Breast Imaging
Mammography involves the imaging of breast tissue for the purpose of locating breast disease at its earliest stages. Imaging is accomplished using special high detail-rendering, computerized imaging equipment (digital). Mammography services are regulated by the Food and Drug Administration (FDA), and audits are conducted periodically; all facilities and physicians providing mammography services must be certified by the FDA.
Breast Imaging FAQ
How often do I need a mammogram?
After age 40, a yearly mammogram is recommended, along with an annual physician evaluation and the patient's monthly self-examination.
Do I need an appointment for a mammogram?
Yes, unless emergent or extenuating circumstances.
Are there any special instructions I need to follow prior to my mammogram?
Yes. We recommend that you wear a two piece outfit. Additionally, please abstain from using deodorant, and powders under your arms and around your breasts. Some studies have indicated that scheduling your mammogram following the onset of your menstrual period is a less uncomfortable examination.
Why do they ask me when and where my last mammography exam was?
Medicare and most insurance companies will only pay for a screening mammogram if at least eleven (11) full months have elapsed since the last examination. Also, when reviewing your mammogram, it is useful to the radiologist to have the prior study(s) to look for subtle changes in the tissues of the breast.
I am currently nursing an infant. Can I have a mammogram?
Except in emergent cases, it is generally better to wait until after you have stopped nursing to have your mammogram.
I have read that ultrasound and laser light are better than x-ray mammograms. Is this true?
X-ray mammography is currently the best way to diagnose breast disease. Ultrasound is beneficial in cases of dense breast tissue, or when suspicious areas on film need further evaluation. Laser, light and heat studies are all investigative at this time and do not approach the accuracy of x-ray mammography.
Is mammography 100% accurate in finding breast cancer?
No single test can predict with 100% accuracy of diagnosis. The current best practice of medicine requires regular screening mammography, monthly breast exams by you the patient, and routine physical exams by your physician. Being vigilant and consistent about your breast health is the best way to identify problems at their earliest and most treatable stage.
I have breast implants. Is mammography still indicated for me?
While a mammography exam poses a risk of rupturing a breast implant, this is a highly unlikely complication. Current breast positioning techniques and the durability of the implants themselves allows for highly diagnostic breast exams. Since implants require special views, please notify our scheduling staff when making your mammogram appointment.
How do I know the results of my mammogram?
Within 24-48 hours of your mammogram, your referring clinician will receive the results of your mammogram. Additionally, you will receive a letter from us regarding your results.
I received a letter from Pueblo Radiology and it says I need additional views. Now what do I do? Do I have cancer?
When additional views are needed, it is usually because an area on your mammogram needs additional evaluation; this can be due to an overly dense area of your breast or superimposed tissues. 70-80% of additional studies reveal a benign, non-cancerous situation.
Why do they compress and squeeze my breast for a mammogram?
Compression is required to achieve the maximum diagnostic value of a mammogram. Compression helps to spread out the tissues of the breast and allows the radiologist to see breast structures more clearly. An additional benefit is that a compressed (and therefore thinner) breast requires less radiation to obtain a diagnostic study.
More Information:
Diagnostic Breast Ultrasound
Breast ultrasound is typically used in a focused manner to “problem-solve”, most often in conjunction with physical examination and mammography, and determine whether an abnormality on a mammogram is a solid or cystic tumor. Additionally, diagnostic breast ultrasound is used as a adjunct to mammography for cancer detection in dense breast tissue. As the image quality of ultrasound has continued to improve, the medical community’s awareness of the power of ultrasound in detecting subtle breast abnormalities has been heightened. The technology is very patient-friendly, in that the patient simply lies on their back while a licensed technologist passes the ultrasound probe over the breast(s). This directed, problem-solving type of exam takes approximately 15 - 30 minutes, requires no preparation by the patient, and is covered under most health insurance plans.
Once the images have been obtained, the radiologist reviews the images, as often as possible in comparison with your prior breast imaging studies. The radiologist summarizes the results on a written report which is then sent to your referring physician.
Minimally Invasive Interventional Procedures for Breast Disease
Pueblo Radiology offers several minimally invasive alternatives in the workup and treatment of a breast problem, which previously could only be dealt with by surgery.
For example, cysts were formerly diagnosed and treated with open surgical biopsy. Today, these are accurately diagnosed and treated by ultrasound evaluation and, if indicated, by cyst aspiration under direct ultrasound visualization to accurately guide the needle in to the cyst.
Solid masses are also accurately sampled without surgery. Using either X-ray or ultrasound for guidance, a needle can be introduced into a mass, tissue samples obtained for pathology and the diagnosis available in a day or two. Benign masses, such as a fibroadenoma, may be safely followed. Malignancies are treated surgically.
Diagnostic breast ultrasound and Ultrasound-guided biopsy are available at both of our offices.
Tiny clusters of calcifications, which sometimes indicate cancer, can now be sampled by a special needle attached to a stereotactic machine which uses digital spot mammograms (Xrays) for precise localization. This special equipment is located at the Breast Care Center at Goleta Valley Cottage Hospital.
Occasionally, a ductogram is indicated for evaluation of bloody nipple discharge. A tiny blunt tipped needle is introduced into the duct from which blood emerges. Contrast material, a type of dye, is introduced into the involved duct. Mammographic images of the duct are obtained and evaluated. This unique procedure is performed at the Breast Care Center.
Pre-operative wire localization of tumors can also be performed to aid the surgeon in accurately removing cancers and worrisome abnormalities.
Whole Breast Ultrasound (WBUS)
This dedicated breast screening / diagnostic tool is particularly useful in women with dense breast tissue and in those with breast implants.
Advantages of WBUS:
- No Radiation Used
- Minimal Breast Compression Required
- Excellent Image Quality, Multiplanar Reconstructions
- Ultrasound's Enhanced Ability to Detect Cancers in Dense Tissue at an Earlier Stage
Patients with these conditions should be considered for WBUS:
- Dense Breast Tissue
- Breast Implants
- Young Women
- High Risk Women
This service is available at our affiliate office, Santa Barbara Women's Imaging Center located at 1525 State Street, Suite 102, Santa Barbara, CA 93101; call 805-560-8111 for an appointment or more information.
Pueblo Radiology is the only area provider to offer a full complement of breast imaging services with mammography, computer-aided-detection (CAD), automated breast ultrasound, conventional ultrasound, breast MRI, ultrasound and MR guided breast biopsy, and stereotactic breast biopsy (at the Breast Care Center at Goleta Valley Hospital and Santa Barbara Women's Imaging Center).
For more information or to schedule an exam call Pueblo Radiology at 805.682.7744.
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