Breast Imaging Diagnostic Services
Swedish offers a full spectrum of advanced screening and diagnostic tools through the Swedish Breast Centers and associated Medical Imaging departments. We are proud to offer state of the art technology such as full-field digital mammography and computer assisted detection (CAD).
Digital mammography is used exclusively at Swedish. It differs from conventional mammography in that it captures images digitally instead of on film (similar to the way a digital camera takes pictures versus a traditional camera). Digital technology offers advantages such as improved image contrast and lower radiation dose to patients. Early data suggests digital mammography can help detect cancer better in many women. It also allows for quicker, easier electronic retrieval and storage of images. The future of digital mammography is quite promising.
When a lump is discovered or a screening mammogram shows an area of concern, additional tests will be performed to get more detailed information. In the majority of cases, these tests show that everything is fine. However, if cancer is present, the additional information that is gathered can be valuable in planning treatment. These additional tests may include:
Diagnostic Mammogram — For people who are experiencing current breast problems or who have had an abnormal screening mammogram, a diagnostic mammogram is the next step. As many as 10 percent of women who have screening mammograms may be called back for a diagnostic mammogram.
A diagnostic mammogram uses the same technology as a screening mammogram, but usually involve additional tailored images that allow the radiologist to get a better, more detailed look at the areas in question. More often than not, these additional images eliminate any further cause for concern.
Breast Ultrasound — Ultrasound is another important imaging method that uses sound waves instead of xrays to produce an image. Ultrasound does not use ionizing radiation, but is not as sensitive as mammography for detecting breast cancer. Ultrasound is often used along with mammography to provide additional information about a lump or an area of concern. It is very useful in telling the difference between normal or benign areas and those that need further evaluation.
Magnetic Resonance Imaging (MRI) — Although not as commonly utilized as ultrasound, MRI can be another tool used in selected situations where the mammogram or ultrasound may be of limited use or has raised questions. MRI is very sensitive and frequently leads to additional testing to clarify the findings. Annual screening breast MRI studies are currently recommended by the American Cancer Society for women who are at high risk (over 20% lifetime risk) for breast cancer.
Nipple-Discharge Procedures — When nipple discharge is present, a sample of the fluid may be collected and examined for cancer cells under a microscope. Another way to determine the cause of nipple discharge is to take a special kind of X-ray called a galactogram or ductogram where dye is put in to the involved duct and a mammogram is taken.
Needle Biopsy — There are two non-surgical ways in which a radiologist can further examine an area of concern. These minimally-invasive techniques are called fine needle aspiration and core needle biopsy. The tissue sample removed in either of these tests is examined in a laboratory by a pathologist (a doctor trained to interpret tissue samples) to check for signs of cancer.
A fine needle aspiration is a simple procedure in which a thin, hollow needle is inserted into the area of concern. Once the needle is in the appropriate place, suction is used to help collect a few cells for study. A local anesthetic is typically used to numb the breast tissue during the procedure. Often ultrasound is used to help guide the needle into the correct location.
In a needle core biopsy, the needle is larger, which allows the doctor to remove a larger tissue sample. For this procedure, doctors may use special images to help guide the needle precisely to the area of concern. These images are created by either X-rays and computers (known as a stereotactic biopsy) or by ultrasound.
Surgical Biopsy — A surgical, or excisional, biopsy is what many people think of when they hear the word “biopsy”. The procedure, performed by a surgeon, is used to remove or collect a tissue sample from the area of concern. The sample is then studied by a pathologist under a microscope to confirm or rule out a breast-cancer diagnosis.
Swedish is pleased to announce that Swedish Breast Imaging Center at First Hill, the Swedish Edmonds Breast Center and the Breast Center at Swedish Issaquah have all been designated as Breast Imaging Centers of Excellence by the American College of Radiology (ACR). The breast imaging services at these centers are fully accredited in mammography, stereotactic breast biopsy, breast ultrasound and ultrasound-guided breast biopsy. Peer-review evaluations, conducted in each breast imaging modality by experts in the field, have determined that these facilities have achieved high practice standards in image quality, personnel qualifications, equipment, quality control procedures, and quality assurance programs.
Our mammography services at our Ballard, Issaquah, Mill Creek and Redmond campuses, as well as our mobile mammography program are also fully accredited by the American College of Radiology (ACR). In addition, our breast ultrasound program at Ballard is accredited by the American College of Radiology (ACR).