• Digital Mammography
• Breast sonography (ultrasound)
• Breast MRI
• Bone densitometry (DEXA)
• Stereotactic breast biopsy
• Ultrasound core biopsy
• Fine needle aspiration

• Cyst aspiration
• Pelvic and abdominal ultrasound
• Thyroid ultrasound
• Thyroid biopsy
• Hysterosonogram
• Hysterosalpingogram

We are proud to announce that we have recently installed the Hologic Selenia Digital Mammography system.

Mammography is an x-ray exam of the breast using dedicated low dose radiation equipment. It is the only exam proven to reduce mortality from breast cancer because of its ability to detect early breast cancers before the patient or doctor can feel a lump. Mammography aids in the detection and diagnosis of breast diseases, both benign and malignant (cancer). During the procedure, the breast is placed on a small platform and compressed with a plastic paddle while it is exposed to a small amount of radiation. Yearly mammograms are recommended for women beginning at age 40. Women who are at increased risk of developing breast cancer, such as those with a strong family history of breast cancer, or pre-malignant conditions, should consult with their physician about when to start mammography.

Helpful Information on Mammography's

• Society of Breast Imaging Talking Points: USPSTF Screening Guidelines
• USPSTF Mammography Recommendations Will Result in Unnecessary Breast Cancer Deaths Each Year

Ultrasound or sonography produces images using high-frequency sound waves. During the procedure, the patient is positioned on an examination table and a warm, clear gel is applied to the area being examined. A transducer is then firmly pressed against the skin and swept back and forth to obtain the image.

Ultrasound of the breasts has been shown to be extremely effective in detecting tumors in women with dense breast tissue. Dense breast tissue is normal, but can limit the sensitivity of mammography. Ultrasound is therefore commonly recommended as a supplemental study.

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MRI, or Magnetic Resonance Imaging, is a radiation-free scanning technique that uses radio waves and magnetic fields to produce clear and detailed three-dimensional images of the body. MRI of the breasts has been shown to detect tumors than cannot be seen with mammography or sonography. The indications for breast MRI include:

• Women with dense breast tissue and a strong family history of breast cancer;

• Women who are at a high risk for developing breast cancer because of certain abnormalities in their breasts, including a past history of breast cancer;

• Women newly diagnosed with breast cancer, as an aid to planning surgery; and

• Women with suspected implant rupture.

Abnormalities identified in the breast may be tested with a needle biopsy rather than a surgical biopsy. Needle biopsies may be performed by different methods, using different specialized equipment, depending on the type of abnormality.

• Stereotactic Vacuum-Assisted Biopsy is performed with mammographic images guiding the procedure. The abnormal area in the breast is compressed in a manner similar to routine mammography. The area is cleaned and numbed with local anesthesia before a special needle is inserted into the breast. Tissue is removed swiftly and painlessly with suction. A tiny titanium clip may be inserted into the breast to mark the biopsy site in case surgery is required following the procedure.

• Ultrasound-Guided Needle Biopsies may be done with a variety of needles. Ultrasound is used to guide the biopsy when the abnormality is seen only on ultrasound or is most easily approached with ultrasound. The different biopsy procedures include automated core biopsy, vacuum assisted biopsy, and fine needle aspiration biopsy.

  • CORE Biopsy - The abnormal area is localized with ultrasound. Local anesthesia is given, a small incision is made, and the needle is inserted into the breast. Small samples of tissue are removed. A tiny titanium clip is occasionally inserted to mark the site.

  • Vacuum-Assisted Biopsy - Is similar to the core biopsy described above; however, the needle used for sampling the tissue is connected to a vacuum source, and suction is used to obtain slightly larger samples of tissue. A tiny titanium clip is occasionally inserted to mark the site.

  • Fine Needle Aspiration - In this procedure the abnormal area is localized with ultrasound. Unlike the other biopsy procedures, a skin incision is not made and the abnormality cannot be entirely removed. Local anesthesia is give and a tiny needle is inserted into the breast. In our office, slides are reviewed from the biopsy and a preliminary result is given to the patient immediately following the procedure.

  • Cyst Aspiration - This procedure involves draining fluid from a cyst (fluid-filled nodule), using a small needle and ultrasound guidance. Local anesthesia is administered.

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DEXA (Dual-Energy X-ray Absorptiometry) is a test used to determine whether one has osteoporosis (weakened bones susceptible to fractures). It is an enhanced x-ray image of the skeletal system that provides the most accurate measurements of bone density available. During the procedure, a beam of low-dose x-rays is targeted at the area, usually the lower spine and hips. The energy is measured as it is absorbed by soft tissue and by bone, and special computer software then processes the gathered information. Exams are painless and take 10-15 minutes.

Our specific DEXA unit enables us to visualize the entire spine, which may show signs of collapsed vertebral bodies. This is an extremely important piece of information, as women with even partially collapsed vertebral bodies are at an increased risk of developing fractures secondary to osteoporosis, even if their DEXA measurements are normal.

Nodules and lumps in the thyroid gland may be evaluated by ultrasound. Although most nodules of the thyroid are benign, a fine needle biopsy may be recommended. During a biopsy, local anesthesia is administered, and some cells are extracted from the nodule with a thin needle under ultrasound guidance. This sample is tested to determine if it is benign or malignant.

Hysterosalpingography, or HSG, is an x-ray exam of the uterus and fallopian tubes using a contrast dye injected through the cervix into the uterus. The test is usually performed to detect abnormalities or blockages of the fallopian tubes.

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