- I'm Jessica Salazar, I'm the director of marketing here
at Overland Park Regional Medical Center,
and today we're gonna talk about
what to expect during a mammogram.
We have Betsy with us, Betsy has agreed
to let us follow her through her first mammogram.
And so Betsy, are you nervous?
- I'm a little nervous, yes, not gonna lie, yes.
- So why did you decide to get a mammogram today?
- Well, in the past I've had a lump and had a sonogram done.
It was benign, but I just feel that it's important
to have it done and checked out
and would like to know if there's anything there.
(Betsy laughs)
- Do you have some preconceived notions about mammograms?
Some of the women in your life, friends,
have had mammograms?
- Yes.
- What's in your mind, what are you thinking?
- Yeah, talking with my mom, I hear that it hurts.
It squishes you, and as I was telling some of my friends
I was coming over here to do this,
they told me, "Don't punch the technician."
So I will try not to do that.
Little nervous that it's gonna hurt a little bit,
but that's okay. - And that's okay.
It's okay to be nervous.
Thank you for being our volunteer.
This is great education.
I know lots of women probably have
the same preconceived notions that you do.
So let's really show them what happens during a mammogram.
So we're gonna bring in Jessica and Becky.
They are our mammography techs
here at the Women's Imaging Center
in Overland Park Regional Medical Center.
- Hi.
- And so they are gonna get Betsy ready
for her first mammogram.
- So yes, for your first picture,
you're just gonna stand facing forward.
And this is how the machine works, so this is a face shield.
We do top pictures and side pictures of both sides,
so when the paddle comes down like that, it won't hurt.
It'll be tight, it'll be taut,
but I promise, it's not gonna hurt.
(Betsy laughs)
- When it takes the pictures, this just keeps your head
out of the way, you'll get real close to it,
and this camera's gonna move back and forth.
It won't touch you, you just might see it
out of the corner of your eye.
- Okay.
- Okay, and I start on your right side,
I kinda go back and forth.
So just stand facing forward, you don't have to unsnap.
We'll just swing this behind you
and just walk you forward this way.
I'm gonna bring this way up,
and yeah, you're kinda just gonna look at me
get your chin close to there.
And the machine will feel kinda cold,
that part I can't really help, I'm sorry.
- [Betsy] No, you're fine.
- So here comes that paddle's coming down.
It's kinda tight, it's kinda taut,
I will tell you when to hold your breath.
Do the best you can, it's more for holding still.
And you can grab underneath,
and we're gonna take a picture here, hold on just a minute.
- [Becky] Okay, and then as it takes that picture,
that top of that will move from side to side,
taking 15 pictures through the breast.
- [Jessica] Okay, you can go ahead and step out.
- And then it automatically releases the compression,
so you're not compressed for more than
just a few seconds at a time, you're good.
- [Jessica] So that was your first one Betsy,
how're you feeling?
- [Betsy] Fine.
- Good.
- It didn't hurt at all.
- [Becky] So here is what a mammogram looks like.
This circle here we've marked.
What Betsy has are some moles that will often show up
on a mammogram, and they can look like
you actually have something growing inside of your breast
'cause it's hard to tell that it's actually on the skin,
so we mark them with these circles,
just so that when the radiologist reads it,
she knows, okay, there is something there,
but that's actually just a mole, yep.
- [Jessica] And this is a 3D mammogram.
- This is a 3D mammogram.
- [Jessica] So this is the highest technology
for women to get mammograms.
- That's correct, yep, that is correct.
Okay, we'll move on to her right.
- This one is just to get more tissue on the sides.
And I'm gonna stick on the right side,
so we'll kind of just lean.
Still look at me, and you can grab underneath,
that's fine, it'll just come up really high.
Try to keep your feet flat.
A lot of people like to stand on their tip toes.
(women laugh)
And I'm so tall so I think you can lay your arm right here.
There we go.
So this one pulls this little bit,
so there will be a tightness right there.
Same thing, you just hold real still,
you're doing fine.
- [Betsy] Okay.
- It takes a minute here.
And we're gonna take the picture.
(machine beeps)
- [Jessica] Okay and how was that?
- [Betsy] So far, so good.
- No pain?
- [Betsy] No pain.
- [Jessica] So now I'm gonna do a side picture.
I might do all your right side first.
- [Betsy] Okay.
- [Jessica] So the side picture is to get the lymph nodes
up in your shoulder.
- So for this one, we did a little farther back
because on younger patients, they tend to have
denser breast tissue.
But there's always an area of fat behind that denser tissue
so we did that extra picture to get all the way back behind
that dense tissue all the way to the fat.
So if you look on here, you can barely see
on the edge here is her muscle,
this is her chest muscle, this white part here.
But all this white in here is dense tissue.
The part here that's darker, that's actually fat.
- [Jessica] And so what's unique though,
is that you're able to actually view that dense tissue,
even more clearly and accurately
because of the 3D technology.
- Yes, because of the 3D technology
and because now that we're digital as opposed to
15 years ago when we were still using actual films,
we can see right away that we need to do
additional imaging to make sure that Betsy
or anybody gets the proper examination.
- Wow, so you're trained on the spot
to see if you need to take additional pictures
of a woman's breast?
- That's correct, yes.
- So we'll move onto the left.
- [Jessica] Actually, I'm gonna do a right.
So this one is to get the lymph nodes up in your shoulder.
It's going to get real tight up here,
I'm going to go this way.
So we're going to put our arm here,
and scoot to your left just a little.
And let your arm go straight.
I'm going to go over the machine,
so it will get real tight up in your shoulder,
and up in your neck.
That part, before it gets tight in the bottom half.
And you can hang on there,
and now the tube is gonna move,
it won't touch you.
- [Betsy] Okay.
- I'm gonna lift everything up.
So this is the one people tend to remember,
because it does get tighter quicker.
Especially up under your shoulder.
So I'm gonna kind of push your shoulder back.
Okay, there we go.
So yes, the camera is gonna move,
so just look up to the ceiling with your chin,
I might tilt your head just a little.
Okay, we'll take a picture here.
(machine beeps)
- Okay, good job.
We're half way there!
- [Betsy] Yay.
- You can go ahead and step back.
So we're going to do the same thing to the left side.
- Okay.
- [Becky] We'll show her in just a second,
as soon as it finishes processing.
Okay, so this is that side picture that we did.
It compliments the other one in that
all of this white is the pectoral muscle in her chest.
And the idea is that we want to see this muscle
go all the way down to the level of the nipple.
So that if you drew a line straight from the nipple back,
they would be equal to each other.
So that's a good exam there.
This is the underneath part of her breast,
and then this is the top part of her breast, up here.
So it's truly a side picture.
- [Jessica] Okay, so we'll do the same thing
to your left side.
So I'm going to try to stand you here like this,
and then we'll just do it again.
So let me scoot your body this way a little bit.
- And if you have any questions during the process,
please let us know.
And Becky and Jessica can answer your questions, too.
- Yes, absolutely.
- [Jessica] Same thing, there goes the paddle.
Okay, I'm going to move your neck just a smidge more.
There we go.
You're doing great.
(machine beeps)
- Okay good job.
You can step back as soon as that releases.
We'll do that one kind of over here in a minute.
- So we're doing the same thing on this side
that we did on the other side,
where we do just a little more extra picture
to get back on the side of her breast a little bit more.
'Cause again, she's young and still has that dense tissue.
So we want to make sure we're giving her a complete exam.
All right, we're ready.
- Okay, so same thing,
it's to get this little part right here.
So turn a little bit this way,
and we're just going to go like this,
and your arms are fine,
they're not in the way at all.
And again, it's just that little bit right there.
Okay, we'll take a picture here.
(machine beeps)
- Okay, good job.
We'll do one more picture on that side,
one up in your armpit, and then we'll be done.
- [Betsy] Yay!
- One more picture and then she's all done.
So the whole mammogram takes maybe five minutes at most.
So even if you're nervous, or overly shy,
it is actually a really fast exam.
- Yes.
Now this last one might be a little tricky.
So we will see.
Raise up your arm this way.
So same thing like what we did on your right.
So just scoot up just a little.
- So what she does, is as she's positioning that,
she turns the machine to the side
and tries to get the corner of that,
right up that underneath of the arm,
so that we actually get as much of that muscle
and into the lymph nodes as we can.
So then we want the breast just to lay against
that detector there, which is what captures the image.
And then she can press this from the side,
and it does sometimes kind of,
that's the thing we hear the most,
is that it's pulling on my neck,
and it does just pull the skin really taut,
but we're not actually imaging the neck.
- [Jessica] Okay, look up with your chin.
And we'll take a picture here.
- Perfect right here.
(machine beeps)
- You did it!
You made it!
- And actually I'm going to show you,
let me fix this real quick.
On this side, you can actually see
a couple of her lymph nodes.
Okay, so on this side, up there under her arm,
those are actually lymph nodes, under there.
And it's normal for them to look like that,
and sometimes you'll see lymph nodes
actually into the breast tissue,
because we kind of have lymph nodes all over our body.
The middle of our chest, down in our groin,
so you can see that those are lymph nodes there.
And again we have the muscle going all the way down.
Remember that imaginary line going
from the nipple straight back.
We want that muscle to be down as far as the nipple.
Yeah, very good.
- So that took about five minutes, how do you feel?
- Fine, yeah.
It wasn't bad at all.
- It wasn't bad at all.
- No.
- I mean, did it hurt?
- It was just a little pressure, but it was not
what had been explained to me before
from my mom or other women that have done this.
- Like a cartoon where they walk out
and their breast is just squished?
- Yeah, it wasn't bad at all.
It didn't hurt at all.
- [Becky] Good.
- What would you tell a woman who was debating
on whether or not to get a mammogram?
- Get it done.
Get it done.
There's no reason why not to.
- And everybody seemed really, Jessica and Becky
seemed really gentle, they walked you through the process.
- Yes, very gentle.
- So that's a good experience for you?
- Yep.
It felt very comfortable, not nervous after we got started.
After that first one, knowing what it felt like,
knowing what it was, after that.
- Yeah, awesome.
Now you can go back to work.
- I know, yeah that was my lunch break,
now I get to go back.
(women laugh)
- Thank you, Betsy.
We're going to ask Becky and Jessica
some more questions, so thank you for your time.
- All right, thank you guys.
- Before you leave, we do wanna say that we do
get those read by our breast radiologist,
we will send you a letter in the mail with your results.
We do also send the report to her physician,
if by any chance they see anything in your mammogram
that they think needs extra pictures or an ultrasound,
we will call you, or your doctor's office will call you
to schedule that follow up, okay?
Somebody will call you.
- Okay.
Thank you.
- [Jessica And Becky] Bye!
- So you walked Betsy through the process
of what happens afterward.
It's read by a breast radiologist.
- Yes.
- The reports are sent to her primary care physician.
Why is it important that a breast radiologist
reads the mammogram?
Why is that unique to Overland Park,
and why is that important?
- Yes, our radiologist that is here full time,
she is actually a Breast Fellowship trained radiologist.
So not only did she go through her medical school,
and then her internship and then specialized in radiology,
she went beyond that and did a fellowship,
it's two years I think.
- [Jessica] It's two years, I think so.
A breast fellowship where she focused
just on breast imaging.
- And that's very unique?
- It is.
Not every facility has a breast radiologist.
- So that's just an extra level of protection
for us to have?
- Yes.
And she performs a lot of our biopsies,
when we call patients back and have them come back
for extra imaging, she is who we show our images to.
- Okay.
I want to see if we have any questions.
So if it comes back not normal,
then is a biopsy the next step?
- No, we call them back in for usually additional pictures.
We have a whole wall here of paddles that we use.
So if it comes back that she has maybe a nodule,
we'll bring her back and instead of using that paddle
that compresses her whole breast,
we would use this smaller one,
and compress just on a small area of her breast.
The idea with this is, a lot of times
when patients get called back,
it's what we call a summation artifact,
which is just a shadow or overlapping tissue.
And so we use this paddle to kind of spread that tissue out
so we can see all the way through it, a little bit better.
- [Jessica] Okay.
- And then usually that's accompanied also
by a breast ultrasound.
- So I know there's a lot of conflicting reports
about who should get a mammogram.
- Oh, every woman 40 and above.
If you have a high family risk of breast cancer,
meaning a first degree relative,
mother, sister, grandmother, then you should start 10 years
before the age that they were diagnosed.
So if your mother was diagnosed at 45,
you would want to start your annual screening at 35.
- So I know my grandmother is a breast cancer survivor.
- Yes.
- For two years.
- So she got it at 87.
- At 87.
- So, even though no one else in my family
was diagnosed with breast cancer,
she's the first one, so I know that's kind of
in the back of my mind, and my mom's mind as well.
We should probably be getting mammograms.
- Oh yes, absolutely.
Yes.
For sure.
And we get a lot of questions about
when can I stop having mammograms?
It's a very personal decision.
I always recommend, and I think Jessica does the same,
if you're at an age where you don't think you would pursue
any kind of treatment, you wouldn't go through surgery,
or you wouldn't do radiation,
or you wouldn't do chemotherapy,
that's when you can probably stop having mammograms.
So for most women, that is late 80's or 90's.
Other than being a woman, the biggest respecter
for developing breast cancer, is age.
So the older you are, the higher your risk factor.
- Now let's talk about the types of mammograms we offer.
What is unique about this machine behind us?
- So, this is our 3D machine,
so what I did for the mammogram,
these are different sized paddles.
And the best way I always was told,
we used to do a picture like this,
and a picture like that.
So it's kind of like when you bake a loaf of bread.
Take it out of the oven, you can look at it,
everything looks good, that's fine.
The 3D is more when you slice the bread,
so you can see the different parts,
that's probably, or a book, a book is the same way, too.
You can see the top, the side of it,
but you can't really read it, until you open it
and look through page by page.
So that's probably the best way to explain it.
- And so if I make an appointment online,
am I going to get a 3D mammogram?
- Yes.
Not all insurance covers 3D,
so that's something you'd have to check with your insurance,
most of them now are, and we're pretty good,
our receptionist is really good about checking it.
We would not have you do it unless you were comfortable
to do it, and you knew your insurance covered it.
And if your insurance doesn't cover it,
I believe it's 70 dollars extra, maybe.
And even if you don't do the 3D,
the difference is you just don't get that tube angle,
so we'll still do the top picture,
and we'll still do the side picture,
we just don't have the different layers in between.
- [Becky] Yeah.
- So you still get an adequate exam,
it's not that you're not getting,
it's just a little bit more in depth.
- Now can I schedule an appointment myself?
Or do I have to have a physician referral?
- For a screening, meaning you don't have any problems,
you can just come on in whenever you make your appointment.
We do have some walk-in days, too.
If you do have a problem, if you feel something,
you have some discharge coming out,
you were in a car accident, you fall down,
the winter is coming up, those things could happen.
Then you would need to see your doctor first.
They would physically look at you, write an order,
we would do these pictures
with probably some additional pictures,
and then maybe follow it up with an ultrasound,
but we always have a mammogram first.
- Okay.
Well thank you, Jessica and Becky.
This has been very educational for our viewers.
We also offer a free breast cancer risk assessment
that you can take online
at oprmc.com/mammogram.
Schedule your mammogram now.
It takes less than five minutes
to schedule the mammogram online.
The whole procedure took about five minutes.
You can schedule online,
we have walk-in hours,
you can find all that information
and the breast cancer health-risk assessment
at oprmc.com/mammogram.
Thanks for joining us.