What is breast tomosynthesis or 3D mammography?
Breast tomosynthesis converts a stack of digital breast images into a “3-dimensional mamogram” so that a radiologist can see breast tissue detail in a way that is not possible with 2D mammograms. In a 3D mammogram, fine details are more clearly visible and are no longer hidden by the tissue above and below. That said, 3D mammograms take substantially more physician time to interpret the images so many facilities limit 3D mammography to patients with existing findings or certain risk factors.
Here at Little Silver Mammography & HerSpace, we believe that all patients benefit from 3D mammography starting at their first visit.
Research shows that 3D mammography detects 27% more cancers than traditional 2D mammography alone and detects 40% more for invasive cancers like lobular breast cancer. Since the breast is composed of pockets of dense tissue surrounded by fat, when x-rayed, it creates an image that can look something like a smoky haze. The overlapping tissue in the image makes it difficult to see tiny “spots” called microcalcifications, and other subtle signs of early cancer.
Is there any difference in the experience of having a 3D mammogram?
A breast tomosynthesis exam is very similar to a traditional mammogram. The technologist will position you, compress your breast under a paddle and take images from different angles. A breast tomosynthesis exam may be used as a screening tool in conjunction with a traditional digital mammogram or may be used for a diagnostic mammogram.
The breast imagers at Little Silver Mammography & HerSpace are often asked to provide a second expert interpretation of breast imaging initially performed elsewhere. It is advised that a woman seek an expert opinion from a dedicated Breast Imager regarding an abnormal mammogram reading before undergoing a biopsy. Many times the outside recommendation is reversed or altered or, if the biopsy is deemed necessary, the patient may be offered a less invasive biopsy approach.
High resolution contrast-enhanced breast MRI (magnetic resonance imaging) may detect small cancers not seen on mammography. It is helpful in better assessing extent of disease in some patients recently diagnosed with breast cancer. The added information an MRI provides can help fine-tune the surgical management of the disease. Breast MRI is also used to evaluate for breast implant rupture. The role of MRI in screening high risk patients is currently being evaluated in clinical trials. The Breast Imagers at Little Silver Mammography & HerSpace offer expert interpretation of Breast MRI studies performed on a high field strength magnet at the Montclair Breast Center, located in 37 Fullerton Ave Montclair NJ. Call us at 732-571-9100 for further information and/or assistance in scheduling an appointment.
Over one million breast biopsies are performed annually in this country. Previously all of these women would have undergone surgical biopsy. Over the last decade, imaging-guided needle breast biopsy has been perfected.
Reconstructed sound waves reflected back to a computer from the breast tissues generate an image of portions of the breast. This modality is used to determine if an abnormality is a cyst or solid tumor and, if a solid tumor, whether it has benign or malignant features. This helps the radiologist determine if the next step is routine follow-up, short interval follow-up, aspiration, or biopsy. The lack of ionizing radiation also makes this study ideal for the primary evaluation of breast abnormalities in younger or pregnant women. Screening breast ultrasound may be recommended in addition to the yearly screening mammogram for those women who are at high risk for breast cancer and have dense breasts or otherwise difficult to interpret mammograms. Studies have shown an increase in the cancer detection rate of 20-30% in this population of women when screening ultrasound is added to screening mammography. Ask your referring physician and the breast imagers at Little Silver Mammography & HerSpace if you meet the criteria for this study.
This quick, minor procedure uses a fine needle to drain fluid from a cyst which is either complex or “dirty” in appearance on ultrasound, painful or large enough to obscure portions of the mammogram.
This technique localizes a breast abnormality seen on imaging studies to allow for accurate surgical excision. The procedure, which uses a thin needle to insert a thinner hooked wire to the area of concern, may be guided by mammography, ultrasound, or MRI. The breast imagers at Little Silver Mammography & HerSpace use digital mammography when the procedure requires x-ray guidance in order to decrease procedure time and discomfort. It is performed prior to a lumpectomy in patients recently diagnosed with breast cancer by core needle biopsy and prior to initial surgical diagnostic biopsy for abnormalities that cannot be biopsied using less invasive techniques.
This simple procedure uses dye instilled into a breast ductal system to evaluate the cause of nipple discharge.
Bone Densitometry (DEXA)
A bone densitometry, or DEXA scan, is used to assess a patient’s risk of fracture due to osteoporosis, which is a thinning of the bones as we age and go through menopause. This fast noninvasive test takes ten minutes to perform and uses a minimal amount of low-energy x-rays passed through your hip and spine to identify bone mineral loss (osteoporosis).
Little Silver Mammography & HerSpace is dedicated to implementing the latest technologies and is proud to offer a wide array of breast cancer detection techniques in order to provide the most thorough screening results available to patients in Monmouth and Ocean County, New Jersey. Above are a few of the services we offer and we encourage every patient – or perspective patient – to call with any questions regarding our center.
“Our goal is to put women at ease while we pursue the clinical objective of detecting and diagnosing breast cancer at its earliest, most curable stage.”
Over one million breast biopsies are performed annually in this country. Previously all of these women would have undergone surgical biopsy. Over the last decade, imaging-guided needle breast biopsy has been perfected and has saved hundreds of thousands of women from surgery. The success of these procedures rests on the physician’s biopsy experience and expertise in breast imaging. You are in particularly good hands here at Little Silver Mammography & HerSpace.
A breast biopsy may be recommended when the radiologist identifies a “lesion” or abnormality on the mammogram and/or breast ultrasound. While it is natural for a woman to feel anxious about the need for a breast biopsy, consider the fact that 70-80% of the lesions recommended for biopsy turn out to be benign. Unfortunately, there is an overlap between what some benign and some cancerous lesions look like on the mammogram and that is why so many benign biopsies are performed.
Breast cancer may have several faces on imaging: it may appear as calcium, as a mass with or without calcium, as a distorted tissue pattern, or as asymmetric tissue density. The significance of calcium on the mammogram is as a sign of activity at the cellular level. This is usually benign activity. However, a percentage of early breast cancers called DCIS (Ductal Carcinoma In Situ) may present as calcium only. This is cancer in its earliest curable stage. When the pieces of calcium are tightly grouped, new or changing and varied in appearance, there exists a higher likelihood that they represent this early type of cancer, and biopsy will be recommended. A mass or tumor is any space-occupying lesion. If fluid-filled, it is a benign cyst. If composed of solid tissue or cells, it may be benign or malignant. If a solid mass is new, enlarging or irregular in contour and content, a biopsy will be recommended. Most invasive breast cancers will present with a mass on imaging. Distortions and asymmetries are more subtle imaging findings of breast cancer, where breast imaging experience and expertise is crucial to avoid delays in diagnosis.
The biopsy will be offered to women at Little Silver Mammography & HerSpace the same day as the abnormality is detected on the mammogram or ultrasound, if desired, to alleviate the anxiety associated with waiting for an answer. If scheduling the biopsy for a later date, please carefully read the following instructions. If you have any questions, don’t hesitate to call us.
- Eat a light breakfast the morning of your procedure.
- Do not take aspirin for 7-10 days prior to the biopsy or nonsteroidal anti-inflammatory agents for 3 days prior to the biopsy.
- If you take coumadin, heparin or other anticoagulants, please tell our staff so we can coordinate discontinuance of the medication and pre-biopsy bloodwork with your physician.
- Bring prescription and any referral or precertifications, if required by your insurance company, on the day of your appointment.
The latest and most technologically advanced core needle breast biopsy technique, mammotomy (also referred to as directional vacuum-assisted biopsy), uses a probe that gently vacuums, cuts and removes tissue samples for testing. The advantages of mammotomy over other needle biopsy techniques include: (a) single insertion of the probe (b) the ability to fully remove many of the smaller lesions and (c) the ability to insert a 2 mm stainless steel marker at the biopsy site for future follow-up.
A dedicated breast imager will relay results directly to the patient and her doctor within 48 to 56 hours. Depending on the patient’s preference, results may be given over the phone or in person, at which time any questions will be answered and necessary referrals made.
For the next day or so you may resume normal activities immediately, but no strenuous upper body movement, including heavy lifting, for 24 hours. Take Tylenol every 4-6 hours for any mild discomfort. Apply ice for the first 12 hours post biopsy, then apply heat to the biopsy site to keep swelling to a minimum and also help relieve any discomfort. Mild oozing from the biopsy site and skin discoloration are common. If more pronounced bleeding occurs, lay down, hold firm pressure with a clean towel and ice for a least 15 minutes. If bleeding continues after that, do not hesitate to call us, though know that you are in no danger. Aspirin and non-steroidal anti-inflammatory medications may be resumed in 24 hours.