Clearer, state-of-the-art images of the breast mean better diagnosis and better treatment. According to the National Cancer Institute, as a screening measure, digital mammography detects 15 - 28% more breast cancer in women with dense breast tissue or who are younger than age 50.
Digital mammography provides enhanced visual detail of any breast type including augmented breasts. It also reduces the procedure time by as much as 50%, when compared to conventional mammography and eliminates the use of nipple markers which cause some discomfort post procedure.
Best of all, at the Avera Breast Center, all women will receive the highest quality digital mammography at no increase in cost compared to traditional mammography.
Compression is still used and important for detailed quality and to minimize the x-ray dose.
A Softer and Gentler Mammogram
Now all mammograms with Avera Breast Center include the use of a single-use soft pad for a more comfortable experience. It has been incorporated to provide a warmer and gentler approach to the mammography experience. This special mammogram pad also reduces the sensitivities of skin prone to tearing, bruising, or that is tender. This technology is more comfortable for women with very small to very large breasts.
Mammography CAD, (Computer-Aided Detection)
Avera McKennan utilizes Computer-Aided Detection technology in conjunction with mammography. This technology acts like a second set of eyes. It analyzes mammography images to help identify areas of concern making it easier for physicians to detect cancer at its earliest stages.
Breast Biopsy and Ultrasound
A breast biopsy involves removing tissue of concern from within the breast. This tissue is checked under a microscope to determine a diagnosis. Often this procedure involves a special needle which can sample small pieces of tissue under local anesthesia. Occasionally, a surgical biopsy is needed to make a diagnosis.
Breast ultrasound imaging, also called sonography, is often used as a diagnostic tool in addition to mammography. In certain cases, this technology helps characterize the nature of a questionable area seen on a mammogram. Ultrasound uses high-frequency sound waves to produce pictures of the inside of the breast. You will lie on your back with your arm raised above your head on the exam table. A warm gel is applied on the skin and a small transducer moves across the gel, at the area of interest, with slight pressure. No radiation is involved with this exam. Pictures are often reviewed by the Radiologist at the time of the appointment.
When an ultrasound examination cannot characterize the nature of a breast abnormality, a physician may choose to perform an ultrasound-guided biopsy. Because ultrasound provides real-time images, it is often used to guide biopsy procedures.
Ultrasound Guided Biopsy and Stereotactic Guided Biopsy
Ultrasound and Stereotactic guidance are both techniques used to assist physicians in obtaining tissue samples from the breast by using either a core or vacuum-assisted needle biopsy technique. After the ultrasound or the stereotactic (mammogram) machine locates the area of concern, the physician cleans and numbs the tissue. A small skin nick is made which allows a hollow needle to be placed at the precise area of concern. Several tissue samples are acquired and images are taken to document the exact biopsy location. Often a very small marker (clip) is left to mark the biopsy site for future reference. No stitches are required for these minimally invasive outpatient procedures. Ask your physician which type of biopsy is recommended for you.
Breast MRI (3 Tesla MRI)
Breast MRI may be recommended by your physician, in addition to mammography for certain cases. The American Cancer Society recently published specific guidelines for the use of breast MRI. MRI can locate areas of concern within the breast by creating images using a large, powerful magnet instead of x-rays. The patient lays on their stomach on a table with the breasts through a special cushioned opening. A coil technology circles the breasts and produces the very detailed images. A contrast material is injected in an IV with pictures taken before and after the injection. Like other MRI's, once in the cylinder-shaped MRI machine, you hear the tapping and humming sounds of the MRI unit.
- Magnetic field strength at 60,000 times greater than the Earth's magnetic pull allows for superior image quality.
- Diagnostic applications enhanced with bilateral breast imaging and spectroscopy
- Scan time is reduced by 40 - 50 %
Breast-Specific Gamma Imaging (BSGI)
Breast-Specific Gamma Imaging (BSGI) is a molecular breast imaging technique that shows the metabolic activity of breast lesions. BSGI can aid in diagnosis when a mammogram is inconclusive; revealing important information that can help your doctor more accurately determine if an area of concern is cancerous or not. An international medical society, the Society of Nuclear Medicine, provides practice guidelines on patient selection criteria, image interpretation, and reporting for BSGI.
- BSGI is a strong diagnostic tool especially for patients who have:
- Dense breast tissue
- Indeterminate areas on mammography, ultrasound or MRI
- Lumps that can be felt, but not seen with mammography or ultrasound
- Implants and breast augmentation
- Scarring from previous surgeries
- High risk factors or previous malignancy
- Recently identified disease requiring evaluation of disease extent
Read more about Breast-Specific Gamma Imaging (BSGI)
48 year old with a digital mammogram on the left and a BSGI on the right. The BSGI detected multifocal disease in the patient with a negative clinical examination, mammogram and ultrasound. Pathology revealed Ductal Carcinoma in Situ (DCIS) and axillary nodes that were positive for cancer. (Legacy Good Samaritan Hospital, Portland, OR)
Contrast Enhanced Spectral Mammography (CESM)
How CESM works
GE’s SenoBright Contrast Enhanced Spectral Mammography (CESM) uses multiple X-ray energies to create two images: one low energy, standard digital mammography image and another high energy image enhanced by a contrast agent. CESM uses the intravenous contrast agent (much like a CT scan) to compare the two images and highlight areas with abnormal blood flow or lesions. These areas with abnormal blood flow or tissue are easier for physicians to see, diagnose and even predict the tissue’s pattern of growth.
CESM patient benefits
- Easy mammogram procedure that takes minutes to perform
- Reduces waiting time and uncertainty of results
- Offers enhanced clarity to patients with dense breast tissue
- Less affected by hormone replacement or menstrual cycles, so the exam can be performed at patient’s convenience
- Can be performed on patients who may not be a candidate for MRI
- Allows doctors to find growing numbers of small blood vessels, which could be the start of a tumor
- Helps doctors and surgeons determine the most effective treatment plan, if cancer is detected
- In the better majority of cases, CESM results can be given to the patient the same day as her exam, reducing her anxiety
Read more about Contrast Enhanced Spectral Mammography (CESM)