Procedures

Screening Mammography

Every woman is at risk for breast cancer and her risk increases with age. According to the American Cancer Society, women with no symptoms of breast cancer should have a screening mammogram every year starting at age 40. Women with a lump or other symptoms of breast cancer should see a physician immediately.

Spartanburg Regional is certified as a Softer Mammogram Provider®. That means we provide a soft foam cushion, called MammoPad®, for each woman's personal use during every screening mammogram.

The MammoPad breast cushion was designed for women by a female breast surgeon. It is FDA-cleared, does not impair image quality, and makes it easier for you to be relaxed, warm and comfortable during your exam. That helps our skilled mammography technicians achieve the best possible mammogram.

Your mammogram will be read by board-certified radiologists utilizing computer-aided detection software. A board-certified radiologist is a physician who has special training in interpreting mammograms and other radiological procedures.

You should bring a physician’s order with you the day of the your appointment. This ensures the results are forwarded to the proper doctor once the radiologist has read the mammogram.

Diagnostic Mammography

Diagnostic mammography is an x-ray exam of the breasts that evaluates a breast problem or abnormality detected by physical exam or routine screening mammography. Diagnostic mammography is different from screening mammography in that it is utilized to evaluate a specific area of concern.  With this procedure detailed imaging views are taken of the identified problem to determine if there is a mammographic concern.  Typically, a diagnostic mammogram appointment is scheduled for about an hour since the radiologist is reviewing the images and guiding the technologist if additional images are needed while the patient is present.

The goal of diagnostic mammography is to pinpoint the exact size and location of breast abnormality and to image the surrounding tissue and lymph nodes. In many cases, diagnostic mammography will help show that the abnormality is highly likely to be benign (non-cancerous). When this occurs, the radiologist may recommend that the woman return at a later date for a follow-up mammogram, typically in six months. However, if an abnormality seen with diagnostic mammography is suspicious, additional breast imaging (with exams such as ultrasound) or a biopsy may be ordered. Biopsy is the only definitive way to determine whether a woman has breast cancer.

Breast Ultrasound

Ultrasound, also called sonography, is an imaging technique in which high-frequency sound waves that cannot be heard by humans are bounced off tissues and internal organs. Their echoes produce a picture called a sonogram. Ultrasound imaging of the breast is used to distinguish between solid tumors and fluid-filled cysts. Ultrasound can also be used to evaluate lumps that are hard to see on a mammogram. Sometimes, ultrasound is used as part of other diagnostic procedures, such as needle biopsy. Needle biopsy is the removal of tissue with a needle for examination under a microscope to check for signs of disease.

Ultrasound is not used for routine breast cancer screening because it does not consistently detect certain early signs of cancer such as microcalcifications (tiny deposits of calcium in the breast that cannot be felt but can be seen on a conventional mammogram). A cluster of microcalcifications may indicate that cancer is present.

Breast MRI

In magnetic resonance imaging (MRI), a magnet linked to a computer creates detailed pictures of areas inside the body without the use of radiation. Each MRI produces hundreds of images of the breast from side to side, top to bottom and front to back. The images are then interpreted by a radiologist.

Breast MRI is not used for routine breast cancer screening, but clinical trials (research studies with people) are being performed to determine if MRI is valuable for screening certain women, such as young women at high risk for breast cancer. MRI cannot always accurately distinguish between cancer and benign (noncancerous) breast conditions. Like ultrasound, MRI cannot detect microcalcifications.

MRI is used primarily to evaluate breast implants for leaks or ruptures, to assess abnormal areas that are seen on a mammogram or are felt after breast surgery or radiation therapy. It can be used after breast cancer is diagnosed to determine the extent of the tumor in the breast. MRI is also sometimes useful in imaging dense breast tissue, which is often found in younger women, and in viewing breast abnormalities that can be felt but are not visible with conventional mammography or ultrasound.

Image-guided Breast Biopsy

Imaging techniques play an important role in helping doctors perform breast biopsies, especially of abnormal areas that cannot be felt but can be seen on a conventional mammogram or with ultrasound. One type of needle biopsy, the stereotactic-guided biopsy, involves the precise location of the abnormal area in three dimensions using conventional mammography. (Stereotactic refers to the use of a computer and scanning devices to create three-dimensional images.)

Needle Localization

When a suspicious area is detected on a mammogram, it can often be too small to feel on physical exam. In order for the surgeon to remove the correct area of breast tissue, he or she may need a guide to show the exact location of the lesion. This procedure is performed by mammography guidance or ultrasound.  On the day of surgery the patient will come to the Breast Imaging department were the radiologist will localize the area of interest with a needle and then insert a wire through the localizing needle. The patient will go to surgery with this wire intact so that the surgeon can follow the wire to remove the area of concern.