Mammography is a specialized form of x-ray that is used to detect and monitor changes in the breast tissue. On the day that your exam in scheduled, you should avoid using lotions, creams, powders, perfumes, and anti-perspirant/deodorant products near your breasts (including the underarms), or plan to wash them off prior to the exam. These items may contain ingredients that could interfere with the exam. No other special preparation is necessary. When you arrive for your appointment, you will be given a hospital gown and asked to remove all clothing from the waist up. You will also be asked to remove any jewelry or metal that could interfere with the exam.
A registered technologist with special training in mammography will position you for each image. In a typical exam, two images are taken of each breast. The breast will be positioned between two plates. Just before each image is taken, the plates will compress the breast slightly. Although this is often uncomfortable, it should not be painful. Compression is necessary to get a clear image of the breast tissue.
The actual imaging takes just a few seconds, but the whole procedure lasts 10 - 15 minutes. You will be asked to wait while the technologist checks your images. When the board-certified radiologist reviews your films, he or she may request that additional images be taken or that a sonogram be performed in order to fully evaluate your results. After the examination, the radiologist will prepare a written report for your doctor and a letter will be sent to you explaining your results.
Another procedure available within the Breast Imaging Service is large-core breast biopsy (also called Stereotactic Biopsy). In this procedure, a small tissue sample (a "core" of tissue) is removed with a needle from an apparent abnormality in the breast. No surgical incision is required and only local anesthetic is needed. Specially-designed mammography equipment is used to provide guidance during the procedure to ensure that tissue samples are collected from an appropriate location. After the procedure, the patient can return to normal activities. It is not uncommon for the patient to develop a small bruise over the area. Results of the biopsy are provided to the referring physician. Many patients who have undergone previous surgical biopsy are very enthusiastic about this alternative procedure.
Ultrasound-guided Core Biopsy
Ultrasound guided core biopsies of the breast are also offered. The Ultrasound Guided Core Biopsy is performed in a very similar way to the stereotactic biopsy. The patient lies on her back on the ultrasound table. A brief ultrasound is performed to localize the area of interest (nodule). The skin and breast tissues are then numbed with local anesthetic and a small incision is made in the skin, through which the biopsy needle is inserted. The small samples (cores) of tissue are obtained and sent to the laboratory for analysis.
With either type of biopsy, a marker may be placed at the biopsy site in the breast for future follow up. This does not affect breast tissue and cannot be felt in the breast. The marker will not cause a problem with other exams, such as MRI scans. A mammogram will sometimes be taken after a breast core biopsy, usually to check the position of the marker. Some patients will be asked to return for a follow up mammogram or breast ultrasound three to six months after the biopsy.