Ultrasound uses sound waves instead of X-rays to exam breast tissue. A transducer is passed over the breast. The transmitted sound waves are translated into a picture on a monitor. It does not cause discomfort and because it does not use radiation, it carries very little risk.

Ultrasound is useful for women with dense breasts or for evaluating suspicious areas seen by mammography or felt during a breast exam. It can also find breast lesions that are close to the chest, where mammography is less useful. Breast ultrasound can distinguish between cysts, which are filled with fluid, and other types of breast lumps.

What happens during an ultrasound procedure?

You will put on a gown, and the technologist will have you lie down on the ultrasound table. He or she will apply a warm, water-based gel to the breast, to block any air between the skin and transducer and to eliminate friction on the skin.  The gel also helps the hand-held transducer transmit the sound waves. The procedure takes only 15 to 20 minutes. If you are wearing a two-piece outfit, you can undress only above the waist.

Your provider may request a breast biopsy if a lump or abnormality is found during screening. A biopsy is a very accurate, minimally invasive method of locating and removing tissue for further investigation. Image-guided biopsy allows patients to avoid hospitalization and general anesthesia (previously necessary with traditional surgical biopsy). It is a valuable method of getting a fast, accurate, conclusive diagnosis—without unnecessary time, pain or expense to the patient.

Depending on your medical needs, we provide different diagnostic biopsy procedures:

• Stereotactic biopsy uses mammography to precisely guide clinicians to a lump or abnormality that can’t be felt or seen on ultrasound.  Clinicians see a 3D picture of the lump’s exact location.
• MRI-guided biopsy uses MRI to guide the radiologist to the exact location of the lump. MRI biopsy is usually used when the lump can be seen on breast MRI, but cannot be readily seen on mammogram or ultrasound.

What happens during a biopsy procedure?

While the biopsy is performed, you will either remain seated in a comfortable, upright position or you will lie face down on a special table that allows your breast to be placed in an opening. The radiologist performs a core needle or vacuum-assisted biopsy (see below) while your breast is somewhat compressed in the mammographic biopsy system. You can return home in 30 minutes.

• Vacuum-assisted biopsy devices are used for stereotactic and MRI guided biopsy and selected ultrasound guided biopsies. The device is a special probe that applies suction and allows retrieval of more tissue. Breast tissue is drawn into the sampling chamber of the probe with the vacuum and then cut. Several pieces of tissue are always obtained during biopsies, regardless of the type of needle used.
• In a core needle biopsy, the radiologist locates the lump or abnormality that can be seen on a mammogram, sonogram or MRI. A hollow core needle is then placed inside the abnormality. The needle will then withdraw a small amount of tissue that will be sent to a lab for analysis. Prior to the procedure, you will be given some local anesthetic similar to the anesthetic used for dental procedures to numb the area. You may feel some pressure and mild discomfort but most patients do not feel pain. The doctor will insert the needle several times to get adequate tissue samples. After the procedure, you can resume normal activities immediately. You may experience some slight bruising but should not have a scar. It may take several days to one week to obtain results from the lab.

Some women — because of their family history, a genetic tendency or certain other factors — should be screened with MRI in addition to mammograms.(The number of women who fall into this category is small: less than 2 percent of all the women in the US.) Talk with your doctor about your history and whether you should have additional tests.

Breast MRI helps to detect small lesions sometimes missed by mammography — without using radiation or compressing the breasts. MRI uses powerful magnets and radio waves to take very clear pictures of soft tissues, so it can be extremely useful in breast imaging. However, it is not used routinely to look for breast cancer because it tends to have a high rate of “false positives.” That is, MRI finds lesions that often turn out not to be cancerous.

It is also much more expensive than mammography or ultrasound. While MRI’s sensitivity makes it a valuable tool for certain groups of women, it should be used selectively so that it doesn’t create unnecessary worry or needless breast biopsies for women who aren’t at high risk.

Who is a candidate for Breast MRI?

You should always consult your doctor. Appropriate candidates for this test include women with:

• Two or more close (first or second degree) relatives with breast or ovarian cancer.
• Carriers of BRCA1 or BRCA2 mutations.
• Past radiation to the chest.
• Suspected rupture of breast implants.
• Selected cases of known breast cancer.
• Selected cases of inconclusive mammography or ultrasound findings.
• Cancer in a lymph node (gland) under the armpit but the origin of cancer is unknown.

What Sets Valley Radiology Apart?

We combine the most advanced technology, skilled radiologists and compassionate care to provide highly accurate breast MRI to patients who are appropriate for this procedure. We perform thousands of breast MRIs each year. Our specialized radiologists are highly experienced in interpreting breast MRIs, and we use experienced, certified technologists. Our equipment also makes a difference; we use high field strength magnets (1.5 Tesla or greater) with special software to provide the most advanced detection of cancerous lesions, and advanced VIBRANT technology to image both breasts at the same time without a loss in quality.

What happens during a breast MRI procedure?

Because the MRI uses a powerful magnet, our staff will first carefully screen you to make sure that you don’t have any ferromagnetic metals on or in your body that could interfere with the magnet. For your safety, it is essential that you inform staff of any such objects. Just prior to the procedure, the technologist will insert an IV catheter into a vein in your arm which will allow the injection of contrast material during the MRI.

During the procedure, you will lie face down on a special scanning table with your breasts suspended into special depressions that contain the breast imaging coils. The table will move into the MRI magnet and a series of images will be taken in less than an hour. You will be asked to lie still while images are taken.

The technologist will provide you with earplugs to reduce the noise, but you will be able to communicate with him or her throughout the procedure. After several initial images are taken, the technologist will inject contrast material into your body to determine if any tissue “enhances,” or gets brighter. Enhancing tissue helps clinicians find a cancerous lesion. After the procedure, you may resume normal activities right away.