When a screening or routine
mammogram is performed, the films are reviewed by the
physician within 24 hours, and a report/letter will be sent to
you by mail. You may be asked in that letter to come
back for additional compression or magnification views to
better visualize any unclear areas on the mammogram. You
may be asked to return for a sonogram to clarify areas of the
mammogram or as an additional a screening exam to further
evaluate dense breasts.
A diagnostic
mammogram is a mammogram performed to solve a problem or
answer a question - "what is the lump I feel in my
breast?" Why do I have pain in my breast? Or "I am
following up some calcium that was found in my breast a few
months ago". At this time special views or additional
views may be performed; or additional tests such as an
ultrasound, biopsy or ductogram will be recommended. When
possible, any necessary testing is done at the time of the
visit to complete the diagnostic assessment.
When breasts with implants are
imaged, special "push back" views are performed. The
implant is pushed back toward the chest wall away from the
breast tissue in the front of the breast so that the normal
tissue can be better seen. Although this may be slightly more
uncomfortable than the routine mammogram, it is important that
it be done so that breast cancers are not missed on the
mammogram. There is insignificant risk of implant rupture as a result of
the mammography and special push back views.
When you have a
diagnostic mammogram, the physician will sit with you after
the procedure and explain the findings and
answer any questions you may have. When you leave the office
you will know the findings of your mammogram and the
recommendations for future follow-up.
All mammograms are read with
the assistance of the R2 "imagechecker" the
new state of the art computer aided mammography detection
system. The mammogram images are digitized and analyzed using
a signal processing software which highlights areas on the
mammogram which contain features associated with cancer. The
radiologist reviews the images conventionally and then she
reviews the R2CAD markers displayed on the monitors. This
system reduces observation oversights and aids in the early
detection of breast cancers.
Please bring any old films and
reports you may have if this is your first visit to Promedica.
The best possible interpretation is performed when prior films
are available for comparison.
Breast
Ultrasound
Using newest state of the art
equipment, high resolution ultrasound scans are obtained by
registered, trained technologists, and interpreted by
physicians specializing in breast imaging. Because ultrasound
is highly dependent on technical factors, and is operator
dependent, technologists at Promedica are skilled in breast
ultrasound and registered in their field. Each patient is seen
and evaluated by the physician at the conclusion of her
ultrasound exam..
Indications
for breast ultrasound include:
- women
with dense breasts - for screening
- women
with dense breasts and family history of breast cancer -
for screening purposes
- women
with prior history of breast cancer - for screening
purposes
- women
with a lump they feel or pain in the breast
- women
with abnormality on mammogram that needs further
evaluation
- localization
for surgery
- guidance
for biopsy or cyst aspiration
When a nodule is found in the
breast on a mammogram, or the patient feels a lump in the
breast, ultrasound is performed to evaluate it further. Most
breast nodules are benign . Ultrasound of the breast is used
to differentiate fluid filled from solid nodules. If the
nodule is fluid filled it can be aspirated and it will
disappear; or if it is solid, it can be biopsied in the office
with a needle to determine its etiology. (see breast biopsy)
Breast ultrasound is particularly useful in the evaluation of
women whose breasts are dense, as nodules may be obscured on
the mammogram and found only on ultrasound.
Ultrasound is also important in
evaluating "lumps" that women feel in their breast,
even when the mammogram is normal. It is important that anyone
that has a "lump" in their breast, that is, they
feel something, have a sonogram either with or without a
mammogram. Although breast pain is not usually a sign of
breast cancer, anyone with focal breast pain, that is breast
pain that can be localized to one area of the breast, should
also have a sonogram to look for a cyst or other abnormality.
Many kinds of needle biopsies are performed using the
ultrasound image as a guide for the needle. (See breast
biopsy)
Masses that are seen only on
ultrasound, can be localized (marked) by ultrasound for
surgical excision. Cysts can be aspirated (fluid drained out
with a needle) using ultrasound guidance.
Ductography
Ductography is a
procedure that is often used to define the cause of
unilateral, single-pore spontaneous nipple discharge. Most
nipple discharge is caused by benign tumors, such as
papillomas but occasionally insitu ductal carcinoma can be the
cause. Identifying intraductal abnormalities is important.
The technique is
simple. A very tiny cannula or tube is inserted gently into
the duct which is discharging. A small amount of contrast
material is inserted into the duct, and then mammographic
magnified images are taken to visualize the abnormal duct.
There is no preparation for this procedure or "after
effects."
Mammogram
is a special x-ray of the breast using dedicating low dose
radiation equipment.
