Breast Imaging

Ultrasound uses sound waves to generate a picture of the breast tissue. No compression is necessary. Ultrasound is particularly useful in telling cysts from solid masses in the breast. Cysts are very common and totally benign; about half of all women have some cysts in their breasts at some point. Ultrasound is also very helpful in characterizing masses and lumps.

Sometimes we do find a lesion that requires a biopsy to find out what it is. Fortunately, the vast majority of breast biopsies can be accurately performed with a needle and do not require surgery. Depending on the finding, a needle biopsy is performed, using either stereotactic (mammogram), ultrasound, or MRI guidance.

Stereotactic-Guided Breast Biopsy

The stereotactic table is specifically designed so that you can lie face-down with one breast positioned through a hole in the table. Two digital x-ray images are taken from different angles, allowing the radiologist to precisely localize the area to be biopsied. Once the area has been located, the radiologist numbs the area with a local anesthetic, then uses computer guidance for precise needle placement and collection of small tissue samples.

Ultrasound-guided Breast Biopsy

The radiologist uses ultrasound to locate the area for biopsy and to direct the needle used in collecting breast tissue samples.

Both Methods are as accurate as a surgical biopsy and are performed on an outpatient basis, taking less than 40 minutes to perform and requiring no stitches. Furthermore, the patient can resume normal, non-strenuous activities immediately after the procedure is done. The samples are sent to the pathology lab for analysis. Results are usually available within 48 hours.

MRI-Guided Breast Biopsy

We can perform a standard needle biopsy in the MRI suite if a lesion is detected only on a Breast MRI exam, and this can be performed in under an hour.

MRI is a technique using a very strong magnet and radio waves to pick up signals from the breast tissue. We use state-of-the-art equipment including a dedicated bilateral breast surface coil. The patient lies face down within the scanning field for approximately 25 minutes. The primary way that abnormal tissue stands out on MRI is because it gets more blood flow than the remaining tissue. We can detect blood flow by taking images before and after infusion of an intravenous substance (gadolinium) that is easily seen on MRI. Breast MRI is most useful in detecting breast cancer and evaluating the integrity of implants. Breast MRI is often employed in patients with a known breast cancer in whom there is a question about how extensive the disease is. Medical indications for Breast MRI are evolving, and are the subject of many studies around the country. We use a special computer-assisted detection (CAD) program designed for the processing and interpretation of Breast MR Images.

A ductogram, also called a galactogram, is a test done if you are having persistent nipple discharge from a single duct, and your mammogram is normal. A tiny tube is inserted into the duct and a tiny amount of iodine contrast dye is injected into the duct. Several mammogram pictures are then obtained, with the ducts outlined by the iodine contrast. This shows whether there is anything inside the duct which could be producing the discharge. When the duct is filled with fluid, it may create a cramping sensation similar to what many women experience with their menstrual cycle.