Breast health

Sarah Cannon, the Cancer Institute of HCA Healthcare, recommends women between 40 and 74 years old receive an annual screening mammogram. Sarah Cannon also emphasizes the importance of digital mammography, which produces clearer images and fewer false positives.

In addition to mammography, some women may require another form of breast imaging, such as breast magnetic resonance imaging (MRI). This may be the case for women at high risk for breast cancer or women with dense breasts.

Women who are at high risk for developing breast cancer should still receive regular mammograms in addition to other recommended forms of screening.

If you'd like to learn more about our breast cancer care services, call askSARAH 24/7 at (352) 339-7000.

Mammography services

A mammogram is an X-ray of the breast. It is used to identify tumors that are too small to feel during a breast self-exam or clinical breast exam. Mammograms also help identify ductal carcinoma in situ (DCIS) — abnormal cells in the lining of a breast duct that can develop into cancer.

A mammogram alone cannot determine if breast cancer is present, but it can detect abnormalities that require further examination, such as a breast biopsy. Mammography is a valuable screening tool that helps detect the early signs of breast cancer.

Digital mammography is known to produce clearer images for our patients. All women 40 years old and older should receive annual screening mammograms.

For a consultation or to schedule a mammogram, please call (888) 821-1632.

Preparing for a mammogram

When you come in for a mammogram, dress for comfort. You should only need to remove your top during the imaging exam. Do not wear deodorant, perfume or powder on the day of your mammogram.

What to expect during a mammogram

The patient is first asked to stand in front of the mammography unit while the breast technologist carefully positions the breast on a clear plastic plate for imaging. Next, a second plate lowers until the breast is compressed between the two plastic plates. X-ray images are taken of the breast from a front-view and side-view.

If your breasts become more tender or swollen during your menstrual cycle, consider scheduling your mammogram the week after your menstrual cycle.

Every person is different, and there is no "normal" or "standard" classification of breasts. Women's breasts differ in size, shape and density, and one breast may be slightly different from the other. Lifestyle factors, such as pregnancy and menstruation, may also affect the size and tenderness of the breasts.

Breast self-exam

Healthcare professionals recommend conducting breast self-exams to track any changes in the breasts and identify any signs of breast cancer early.

Sarah Cannon recommends that women 20 years old and older conduct monthly breast self-exams. Men who are at increased risk of developing breast cancer due to the BRCA gene mutation are recommended to begin self-exams at 35 years old.

We recommend following these guidelines when conducting a breast self-exam:

• Perform your exam two weeks after you menstrual cycle starts. During this time, your breasts are less likely to be sensitive or sore.
• Stand in front of a mirror and place your hands on your hips to observe your breasts. Take notice of their usual size, color and shape. Make sure there is no visible distortion or swelling. Look closely for dimpling, puckering or bulging of the skin, nipple discharge or a change in nipple position. Also watch for redness, soreness, a rash or swelling.
• Remaining in front of the mirror, raise your arms and look for the same signs as you did when your hands were on your hips.
• Next, lie down and use your right hand to feel your left breast and left hand to feel your right breast. Use a firm, smooth touch with the pad of your fingers and make circular motions about the size of a quarter to feel all parts of the breast. Be sure to cover all parts of the breast, from collarbone to the top of your abdomen and from armpit to cleavage.
• Use light pressure when examining the skin and tissue just beneath the nipple and medium pressure for the tissue in the middle of the breast. Use firm pressure for the deep tissue in the back — when you feel this part of the breast, you should also feel your rib cage.
• Finally, repeat this exam process on the other breast.

If you come across any unusual findings in your breast self-exam, schedule an appointment with your doctor.

Clinical breast exam

A clinical breast exam is performed by your healthcare provider and involves feeling the breast and underarm areas for lumps or other abnormalities.

If an abnormality is identified during a breast self-exam, clinical breast exam or mammogram, further imaging services may be needed to confirm a breast cancer diagnosis. We use breast MRI and breast ultrasound to take a closer look at the breasts and any identified abnormalities.

Breast ultrasound

A breast ultrasound is often used when a lump or abnormality is identified during a breast self-exam, clinical breast exam or mammogram. Ultrasound uses high-frequency sound waves that bounce off tissue to create an image of the breast.

This imaging procedure is conducted while a patient is lying down with their arms raised above their head. A water-based gel is applied to the area where the abnormality was found. The radiologist then uses a transducer over the breast. A breast ultrasound is not a replacement for regular mammograms.

Breast MRI

Breast MRI is a useful tool in determining the stage of breast cancer and identifying lesions in women who have already received a breast cancer diagnosis. A breast MRI creates a 3D image of the breast. Sometimes, a breast MRI may be ordered with contrast, which means a contrast agent, or "dye," will be injected intravenously.

High risk women's program

HCA Florida North Florida Hospital offers a high-risk women's program to screen and identify women at an elevated risk for cancer. Currently, a small fraction of individuals at a higher risk for hereditary cancer complete genetic testing, which enables them to be proactive about their healthcare through personalized screening and management recommendations based on their risk. A patient who chooses to be tested reviews their results with our genetics counselor, who provides management recommendations. Our collaborative, comprehensive program makes this process easier for providers and patients, resulting in identifying more high-risk patients earlier and improving outcomes. For more information, please call (352) 333-5840.