Mammography

Breast compression is necessary to flatten the breast so that the maximum amount of tissue can be imaged and examined. Breast compression may cause some discomfort, but it only lasts for a brief time during the mammography procedure. Patients should feel firm pressure due to compression but no significant pain. If you feel pain, please inform the technologist. During the mammography examination, breast compression should only be applied two to four times per breast for a few seconds each time.

Breast compression is necessary during mammography in order to:

Minimizing Pain and Discomfort During Mammography

The benefit of mammography in helping to detect breast cancer early clearly outweighs the temporary discomfort of the exam. If you are concerned about any pain associated with mammography, SRC recommends that patients take acetaminophen (Tylenol) or ibuprofen (Advil) 1-1 ½ hours prior to your mammogram.

Learn more about making mammography appointments at Salem Radiology