What is Full Field Digital Mammography(FFDM)?

Full Field Digital Mammography is a special form of imaging system that uses a xray s to examine breasts. It helps in the early diagnosis hence guides treatment of breast diseases.

Two latest advances in FFDM available in our institution are digital mammography and computer-aided detection.

Full-field digital mammography (FFDM), is an equipment which uses xrays obtain images of the breast that can be produced on a computer screen or on special film similar to conventional mammograms. This helps in future references as the images are stored electronically. Additional softwares are available through which the doctor can zoom the image, have a closer look and hence arrive at a precise diagnosis.

Computer-aided detection (CAD)is an advanced software that looks for abnormal areas of density , mass, or calcification that may indicate the presence of cancer . The CAD system highlights these areas on the images, alerting the radiologist to the need for further analysis.

What are uses of the Procedure?

It is the best screening tool to detect early breast cancer in women who have no symptoms and to detect and diagnose breast disease in women experiencing symptoms such as a swelling, pain or nipple discharge.

Screening Mammography

Women at the beginning of 40 are adviced to annual mammograms that lead to early detection of breast cancers, when they have a high cure rate and breast-conservation therapies are available.

The National Cancer Institute (NCI) adds that women who have had breast cancer and those who are at increased risk due to a family history of breast cancer should seek expert medical advice about whether they should begin screening before age 40 and about the frequency of screening.

Diagnostic Mammography

Diagnostic mammography is used to evaluate a patient (both men and women) with a breast lump or lumps—that have been found by them or their doctor.

Preparing for a Mammogram

Before a mammogram you will be requested to fill up a form in a questionnaire pattern to obtain details about your symptoms, family history of cancer etc., which will aid the doctor in perfect detection of the problem.

Do not schedule your mammogram a week before your periods as your breasts are usually tender during this time.

XRAY mammography is to avoided in women less than 30 years although sonomammography (USG) can be done.

Avoid mammograms at the time of pregnancy.

The ACS (American Cancer Society) recommandation:

Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium spots.

Describe any breast symptoms or problems to the technologist performing the exam.

If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam.


A mammography unit is a rectangular box that has a tube in which produces the x rays.It is used exclusively for examination of the breast, with special accessories that allow only the breast to be exposed to the x-rays. Attached to the unit is a device that holds and compresses the breast and positions it so images can be obtained at different angles.

In the past , x-ray images were obtained as film copies (much like a photographic negative). The images obtained in our institution uses the latest advanced technology that produces digital files that are stored electronically. These stored images are easily accessible and can be easily compared to current x-ray images for diagnosis and disease management.


During mammography, a specially qualified radiologic technologist will position your breast in the mammography unit. Your breast will be placed on a special platform and compressed with a paddle. Breast compression is necessary in order to:

Spreads out the breast thickness so that all of the tissue can be visualized.

Any small abnormalities are less likely to be obscured by overlying breast tissue.

Allow the use of a minimal x-ray dose since a thinner amount of breast tissue is being imaged.

Holds the breast steadily in order to minimize blurring of the image caused by motion.

Reduces x-ray scatter and increases sharpness of picture.

Our equipment cause less radiation and minimal pain.

The radiographer changes your position between images. Two views are taken for each breast amouting to a total of four images . The technologist walks behind a glass barrier to operate the machine.

When the examination is complete, you will be asked to wait until the radiologist determines that all the necessary images have been obtained. The examination process should take about 30 minutes.

Screening Ultrasonography:

After obtaining the x ray images you may be asked to wait till the radiologist interpretes your images following which you will be called for an ultrasonographic examination of breasts and axilla performed by specially trained radiologist. Here a sonographic gel (modified water based gel)will be applied and images obtained in a screen which mimics a television monitor.This completes your test.

What will I experience during and after the procedure?

You will feel the pressure on your breasts as it is being squeezed by the compression paddle. Be sure to inform the technologist if pain occurs as compression is increased. If discomfort is significant, less compression will be used.


A radiologist, a doctor specifically trained to image and interpret the test will analyze the images and send a printed report with films and CD to the dispatch section which will available to the patient.

Benefits 0f FFDM over conventional Mammogram:

Appreciable ability to detect even smalltumors and sub millimeter sized calcifications which are difficult to assess with conventional film mammograms.When cancers are small, the woman has more treatment options and a cure is more likely.

The use of screening mammography increases the detection of small abnormal tissue growths confined to the milk ducts in the breast, called ductal carcinoma in situ (DCIS) . These early tumors cannot harm patients if they are removed at this stage and mammography is the only proven method to reliably detect these tumors. It is also useful for detecting all types of breast cancer, including invasive ductal and all other forms of cancers.

No radiation remains in a patient's body after an x-ray examination and have no side effects in the diagnostic range.

Less pain and less radiation.

Electronic storage for future reference.

CAD(Computer Aided Detection) adds up to the diagnosis


There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.

Women should always inform their physician or x-ray technologist if there is any possibility that they are pregnant.

Special care is taken during x-ray examinations to use the lowest radiation dose possible while producing the best images for evaluation.


A stereotactic breast biopsy is a test that uses a special computer to guide a needle to an abnormality seen on mammography. This biopsy is a non-invasive, accurate way to obtain the tissue sample required for diagnosis. The procedure requires little recovery time and there is no significant scarring to the breast.

he stereotactic breast biopsy is performed by a board certified radiologist who specializes in breast imaging.

You will be asked to lie face down on the examination table, making sure you are as comfortable as possible. Your breast will be positioned through a round opening in the table. The table will then be elevated so that the physician and technologist can work from below.

After proper cleaning of the breast will antiseptic solution, the radiologist will inject a local anaesthetic agent (medicine to produce numbness). After the local anesthetic has taken effect, the radiologist will make a tiny incision (usually less than of an inch) through which the biopsy needle will be placed. Another pair of images will be taken to confirm the needle position. Once placement is confirmed, the tissue samples (cores) are acquired.

The sample tissue is sent to the pathologist for diagnosis.


This is a procedure done to obtain breast tissue for confirmation of a suspicious lesion by pathological testing (under microscope). The procedure is same as for screening ultrasonography. After cleaning the area with antiseptic, the radiologist will inject a local anaesthetic agent (medicine to produce numbness). After the local anesthetic has taken effect, the radiologist will make a tiny incision (usually less than of an inch) through which the biopsy needle will be placed and tissue taken. A set of images are obtain in the machine.

Details about the tissue results can be enquired at the pathology department of our institution.