Mammography is a specialized X-ray exam of your breast designed to find early breast cancers. During the exam, the technologist will image your breasts in different positions and with some compression. The compression may be slightly uncomfortable, but should not be painful. It lasts for only a few seconds. Compressing the breast evens out the breast tissue, enabling the image to show very subtle abnormalities. Compression also decreases the radiation dose to the breast.
Length of procedure:
20-30 Minutes
Preparation prior to procedure:
If your mammograms have been uncomfortable in the past, you may want to schedule for the week after your period, when the breasts are least sensitive.
If your previous mammogram was performed at another facility, please be sure to bring it with you or have it sent to us for comparison.
On the morning of your exam, wash your breasts and underarms. Do not use deodorant, powder or perfume, as this may have an appearance similar to calcifications. Wear a comfortable two-piece outfit. If you may be pregnant; have breast implants, scars or moles; are breastfeeding, and/or a history of surgery or biopsy on your breasts, please inform the technologist before your exam.
Post exam instructions:
After the exam, you can return to normal daily activities.
Cyst Aspiration
Cysts are fluid collections in the breast that are very common and are almost always completely benign. The cyst is identified with ultrasound. Occasionally, when cysts look unusual on ultrasound or when they are painful, a doctor will recommend aspiration. The breast is numbed with local anesthetic, and a small needle (about the same size as that used to draw blood) is used to drain the fluid.
Length of procedure:
The procedure takes 5 to 10 minutes and is usually painless.
Preparation prior to procedure:
There are no special instructions.
Post exam instructions:
The patient goes home immediately following the procedure and may resume all of her normal activities.
Stereotactic Core Biopsy
This type of needle biopsy is used to sample an abnormality seen on a mammogram. Almost all abnormalities seen on mammography can be sampled this way. This procedure is a less invasive alternative to surgical biopsy. Studies have shown it to be equally accurate to surgery, with both being approximately ninety-eight percent accurate. The patient lies on her stomach on a special table with her breast through a hole in the table. The doctor works from below the table to perform the biopsy.
During the procedure, the breast is compressed in a way similar to that used to perform a mammogram. The area in question is identified with preliminary x-ray images and the breast is cleaned with antiseptic and numbed with local anesthetic. The entire procedure is performed through a small nick in the skin. A needle is inserted and multiple samples of the abnormality are sent to the laboratory for analysis. Often a small stainless steel clip is placed at the biopsy site at the end of the procedure to make it easier to follow-up the area. This is particularly useful in those cases in which the entire abnormality is removed by stereotactic means.
The procedure is usually painless aside from slight discomfort as the anesthetic is given. A nurse is present with the patient throughout the procedure to provide support and information.
Length of procedure:
The biopsy takes about 20 to 30 minutes, but we usually allow a total of 2 hours for the patient to allow time for registration, pre-assessment and post-biopsy care.
Preparation prior to procedure:
Patients should avoid aspirin, Advil, Motrin, Aleve, ibuprofen and similar medications for five days prior to the procedure as these medications can cause bleeding. Tylenol does not increase the risk of bleeding and is the preferred medication for pain during the five days preceding the procedure. Any patient taking coumadin or heparin should speak with one of our nurses or physicians prior to scheduling the procedure.
On the day of the procedure, the patient should wear a comfortable two piece outfit and a bra that will provide support for an ice pack after she leaves our facility.
Post exam instructions:
After the procedure, pressure and ice are applied to the biopsy site to reduce bruising. A small dressing is applied and the patient goes home with written follow-up instructions and extra ice packs. Patients can drive themselves home and can return to work if they desire. We do ask that for twenty-four hours following the procedure the patient avoid lifting objects more than ten pounds and avoid vigorous physical activity such as aerobics. The patient should keep the biopsy site clean and dry for twenty-four hours following the procedure, avoiding swimming or showering. A sponge bath or tub bath without wetting the biopsy site is fine.
Ultrasound Core Biopsy
This is a type of needle biopsy used to evaluate solid abnormalities seen on ultrasound. It is a less invasive alternative to surgical biopsy for most patients with an ultrasound abnormality.
Ultrasound core biopsy is performed on an outpatient basis. The patient lies on her back on a stretcher and the area is identified with ultrasound. The skin is cleansed to avoid infection and the breast is numbed with local anesthetic. A hollow guide is placed into the breast next to the abnormality. The doctor then places a needle through the guide that is used to remove several samples of the abnormality to send to the lab The procedure is usually painless aside from slight discomfort as the anesthetic is given. A nurse is present with the patient throughout the procedure to provide support and information.
Length of procedure:
The biopsy usually takes 15 to 20 minutes but we usually allow 2 hours total time for the patient to allow time for registration, pre-assessment and post-biopsy care.
Preparation prior to procedure:
Patients should avoid aspirin, Advil, Motrin, Aleve, ibuprofen and similar medications for five days prior to the procedure, as these medications can cause bleeding. Tylenol does not increase the chance of bleeding and is the preferred pain medication for the five days preceding the procedure. Patients on Coumadin or Heparin should notify one of our nurses or physicians prior to scheduling their biopsy. On the day of the procedure, the patient should wear a comfortable two-piece outfit, and a bra that can provide support for an ice pack on her way home.
Post exam instructions:
After the procedure, pressure and ice are applied to the biopsy site to reduce bruising. A small bandage is applied and the patient goes home with ice and written follow-up instructions. The patient may drive herself home and may return to work if she desires. We do ask that for twenty-four hours following the procedure patients avoid lifting objects weighing over ten pounds and avoid vigorous physical activity such as aerobics. We also ask that the patient keep the biopsy site clean and dry for twenty-four hours, avoiding swimming or showering. A tub bath or sponge bath is fine as long as the biopsy site is kept dry.
Ductogram (Galactogram)
This procedure is used to evaluate certain types of nipple discharge. The breast is cleaned to avoid infection and the duct producing the discharge is identified. A very tiny catheter (not a needle) is placed into the duct and a small amount of contrast is injected into the duct. This outlines any abnormalities inside the duct. Mammogram images are then taken.
Length of procedure:
The procedure usually takes from 30 minutes to 1 hour and is usually completely painless.
Preparation prior to procedure:
On the day of the procedure, the patient should wear a comfortable two-piece outfit.
Post exam instructions:
The patient can drive herself home following the procedure and may resume all normal activities.
Needle Localization
This procedure is performed prior to surgery on many patients. If a surgeon cannot feel the abnormality, which needs to be removed, the abnormality must be identified prior to surgery so that the surgeon knows which tissue to remove.
The patient reports to the Surgery Department first to change into a gown and be given an I.V. The patient is then brought to the Radiology Department for localization. The needle localization may be performed either under ultrasound guidance or mammographic guidance, depending on which type of imaging best shows the abnormality.
The breast is cleaned with antiseptic and is anesthetized with local anesthetic. A small needle is placed into the breast in the area of abnormality. After the radiologist is certain that the needle is in exactly the right position, a thin wire is placed through the needle and the needle is removed. All that is left in the breast is a thin wire marking the area of abnormality. Mammographic pictures are then taken and sent with the patient to the Operating Room. There is usually only slight discomfort, if any, during this procedure.
Length of procedure:
Varies based upon the type of surgical procedure being performed.
Preparation prior to exam:
Varies based upon the type of surgical procedure being performed.
Post exam instructions:
Varies based upon the type of surgical procedure being performed.
