When a screening mammogram shows an area of concern, you're going to want answers right away. First, remember that an abnormal mammogram does not necessarily mean you have breast disease or cancer. As many as 10 percent of women who have mammograms are called back for further evaluation. The majority find out through further tests that they are fine.
At the Swedish Breast Centers, we also offer a wide range of state-of-the-art diagnostic capabilities that let us tell you what's going on with your breasts quickly, accurately and using minimally invasive techniques.
When a lump is discovered, 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 — 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 X-rays 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.
- 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.
- 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.
In addition to the most modern equipment, we have a caring and experienced medical staff that specializes in breast care and that exceeds national certification standards. These specialists can be an enormous help in answering questions, explaining procedures, assessing personal risk and lending a supportive ear.
What's more, the Swedish Breast Centers are part of Swedish Medical Center. So if you do need additional treatment, you'll have access to the Breast Cancer Program at the Swedish Cancer Institute — the largest, most comprehensive cancer-treatment facility in Washington state.