Can Registered Nurses With Training And Experience Perform A Medical Screening Exam?

Mammography is an X-ray examination of the breasts that can discover cysts or tumors unpalpable during a physical exam. A biopsy of an area of suspicion may be needed to confirm malignancy. Mammography may follow screening procedures, such equally ultrasonography or thermography.

There are ii uses of mammogram (screening and diagnostic). A screening mammogram is used to screen for unsuspected breast cancer in women with no signs or symptoms. It usually involves two ten-ray images of each breast to detect tumors or small calcifications within the breast tissue. While a diagnostic mammogram is used to diagnose breast cancer in a patient with a suspicious lump or other signs such as chest pain, nipple discharge, thickening of breast peel, or sudden modify in breast shape or size. It is also utilized to examine breast abnormalities found during a screening mammogram and in such cases for patients with breast implants since it provides a more detailed ten-ray of the breast than using a screening mammogram.

Although mammography tin can detect 90-95 % of chest cancers, this test produces many false-positive results. The American College of Radiologist, American Cancer Order, and the National Cancer Institue suggests that women should begin screening mammogram at age 40 annually for women with average take a chance while higher-run a risk women should get-go before and may benefit from supplemental screening modalities.

Nurses take important responsibilities in assisting patients during mammography past providing data about breast disease and breast exam, providing emotional support, and analogous with other healthcare specialists for further diagnostic and laboratory exam.

This written report guide can assist nurses understand their tasks and responsibilities during mammography.

Types

The following are the different types and advances in mammography:

Full-field digital mammography (FFDM). Also known as digital mammography, is performed in the same style every bit conventional screen-film mammography (SFM). The difference is that FFDM images are generated by digital signals rather than from the traditional ten-ray moving picture as with (SFM). The images of the chest are examined on a estimator monitor or printed on a special film.
Figurer-aided detection (CAD) system.Uses software to search images from SFM or FFDM for abnormal areas of breast tissue evidenced past denseness, abnormal size, or calcifications that may indicate the presence of cancer. Abnormal areas are "marked" for further review by a radiologist.
Three-dimensional (iii-D) breast imaging or chest tomosynthesis. Uses equipment that rotates in an arc over the breast instead of the stationary organisation used in conventional SFM. The 3-D equipment produces thin slices of the breast from a great number of angles that generate clearer images, especially of dense breast tissue.

Indication

Mammography is generally indicated to:

Differentiate between beneficial breast affliction and breast cancer
Investigate breast pain, nipple retraction, nipple discharge
Evaluate palpable and unpalpable breast masses
Screen for cancerous breast tumors
Monitor effectiveness of breast radiation therapy
Evaluate opposite chest following mastectomy

Contraindication

These are the contraindications for the procedure:

Pregnant women, unless the potential benefits of a procedure using radiations outweigh the risks of maternal and fetal damage
Patients younger than age 25 or patients with very dumbo breast tissue

Interfering Factors

These are factors or conditions that may alter the outcome of the report

Awarding of substances such every bit antiperspirants (deodorants), talcum powder, lotions or creams to the underarm and chest expanse that may interfere with the accuracy of the results
Failure to remove metallic objects and clothing
Previous breast surgery, agile lactation, and glandular breast (mutual in women age 30 below), which can bear on the quality of the images
Breast implants which may foreclose full visualization of the breast
Inability to cooperate or remain still during the process due to age, health condition, or mental status

Procedure

A mammography is performed on an outpatient footing and the footstep-past-step process is as follows:

Set up the patient.
The patient stands and is asked to residue one chest on a table above an 10-ray cassette.
Technician places breast onto pinch plate.
The pinch plate is placed on the breast and the patient is told to hold her breath. A radiograph is taken of the craniocaudal view. The machine is rotated, the breast is compressed again, and a radiograph of the lateral view is taken.
Repeat procedure on other breast.
The procedure is repeated on the opposite breast.
Review if films are reliable
After the films are developed, they are checked to make certain they're reliable.

Nursing Responsibility

The post-obit are the nursing interventions and nursing care considerations for a patient indicated for mammography:

Before the process

The following are the nursing interventions prior to mammography:

Explain the procedure and what to await after.Tell the patient who will perform the examination and where it will take place. Inform the patient that although the test takes merely about 15 minutes to perform, she may be asked to wait while the films are checked to make certain they are readable. Advise her that there's a high rate of false-positive results.
Permit the patient to express concerns and fears about the procedure. Assess the patient's agreement of the procedure, answer any questions, and correct whatsoever misconceptions.
Remove interfering factors. Instruct the patient to avoid using underarm deodorant or powder on the twenty-four hour period of the exam.
Schedule a senior technologist on a patient with breast implants. If the patient has breast implants, notify him/her to inform the staff when he/she schedules the mammogram so that a technologist familiar with imaging implants is on duty.
Prepare the patient. Just before the test, requite the patient a gown to wear that opens in the front end, and ask her to remove all jewelry and clothing above the waist.

During the procedure

The following are the nursing interventions during mammography:

Assist with patient positioning. Place patient in a continuing or sitting position in front of the Ten-ray machine, which is adjusted to the level of the chest. Place the patient's arms out of the range of the area to be imaged.
Tell the patient that some discomfort may exist felt.Hurting/discomfort may exist caused past the force per unit area required to compress the breast tissue confronting the X-ray plate.
Propose the patient to cooperate completely and follow directions. Instruct patient to remain even so throughout the procedure since movement produces unreliable results. Inquire the patient to hold breath while the 10-ray films are being taken.

After the procedure

The nurse should note of the following nursing interventions afterward:

Provide information almost the availability of the results. Inform the patient a study of the findings will exist given to the requesting dr., who will discuss the results with the patient.
Reinforce the information given by the patient'due south HCP. Help the patient in arranging an boosted test, therapy, or referral to another HCP if an aberration is found.

Normal Results

Normal findings in mammography will evidence:

Normal breast tissue, with an absence of cysts, tumors, or calcification

Aberrant Results

Abnormalities in mammography will reveal:

Chest abscesses or cysts
Breast tumors
Breast calcifications
Hematoma resulting from trauma
Mastitis (inflammation of breast tissue)
Soft tissue masses
Vascular calcification (small calcium deposit within breast tissue)

Gallery

Images related to mammography:

References

Additional resources and references for mammography:

Anne M. Van Leeuwen, Mickey Lynn Bladh. Laboratory & Diagnostic Tests with Nursing Implications: Davis's
Bird, R. Eastward., Wallace, T. Westward., & Yankaskas, B. C. (1992). Analysis of cancers missed at screening mammography.Radiology,184(three), 613-617.
Kerlikowske, K., Grady, D., Rubin, Due south. Thousand., Sandrock, C., & Ernster, V. L. (1995). Efficacy of screening mammography: a meta-analysis.Jama,273(2), 149-154.
Nyström, L., Wall, S., Rutqvist, L. Due east., Lindgren, A., Lindqvist, Grand., Ryden, S., … & Tabar, Fifty. (1993). Breast cancer screening with mammography: overview of Swedish randomised trials.The Lancet,341(8851), 973-978.
Suzanne C. Smeltzer. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests: Lippincott Williams & Wilkins