Breast Care Exams

The newest and most advanced technology in breast cancer detection, tomosynthesis can offer better visualization for radiologists who are helping certain groups of patients — particularly those with dense breasts. This improvement in visualization can result in fewer callbacks and, thus, less anxiety for patients.

This exam is performed at the same time as a traditional 2D mammogram; a second set of images is obtained to create a 3D image of the breast, allowing the radiologist to evaluate the breast tissue one “slice” at a time.

All women may benefit from tomosynthesis; however, there is an increased benefit to women with dense breast tissue because dense breast tissue may look similar to cancer tissue. Fine details are more clearly visible on a 3D mammogram.

We’re thrilled to be able to offer tomosynthesis to our patients. Mammography remains the gold standard for early detection and has been proven to reduce mortality from breast cancer in all age groups starting at age 40.

Annual Screening Mammogram vs. Diagnostic Mammogram

Screening Mammogram
If performed annually as recommended, screening mammography is the key to detecting breast cancer early and saving lives. Women who are 40 years of age and older with no symptoms of breast disease should schedule their screening mammogram appointments annually. A physician referral is not required for this exam, however, the physician can request that the patient be seen in office prior to the exam.

Diagnostic Mammogram
While a screening mammogram is encouraged each year for women who do not have significant breast symptoms, a physician may order a diagnostic mammogram if the patient is experiencing a worrisome lump, changes in the breast skin, pain, nipple discharge, or if they have a personal history of breast cancer. Diagnostic mammography may also be performed if the screening mammogram demonstrates a possible abnormality. The type and number of mammographic views taken will be customized to the patient’s situation. A diagnostic mammogram is not considered a preventive care service by most insurance companies. This exam may be subject to deductibles and co-insurance, so we suggest the patient contact their insurance provider with coverage questions.

There is no preparation for this exam.

A breast ultrasound is an imaging technique utilized for examining the tissues inside the breast. Gel is applied to the area to be scanned and a transducer is passed gently over the skin. Sound waves are reflected off the internal structure of your breast to reconstruct an image on a computer. This image will assist the Radiologist in identifying abnormalities.

Screening Breast Ultrasound vs. Diagnostic Breast Ultrasound

Screening Breast Ultrasound

If you have dense breasts, this means that you have more fibrous and glandular tissue and less fatty tissue. Dense breasts can make it more challenging for doctors to see breast cancers on mammograms. This elevates the likelihood of cancer diagnoses being overlooked.

Some insurance companies may not consider this exam to be preventative care. This exam may be subject to deductibles and co-insurance, so we suggest the patient contact their insurance provider with coverage questions. A physician referral is required for this exam.

Diagnostic Breast Ultrasound

If an area of concern is identified on your mammogram or if you feel a lump that cannot be localized on your mammogram, you may be referred for an ultrasound of the area in question.

A diagnostic breast ultrasound is not considered a preventive care service by most insurance companies. This exam may be subject to deductibles and co-insurance, so we suggest the patient contact their insurance provider with coverage questions. A physician referral is required for this exam.

There is no preparation for this exam.

Ductograms are performed on patients with active nipple discharge. The breast will be manipulated to produce the discharge in the examination room, thereby identifying the specific duct. A needle is then inserted into the duct and contrast material is injected. Mammography images are then taken as the contrast material will highlight the specific duct and assist the radiologist in identifying abnormalities.

There is no preparation for this exam, however, there needs to be active discharge.

The definitive method to determine whether a condition is benign or cancerous involves obtaining tissue samples. This procedure enables the collection of breast tissue samples to confirm or rule out the presence of breast disease. A local anesthetic will first be administered to numb the area. During the procedure, a very thin needle is inserted into the breast with a syringe to remove fluid from a cyst within the breast. The fluid is then sent to a lab for analysis.

There is no preparation for this exam.

This procedure is done the day of surgery and is used to help identify the sentinel lymph node, which is the first lymph node to which cancer cells are likely to spread from the primary tumor. Radioactive tracer will be injected into the skin near the areola. This special dye will determine which lymph nodes are the main draining lymph nodes. The tracer leads your surgeon to your sentinel lymph nodes, which may help to determine if they need to be removed.

Biopsies are the only definitive way to confirm if breast tissue is benign or cancerous. Abnormalities are examined further by having a sample of tissue, cells or fluid extracted for evaluation in a laboratory.

The area of the breast will be numbed, and a small incision will be made. A hollow needle will be inserted into the nodule and small samples will be removed via a small vacuum. The samples are sent to a lab for analysis.

Ultrasound Guided vs. Stereotactic Guided

Ultrasound-Guided

An ultrasound-guided procedure will be conducted if the issue is detectable through ultrasound. The radiologist will administer a local anesthetic for your comfort before inserting the biopsy needle through a tiny incision in the skin to collect tissue samples for analysis. A small marker clip will be placed at the biopsy site to facilitate easy identification for subsequent monitoring or surgical intervention if required.

Stereotactic-Guided

A stereotactic-guided procedure will be conducted if the issue is detectable through mammography. The radiologist will administer a local anesthetic for your comfort before inserting the biopsy needle through a tiny incision in the skin to collect tissue samples for analysis. A small marker clip will be placed at the biopsy site to facilitate easy identification for subsequent monitoring or surgical intervention if required.

There are medication modifications required for these exams. Please call our Interventional Scheduling Department at (315) 362-8346 to discuss with one of our specialists.

If you will be having surgical removal in an operating room, we will “localize” the area for your surgeon. Mammographic images or ultrasound guidance will be performed to identify the exact location of the area to be biopsied. When this has been completed, the radiologist will insert a needle into the breast, into the lesion/nodule. Additional mammographic images will then be obtained to verify the needle is in satisfactory position for you to proceed to the operating room for surgical removal of the area.

Breast MRI (magnetic resonance imaging) uses radio waves and strong magnets to make detailed pictures of the inside of the breast. Breast MRI may be used with mammography as a screening tool for detecting breast cancer in some people. This includes women with a high risk of breast cancer, who have a strong family history of breast cancer or who have hereditary breast cancer gene changes.