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Diagnostic Mammogram
Diagnostic mammography is for women with breast problems such as a lump, pain in one breast, nipple problems, prior history of breast cancer, follow-up from an abnormal screening mammogram or any other changes. The test normally requires a physician's order. We recommend you have follow-up exams of one or both breasts for the first two years after being diagnosed with breast cancer.
Mammogram
A mammogram is an x-ray of the breast. It is the best way to reveal tumors that are too small to be felt. Mammograms can also show other changes in the breast that doctors believe may suggest cancer.
Mammograms are the best available tool for early detection of breast cancer. Women over age 40 are recommeded to have an annual mammogram.
Screening Mammogram
A screening mammogram is a yearly exam for patients who are currently having no problems with their breasts. Screening mammograms are the best tool available for finding breast cancer early, even before you are able to feel the lump or other symptoms appear. A screening mammogram can spotlight changes in the breast that could be a sign of cancer, including small deposits of calcium. While these are usually benign (non-cancerous), they could be an early sign of cancer. If an area on the mammogram looks suspicious or is not clear, additional diagnostic mammograms or a breast ultrasound may be needed.
A diagnostic mammogram is performed under the direct supervision of the radiologist. Diagnostic mammography consists of verification, localization and characterization of breast abnormalities and uses a variety of tools to evaluate abnormalities.
Breast MRI
Breast MRI may be used to more closely evaluate breast abnormalities first seen on a mammogram. Mammography uses low dose x-rays to image the breast whereas MRI uses powerful magnetic fields. Breast cancer can be multi-focal (in more than one area of the breast), but difficult to see on a mommogram. MRI can help show better visualization. Physicians can also use MRI to detect recurrences in women who have already been treated for breast cancer with lumpectomy.
Benefits of Breast MRI:
Highly sensitive to small lesions
Effective in visualizing dense breasts
Evaluation of inverted nipples for evidence of cancer
Evaluation of the extent of breast cancer
Visualization of breast implants and ruptures
Detection of breast cancer recurrence (return) after breast conserving therapy
Characterization or identification of small lesions missed by mammography
May be useful in screening women at high risk for breast cancer
Breast MRI Exam:
The patient lies face down on a special padded table with the breasts falling through openings in the table (no compression used). The table contains special MRI coils (antenna) that receive the imaging data during exam.
A series of images are taken while the patient lies still.
A tapping sound is heard coming from the machine during the exam.
The exam typically takes between 30 and 60 minutes. There is no pain or compression during the exam.
Stereotactic Needle Biopsy
If a suspicious area that cannot be felt or is very small is seen on a mammogram, stereotactic breast biopsy (Mammotest) may be used to biopsy the area. This biopsy procedure is performed using a mammography table, a biopsy needle adn the guidance of a computer. This test, an alternative to surgical biopsy, takes approximately 45 minutes to perform, and most patients return to their normal activities within a few hours.
Your breast will be compressed with a special mammography machine while stereo x-ray pictures are taken at angles. After the suspicious area has been indentified, the radiologist enters information into a computer that calculates where the needle should be inserted. The area of the breast to be biopsied is numbed with a local anesthetic. An instrument moves the biopsy needle in position and at a rapid rate of speed removes a sample of the suspicous tissue. Damage to nearby tissue is minimal, unlike surgery, which may cause scarring to the breast. Afterward, a small bandage will be placed over the biopsy site. The biopsy sample will be sent to the pathology lab for evaluation. Consult your doctor about how and when you can expect to receive the biopsy results.
Other Diagnostic Tools
Other diagnostic tools your physician might use include physical examination, special mammographic views, ultrasound, short-term follow-up, fine needle aspiration, galactography, core needle biopsy, (stereotactic or ultrasound guided).
