Technology

 

Upon your arrival, you will be greeted by a member of our team who will complete your registration. When that has been updated, you will complete a form about your medical history. If you are a new patient, this step involves several questions. All of your information is carried over stored for future visits, which means once you are in our system, this step becomes seamless for future visits. If you prefer to fill out the forms and/or submit in advance click here

At this point, a technologist will then review your medical history with you, talk to you about any concerns you may be having, answer any questions and then will begin your exam. It is important to make her aware if you have breast implants, if you are experiencing any new problems with your breasts or if you feel any discomfort during your exam.

DIGITAL MAMMOGRAMS

What is a mammogram? A mammogram is a low-dose x-ray exam of the breasts to look for changes that are not normal. The results are recorded directly onto a state-of-the art computer for a radiologist to examine. A mammogram allows the radiologist to take a closer look for changes in breast tissue that cannot be felt during a breast exam.

A screening mammogram is a routine part of a woman’s annual wellness care and is ordered for women who are not experiencing any issues with their breasts. During a screening mammogram, a mammography technologist will take several standard views of each breast. A diagnostic mammogram is similar to a screening mammogram however it is ordered for women who are experiencing some symptoms in their breast, such as a change in the shape or size of a breast, a lump, nipple discharge, or pain. This exam requires that the mammography technologist focus her imaging on the area of concern. At the end of each exam, the technologist will review your history and exam with the radiologist, at which time you will be given your results.

Please know that breast changes naturally occur in all women throughout their lifetime and are not always a cause for alarm. If you have any questions or concerns about your breasts, or are experiencing a new symptom, you should contact your physician for follow-up. If you do not have a physician, you may make an appointment to see one of our nurse practitioners by calling 561.955.4HER (4437).

How should you prepare for your mammogram?
For women who are still menstruating, it is best to schedule a mammogram just after your period when your breasts are less tender. You should also inform the scheduler if you have breast implants as the exam will take slightly longer. On the day of your exam, it is best that you wear a two piece outfit for convenience. It is important to not use any deodorant, lotion, or powder under your arms or on your breasts as these items can show up on the images.

DEDICATED BREAST ULTRASOUND

An ultrasound uses sound waves to make a picture of the tissues inside the body. A breast ultrasound can show all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. It is used to see whether a breast lump is filled with fluid, if it is a solid lump, or used to view the breast tissue of women who have dense breasts. An ultrasound does not replace the need for a mammogram, but it is often used to check abnormal results from a mammogram.

During the exam, the ultrasound technologist will place some gel on your skin and will use a small handheld unit called a transducer that will gently passed back and forth over the breast. A computer turns the sound waves into a picture on a TV screen. The pictures are then stored electronically and reviewed by the radiologist.

At the Center for Breast Care, our specialized ultrasound technologists are experts in this field and have their completed their breast certification, as well as completed rigorous training under the tutelage of our radiologists to ensure their proficiency. The technologists utilize state-of-the-art dedicated breast ultrasound units equipped with the latest software to produce exceptional image quality.

How should you prepare for your ultrasound?
For your convenience, you should wear a two-piece outfit. On the day of your exam, please do not use any deodorant, lotion, or powder under your arms or on your breasts. Be sure to tell the technologists of any concerns or symptoms you are having.

BONE DENSITOMETRY

What is a Bone Density Scan (DXA)?
Bone density scanning, also called dual-energy x-ray absorptiometry (DXA) or bone densitometry, is an enhanced form of x-ray technology that is used to measure bone loss. DXA is today's established standard for measuring bone mineral density (BMD).

DXA is most often used to diagnose osteoporosis, a condition that often affects women after menopause, but may also be found in men. Osteoporosis involves a gradual loss of calcium, as well as structural changes, causing the bones to become thinner, more fragile, and more likely to break. DXA is also effective in tracking the effects of treatment for osteoporosis and other conditions that cause bone loss. The DXA test can also access an individual's risk for developing fractures. The risk of fracture is affected by age, body weight, history of prior fracture, family history of osteoporotic fractures and life style issues such as cigarette smoking and excessive alcohol consumption. These factors are taken into consideration when deciding if a patient needs therapy.

This exam is performed by a radiologic technologist and typically takes about 20 minutes. After the technologist has reviewed your medical history, you will be asked to lay flat on the table. You must hold very still and may be asked to keep from breathing for a few seconds while the x-ray picture is taken to reduce the possibility of a blurred image. The technologist will walk behind a wall or into the next room to activate the x-ray machine. Bone density tests are a quick and painless procedure. Most insurance companies allow a patient to have one DXA scan every two years however there are instances when they can be done sooner.

How should I prepare for a Bone Density Exam?
On the day of the exam you may eat normally. You should not take calcium supplements for at least 24 hours before your exam. You should wear loose, comfortable clothing, avoiding garments that have zippers, belts or buttons made of metal. Objects such as keys or wallets that would be in the area being scanned should be removed. You may be asked to remove some of your clothing and to wear a gown during the exam. You may also be asked to remove jewelry, removable dental appliances, eye glasses and any metal objects or clothing that might interfere with the x-ray images.

It is important to inform the scheduler if you recently had a barium examination or have been injected with a contrast material for a computed tomography (CT) scan or nuclear medicine scan. These items can cause artifacts on your images so you will have to wait 10 to 14 days before undergoing a DXA test to ensure we perform the best scan possible. Also, women should always inform their physician and x-ray technologist if there is any possibility that they are pregnant.

PEM

Positron Emission Mammography is a high-resolution imaging technique performed with a dedicated breast PET scanner. PEM is basically a PET scan that is isolated to your breast. You may hear it called breast PET scan. PEM is a highly sensitive test that has the ability to detect cancerous lesions as small is 2mm. It is amazing technology, and our medical director, Kathy Schilling, was instrumental in the research for PEM and has been training physicians world-wide on how to use this advanced imaging modality.
http://clinicaltrials.gov/ct2/show/NCT00981812
http://jnm.snmjournals.org/content/42/6/960.full.pdf

The images obtained with the PEM scanner show the location of suspicious masses, giving physicians a “map” upon which they can base your treatment options and/or surgical plan. Armed with this information, doctors can better determine candidates for breast-conserving surgery or lumpectomy. Also, knowing the exact location and extent of the cancer guides doctors during surgery and helps assure that they remove all suspicious tissue and thereby avoid repeat surgeries. Your doctor may also use PEM to monitor treatment or to check for a recurrence of disease. PEM also ideal for those patients whose MRI is difficult to interpret due to hormonal influences, women with implants, patients with metal in their bodies, or patients who suffer from claustrophobia. It is exciting that we now have a functional imaging approach with high sensitivity that complements our current anatomic imaging modalities

How should you prepare for your PEM?
Patients will be instructed at the time their appointment is made that they should eat a low-carb diet the day before the exam and do not eat anything at least 6 hours before your exam. Patient may have only plain water in the morning, nothing with sugar. In addition, they should avoid exercise at least 24 hours prior to the exam.

Please share any concerns about fasting during your call.

Equipment and procedure
Prior to beginning your PEM procedure, a technologist will take a drop of blood from your finger to test your blood sugar level. If it is within the acceptable range, a small amount of radioactive sugar will be injected into your arm. You will then be directed to a quiet room and asked to sit still in a chair or lie comfortably in a recliner for about 60 minutes, giving your body ample time to absorb the sugar. After an hour in the quiet room, you will be brought into the PEM scanning room and seated in a chair. The technologist will scan each breast separately for approximate 10-minute scans. Using gentle immobilization, a typical PEM examination includes two (2) scans per breast and the entire procedure, including time in the quiet room, could take up to two (2) hours.

Once your PEM scan is completed, the high-resolution images are reviewed by our radiologist.

The company that makes the PEM machine is Naviscan.
Click the link to visit their website. http://www.naviscan.com

MRI

Magnetic resonance imaging (MRI) uses a magnetic field and pulses of radio waves to make pictures of the breast. MRI may show problems in the breast that cannot be seen on a mammogram, ultrasound, or CT scan. The MRI creates image that show your breast's normal structure as well as demonstrates any abnormal tissue. In most cases, a dye (contrast material) may be used so that abnormalities can be seen more clearly from normal breast tissue. The contrast material makes it easier to find problems. MRI is a safe and valuable test for looking at the breast. You will not have pain from the magnetic field or radio waves. The table you lie on may feel hard and the room may be cool. Some people feel anxious (claustrophobic) inside the MRI machine. Your physician may prescribe medicine (sedative) to help you relax.

An MRI technologist will perform your exam. Before your MRI, the technologist will review your medical history and explain the test to you in great detail. You will need to remove all metal objects (such as hearing aids, dentures, jewelry, watches, and hairpins) from your body because these objects may be attracted to the powerful magnet used for the test. You will need to take off your clothes above the waist and any other clothing that may be metal on it. You will be given a gown to cover your shoulders during the test.

During the test, you will lie on your stomach on a table that is part of the MRI scanner. The table will slide into the machine part that holds the magnet. Your breasts will be placed in a device called a coil that issued to pick up the MRI signals. Inside the scanner, you will hear tapping or thumping noises as the MRI scans are taken. You will be given earplugs or headphones with music to lessen the noise. It is very important to hold completely still while the scan is being done. Otherwise, repeat scans may be needed. Also, you may be asked to hold your breath for short periods of time. During the test, the technologist is right outside the door and is watching you through a window. They will be able to hear you and you can talk to her through a speaker.

How should you prepare for your MRI?
Tell your doctor and the MRI technologist if you:
  • Have a pacemaker, implantable cardioverter-defibrillator (ICD), artificial limb, any metal parts in your body, tattooed eyeliner or metallic-based tattoos, or any other implanted medical device, such as a medicine infusion pump. Also, tell your doctor if you have worked around metal or if you have recently had surgery on a blood vessel. In some cases you may not be able to have the MRI test
  • Are or might be pregnant
  • Become very nervous in confined spaces
  • Have allergies, especially to any medicines
  • Have asthma
  • Wear any medicine patches
  • Have other health problems, such as kidney problems or sickle cell anemia. Contrast material cannot be used with some health problems.

MINIMALLY-INVASIVE BIOPSY

When a breast biopsy is recommended, patients may be able to choose a minimally invasive procedure known as image-guided needle biopsy. This is a technique that does not require surgery and is performed at our Center by one our highly trained breast radiologists. The needle breast biopsy can be performed using either ultrasound, stereotactic, or MRI-guidance. The radiologist who read your imaging exams will determine the type of guidance that is needed and it is based on the type of abnormality that it found. A stereotactic-guided biopsy uses the same technology used when having a mammogram to perform the procedure. An ultrasound guided-biopsy uses ultrasound to localize the area, and MRI does the same.

How should you prepare for your biopsy?
Just after begin told you require a biopsy, you will be contacted by your personal nurse navigator who will walk you through the upcoming procedure, explain what to expect before and after, and answer all your questions. During your conversations, she will instruct you on how to prepare for your biopsy.

What to expect during your biopsy
When stereotactic guidance is used, the patient lies on her abdomen on a specially designed exam table or may also be done with the patient sitting upright in a chair, particularly for those who are unable to lie on their abdomen for any reason. When ultrasound guidance is used, the patient lies on her back on the exam table. When MRI is used, the patient lies on their abdomen as they did during their initial MRI of the breast, which would have preceded this procedure. With each type of biopsy, the procedure begins with the technologist imaging breast to locate the area that needs to be tested.

After giving a local anesthetic, the radiologist makes a small opening in the skin. A sterile biopsy needle is placed into the abnormal breast tissue. Images are taken to confirm the exact needle placement. When the location is confirmed, small tissue samples are taken through the needle. The samples are then sent to the pathology department for interpretation. The entire procedure takes approximately 30 minutes to an hour. Results are usually available in three to five working days.

Minimally invasive biopsy offers these results compared to surgical biopsy:
  • Minimal scarring instead of a large incision
  • Reduced pain and risk of infection after the procedure
  • Potentially lower hospital costs
  • Immediate return to work
  • Shorter recovery time and immediate resumption of daily activities
Every patient is different and will receive the personal care they need to throughout the process. In conjunction with the entire team of radiologists, technologists, and nurse navigators, every patient who requires a biopsy will be treated with care and compassion. We will work with you, your family, and your physicians to ensure the process is as effortless as possible for you.

MOLECULAR BREAST IMAGING

Molecular Breast Imaging (MBI) is a new imaging tool used for the early detection of breast cancer. It takes advantage of differences in cellular metabolism between normal cells and cancerous cells in order to differentiate one from the other. Using this technique, physicians have been able to identify cancers before they are visible with mammography and ultrasound, and before a patient has any signs or symptoms.

Why do we offer Molecular Breast Imaging?

Is MBI the same as a Mammogram?

Who is a candidate for MBI?

What can I expect during the MBI exam?

How can I find out more about MBI?

If you have a prescription for the exam and would like to schedule, please call our Scheduling Department at 561.955.4700.

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