Breast Imaging

DIGITAL MAMMOGRAPHY | BREAST ULTRASOUND | BRCA SCREENING | BREAST CYST ASPIRATION

Digital Mammography

Digital mammography uses computers and specially designed digital detectors to produce an image that can be displayed on a high-resolution computer monitor, and transmitted and stored just like computer files. It is very much like having a conventional screening with compression and x-rays used to create a clear image of the inside of the breast. However, unlike film-based mammography, digital mammograms produce images that appear on the technologist’s monitor in a matter of seconds. The radiologist, using special high-resolution monitors, can adjust the brightness, change contrast, and zoom in for close ups of specific areas of interest. Digital mammography can greatly reduce the need for retakes due to over or under exposure which potentially saves additional time and reduces your exposure to x-rays.

Breast Ultrasound

Breast ultrasound (us) is an extension of the physical exam: instead of placing one’s hands on an organ or mass to feel it, the US probe (transducer) is placed on the skin over the breast making an image of it by bouncing ultra sound waves off the surface of the anatomy and receiving the reflected waves which are processed by a computer into a picture. Gel is applied to the skin to exclude air from the transducer-skin interface since US waves do not pass through air. The closer we can place the US transducer to the anatomy, the better we can see it, which is why superficial organs like the breast and thyroid are well visualized. US has some special properties which make it well-suited to differentiate solid from fluid filled structures such as tumors from cysts. US waves also travel well through dense tissue unlike X-rays which is why it is a good compliment to mammography in which dense breast tissue may obscure a mass.  To learn more about breast density and what it means go to http://www.rudense.org/

BRCA Screening

An initiative to effectively identify patients who are genetically at high risk for developing breast cancer has been the focus of Waterbury physician task force and is ready for implementation throughout the Waterbury area. The task force consists of representatives from obstetrics/gynecology, breast surgery, medical oncology, radiation oncology, pathology and radiology.

Identifying high-risk patients is important because genetic counseling, genetic testing (for BRCA and other mutations), special screening (such as annual breast MRI), or other preventative interventions may be indicated for these patients. In the past there has been no consistent, efficient way to identify our high-risk patients in Waterbury. The task force has recognized that our female patients are seen routinely most often by the radiology practices in Waterbury, at the time of annual mammography, and that this would be an ideal time to identify the patients who are at special risk for developing breast cancer.

At DRA we have always asked patients to fill out a questionnaire at the time of mammography, but this form has now been expanded to include more questions about the patient’s personal and family history. These questions are meant to identify patients at a higher risk of developing breast cancer, and whose blood relatives may also be at increased risk. Those patients will be so informed and will be given a recommendation to have genetic counseling, along with a list of available counselors in the area.

Our program is meant to help provide better identification and better subsequent care for Waterbury area resident who are at high risk of developing breast cancer. If you have questions or concerns, please feel free to contact DRA’s Breast Imaging Coordinator, Felicia A. Ferry, RT(R)(M)(CBPN-I) at 203-756-8911.

Breast Cyst Aspiration

Your physician has requested that you undergo aspiration of a breast cyst. Breast cysts are initially seen as round densities on a mammogram. Cysts cannot accurately be diagnosed by mammography, as they cannot be distinguished from other well-defined masses. When a new or larger well-defined mass is seen mammographically, an ultrasound study is recommended to establish whether a mass is cystic or solid in nature. In some instances, ultrasound imaging is still unable to clearly show whether the mass is fluid or solid and a breast cyst aspiration is ordered. If fluid is removed from the mass and it disappears then it is considered a cyst.

Breast cysts are found in women of all ages and may be solitary (one) or multiple. Breast cysts are not uncommon and 20 to 50 percent of women have breast cysts.

There is no formal preparation prior to the procedure. You may eat and take your medication before coming to the office. If your previous breast imaging (mammogram/ultrasound) was performed at a location other than DRA or Waterbury Hospital, please be sure to bring the images with you.

A breast cyst aspiration is performed using ultrasound imaging to guide a fine needle into the cyst(s). Prior to insertion of the needle, the area will be checked with ultrasound to confirm the location of the cyst. The skin over the cyst will be cleaned and local anesthesia will be used to make the procedure more comfortable. The samples collected may be sent to a laboratory to be analyzed by a pathologist. The entire procedure should take an hour. There are no restrictions after the procedure. Your ordering physician will receive the results in one to two business days and will discuss the results with you. If you do not hear from your physician within 5 business days, please contact his or her office. If you have questions or concerns prior to, or after the procedure, please contact DRA.

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