North Broward Radiologists | Digital Mammography, Breast MRI, Breast Ultrasound & Breast Biopsy

Breast Imaging

Screening Mammography, including digital mammography

For women not experiencing any kind of irregularities or concerns, screening mammography is a safe, low-dose X-ray of the breast designed to identify cancer in the early stages, long before it can be detected by a physical examination.

Screening mammography can detect all types of breast cancer, including invasive ductal and invasive lobular cancer. It is also the only proven method to reliably detect small mineral deposits in the breast, microcalicifications, which may indicate an early form of breast cancer called ductal carcinoma in situ (DCIS). When breast cancers of all kinds are detected early, more treatment options are available.

CAD (Computer-Aided Detection) often times complements a screening mammogram. Through this process, a computer program is used to highlight areas of breast tissue that may be abnormal. This process may identify areas of the breast that could be suspect for calcifications or breast cancer and allow the Radiologist to re-evaluate that portion of the image.

Diagnostic Mammography, including Digital Diagnostic Mammography

Diagnostic mammography may be performed if a screening mammogram demonstrates a possible abnormality, or a patient is having specific breast problems. Symptoms may include a lump, changes in the breast skin, pain, nipple discharge, or a personal history of breast cancer. A diagnostic mammogram may consist of additional views beyond the standard four included in a screening mammogram. The additional views of diagnostic mammography are also commonly used for women who have breast implants because the implant interferes with imaging "through" the entire breast.

Breast MRI

Breast MRI is now proven to be more sensitive than any other modality in detecting invasive breast cancer. MRI is superior at demonstrating the size and extent of a breast tumor prior to surgery. In addition, it is beneficial for screening patients at particularly high risk for breast cancer due to genetic predisposition or strong family history, diagnosing breast implant rupture, staging breast cancer and planning treatment. MRI also plays an important role in post-surgical and post-radiation follow-up. Breast MRI is not a replacement for conventional mammography, but is extremely useful in special circumstances. Early detection improves survival and expands treatment options.

Breast MRI is most accurate in evaluating these features:

Size of a tumor
Lymph node involvement
Metastases
Response to treatment (chemo and radiation therapy).

Breast ultrasound

When a lump or mass is detected by a mammogram or physical examination, a Breast Ultrasound is used to determine whether it is solid, or a fluid-filled cyst.

Some studies have suggested that ultrasound be considered in screening women with dense breast tissue (which is difficult to evaluate by routine mammography). But, use of screening ultrasound instead of mammography is not recommended because small calcium deposits, which may be the earliest signs of cancer, are not visible by ultrasound. For this reason, when ultrasound screening is performed it should be done in addition to mammography. Breast ultrasound is useful for evaluation of some breast masses and is the only way to tell if a cyst is present without placing a needle into it to aspirate fluid. Cysts cannot be accurately diagnosed on physical examination alone. Breast ultrasound may also be used to help doctors precisely guide a biopsy needle into some breast lesions.

Breast Biopsy

Sometimes the only way to tell what a finding on a breast imaging study represents is to obtain tissue for the pathologist to analyze. In the not so distant past, biopsies were almost exclusively obtained surgically. However, many cases can be resolved with non-surgical interventional needle biopsies and thus avoid surgery. These needle biopsies are performed with imaging guidance by either using ultrasound or special mammography equipment called stereotactic biopsy. The advantages of these methods include the avoidance of a surgical procedure, obtaining a diagnosis quickly, less subsequent breast pain and swelling, and no scarring. Since between approximately 60% - 80% of breast biopsies have benign outcomes, these needle biopsies offer distinct advantages in cases where they are applicable. In cases where cancer is diagnosed, a fully planned cancer surgical approach can then be performed. This gives the surgeon the advantage of knowing ahead of time, so that many repeat surgeries can be avoided.

Stereotactic Biopsy

When a suspicious abnormality is detected by mammography, a Stereotactic Biopsy may be performed. Stereotactic breast biopsy is a safe and minimally invasive form of breast biopsy. It is used to obtain tiny samples from an abnormal breast mass for examination by a pathologist. This biopsy is performed using a computer and x-ray technology to position a hollow biopsy needle. Biopsies are the only definitive way to confirm whether suspicious breast tissue is normal or abnormal.

Ultrasound Guided Biopsy

Following a breast ultrasound, a biopsy using ultrasound, or sound waves, may be performed. Ultrasound imaging is used to assist with proper positioning of the biopsy needle so a small sample of tissue can be obtained and then analyzed under a microscope. Ultrasound guided biopsy is a highly effective way to evaluate abnormal tissue within the breast.

MRI Guided Breast Biopsy

MRI-Guided Breast Biopsy is usually a preferred alternative to surgical biopsy. It is a recent development and important for diagnosing breast cancer. When a Breast MRI uncovers suspicious areas, an MRI-Guided Breast Biopsy may be performed to help isolate the problem and provide an accurate interpretation by one of our Radiologists.

Aspirations and Core Needle Biopsy

Many suspicious breast abnormalities can be diagnosed without surgery by using needle biopsy. In the past, excisional surgery biopsy was the only option for this purpose. There are two types of needle biopsies - fine needle aspiration biopsy and core needle biopsy. Fine needle aspiration uses a very thin needle to remove fluid and tiny fragments of tissue. Core needle biopsy uses a slightly larger needle to remove a cylindrical piece of tissue about 1/16 inch in diameter and 2 inches long. Core needle biopsy is the preferred method because fine needle aspiration is difficult due to the small amount of tissue extracted maybe inadequate.

But, even if an abnormality is too small to be felt, fine needle aspiration or core needle biopsy can still be done using breast imaging methods such as ultrasound and stereotactic mammography to guide the needle into the lesion. During an ultrasound examination, the physician can view the needle on a screen as it moves toward and into the mass.

			HOME \| LOCATIONS \| CONTACT US


SPECIALTIES	TELERADIOLOGY	OUR RADIOLOGISTS	PATIENT EDUCATION	FOR PHYSICIANS	CAREERS
Breast Imaging Screening Mammography, including digital mammography For women not experiencing any kind of irregularities or concerns, screening mammography is a safe, low-dose X-ray of the breast designed to identify cancer in the early stages, long before it can be detected by a physical examination. Screening mammography can detect all types of breast cancer, including invasive ductal and invasive lobular cancer. It is also the only proven method to reliably detect small mineral deposits in the breast, microcalicifications, which may indicate an early form of breast cancer called ductal carcinoma in situ (DCIS). When breast cancers of all kinds are detected early, more treatment options are available. CAD (Computer-Aided Detection) often times complements a screening mammogram. Through this process, a computer program is used to highlight areas of breast tissue that may be abnormal. This process may identify areas of the breast that could be suspect for calcifications or breast cancer and allow the Radiologist to re-evaluate that portion of the image. Diagnostic Mammography, including Digital Diagnostic Mammography Diagnostic mammography may be performed if a screening mammogram demonstrates a possible abnormality, or a patient is having specific breast problems. Symptoms may include a lump, changes in the breast skin, pain, nipple discharge, or a personal history of breast cancer. A diagnostic mammogram may consist of additional views beyond the standard four included in a screening mammogram. The additional views of diagnostic mammography are also commonly used for women who have breast implants because the implant interferes with imaging "through" the entire breast. Breast MRI Breast MRI is now proven to be more sensitive than any other modality in detecting invasive breast cancer. MRI is superior at demonstrating the size and extent of a breast tumor prior to surgery. In addition, it is beneficial for screening patients at particularly high risk for breast cancer due to genetic predisposition or strong family history, diagnosing breast implant rupture, staging breast cancer and planning treatment. MRI also plays an important role in post-surgical and post-radiation follow-up. Breast MRI is not a replacement for conventional mammography, but is extremely useful in special circumstances. Early detection improves survival and expands treatment options. Breast MRI is most accurate in evaluating these features: Size of a tumor Lymph node involvement Metastases Response to treatment (chemo and radiation therapy). Breast ultrasound When a lump or mass is detected by a mammogram or physical examination, a Breast Ultrasound is used to determine whether it is solid, or a fluid-filled cyst. Some studies have suggested that ultrasound be considered in screening women with dense breast tissue (which is difficult to evaluate by routine mammography). But, use of screening ultrasound instead of mammography is not recommended because small calcium deposits, which may be the earliest signs of cancer, are not visible by ultrasound. For this reason, when ultrasound screening is performed it should be done in addition to mammography. Breast ultrasound is useful for evaluation of some breast masses and is the only way to tell if a cyst is present without placing a needle into it to aspirate fluid. Cysts cannot be accurately diagnosed on physical examination alone. Breast ultrasound may also be used to help doctors precisely guide a biopsy needle into some breast lesions. Breast Biopsy Sometimes the only way to tell what a finding on a breast imaging study represents is to obtain tissue for the pathologist to analyze. In the not so distant past, biopsies were almost exclusively obtained surgically. However, many cases can be resolved with non-surgical interventional needle biopsies and thus avoid surgery. These needle biopsies are performed with imaging guidance by either using ultrasound or special mammography equipment called stereotactic biopsy. The advantages of these methods include the avoidance of a surgical procedure, obtaining a diagnosis quickly, less subsequent breast pain and swelling, and no scarring. Since between approximately 60% - 80% of breast biopsies have benign outcomes, these needle biopsies offer distinct advantages in cases where they are applicable. In cases where cancer is diagnosed, a fully planned cancer surgical approach can then be performed. This gives the surgeon the advantage of knowing ahead of time, so that many repeat surgeries can be avoided. Stereotactic Biopsy When a suspicious abnormality is detected by mammography, a Stereotactic Biopsy may be performed. Stereotactic breast biopsy is a safe and minimally invasive form of breast biopsy. It is used to obtain tiny samples from an abnormal breast mass for examination by a pathologist. This biopsy is performed using a computer and x-ray technology to position a hollow biopsy needle. Biopsies are the only definitive way to confirm whether suspicious breast tissue is normal or abnormal. Ultrasound Guided Biopsy Following a breast ultrasound, a biopsy using ultrasound, or sound waves, may be performed. Ultrasound imaging is used to assist with proper positioning of the biopsy needle so a small sample of tissue can be obtained and then analyzed under a microscope. Ultrasound guided biopsy is a highly effective way to evaluate abnormal tissue within the breast. MRI Guided Breast Biopsy MRI-Guided Breast Biopsy is usually a preferred alternative to surgical biopsy. It is a recent development and important for diagnosing breast cancer. When a Breast MRI uncovers suspicious areas, an MRI-Guided Breast Biopsy may be performed to help isolate the problem and provide an accurate interpretation by one of our Radiologists. Aspirations and Core Needle Biopsy Many suspicious breast abnormalities can be diagnosed without surgery by using needle biopsy. In the past, excisional surgery biopsy was the only option for this purpose. There are two types of needle biopsies - fine needle aspiration biopsy and core needle biopsy. Fine needle aspiration uses a very thin needle to remove fluid and tiny fragments of tissue. Core needle biopsy uses a slightly larger needle to remove a cylindrical piece of tissue about 1/16 inch in diameter and 2 inches long. Core needle biopsy is the preferred method because fine needle aspiration is difficult due to the small amount of tissue extracted maybe inadequate. But, even if an abnormality is too small to be felt, fine needle aspiration or core needle biopsy can still be done using breast imaging methods such as ultrasound and stereotactic mammography to guide the needle into the lesion. During an ultrasound examination, the physician can view the needle on a screen as it moves toward and into the mass.