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Women's Health & Imaging

WOMEN'S HEALTH & IMAGING

MAMMOGRAPHY ACR ACCREDITED (MAMMOGRAM)

Mammography is the single most effective method for detecting breast cancer in its earliest stages. The American Cancer Society recommends a baseline study at 35-40 years of age; then every year for women over 40 years of age. The three key elements to early detection are: monthly self-exam, annual clinical exam by your physician and a mammogram at the recommended intervals.

A mammogram is a special image of the breast tissue. It is performed by qualified personnel on equipment designed specifically for this purpose. The lowest possible amount of radiation exposure is used to produce the highest quality imaging.

A routine mammogram is performed with images of both breasts obtained from different angles. In order to separate the complex structures in the breast, fairly significant compression must be used. Although this may be uncomfortable, it should not be painful. Many of our imaging locations use "soft MammoPads" to make your mammogram more comfortable. Communicate with your technologist to let her know how you are feeling. Keep in mind that more compression means a more detailed and accurate study. Questionable areas seen on the routine mammogram are usually benign (not cancer). The question can be resolved in a number of ways. The best way is to compare the current study to a previous mammogram. Thus, it is very important for you to help the facility locate any previous mammogram images from other locations. If the radiologist thinks the questionable area is just a combination of shadows, we can ask for a spot compression or additional views, which often separates the tissues and clarifies the region. At times the radiologist may recommend an ultrasound of the breast to evaluate a nodule. The ultrasound helps to determine if something is a solid mass or a fluid filled mass. Spot compression, magnification and ultrasound recommendations usually require a return visit for completion.

BREAST CYST ASPIRATION / CORE NEEDLE BIOPSY

Breast Cyst Aspiration is a simple procedure to remove cyst fluid with mammography or ultrasound guidance.The site is cleaned, the cyst or nodule is located, a needle is placed into the cyst or nodule and tissue or fluid is removed.

PREPARING FOR THE EXAM

There is no preparation.

DURING THE EXAM

When you arrive, you will be asked to change into a gown. The aspiration site is cleaned with alcohol and topical anesthetic is applied. The radiologist will locate the cyst using mammogram or ultrasound guidance, and then will insert a small needle into the breast through the cyst wall. The cyst fluid is drained into a syringe while the radiologist uses the ultrasound or mammographic image to ensure that as much fluid as possible is removed. The cyst fluid may be sent for further laboratory studies.

A Band-Aid is applied to the skin after the aspiration and the patient can usually return to her normal activities.

BREAST NEEDLE LOCALIZATION

This procedure is performed using ultrasound or mammography to localize a lesion in the breast that cannot be felt (non-palpable). This is done by placing a thin wire with a hook on the end into or near the lesion in question so that the surgeon can easily find it during surgery. The wire is passed through the needle and the needle is removed. The wire is secured to the skin after it is placed. The patient is then sent for surgery.

PREPARING FOR THE EXAM

Follow the instructions from your surgeon. Wash your breasts and underarms and do not apply any deodorant or talcum powder which can cause artifacts on the xray images.

DURING THE EXAM

Just prior to surgery, you will arrive at our facility. You will be asked to change into a gown. The radiologist will locate the abnormality on a mammogram or with ultrasound. Under mammogram or ultrasound guidance, the radiologist inserts a fine needle so the tip rests in the suspicious area. A wire and / or dye is injected and then the needle is removed.

PELVIC / OB ULTRASOUND

This procedure is painless and does not expose you to radiation. The image is created using high frequency sound waves to view uterus, ovaries and/or pregnancy.

The preparation that you go through is of vital importance to the outcome of your examination.

PREPARING FOR THE EXAM:

You will be asked to completely drink five (5) 8 oz. glasses of non-carbonated liquid one hour prior to the exam. Do not empty your bladder.This exam cannot be performed unless your bladder is full. At the beginning of the exam, you will be asked to lie still on a table. A gel will be applied to the area being scanned and a transducer will pass lightly across your lower abdomen. A series of images will be taken after which you will be allowed to empty your bladder. A vaginal ultrasound may also be performed depending on your medical condition. In this case, a female technologist will help you insert a small transducer, much like a tampon, into your vagina Then sound waves will be transmitted and picked up in the same manner as the initial part of the exam. A report will be sent to your physician.

BONE DENSITOMETRY

Bone densitometry is for the evaluation of bones for osteoporosis. This procedure is painless. The most common examination sites are the hip and the spine.

Evaluation also includes measurement of height and weight, a thorough history and risk assessment. No preparation is required, however if you have had an imaging procedure for which IV contrast, barium or an isotope was administered, your bone densitometry evaluation will have to be scheduled at least seven days after that procedure. You are allowed to continue taking any medication that has been prescribed for you. You will be asked to lie still on a table during the examination. A scanner arm will move back and forth above you. A series of images will be taken. A report will be sent to your physician.

HYSTEROSALPINGOGRAM

An HSG (hysterosalpingogram) is an image of the inside of your fallopian tubes and uterus. This imaging exam is most often performed as part of an infertility workup. First you are asked to lie on an xray table with your knees bent and the procedure begins much like a PAP test. Then a thin tube is inserted through the cervix and contrast (dye) is injected into the uterus through the tube. Images are taken and displayed on a monitor. An HSG usually takes 10-20 minutes. You can probably return to work right after your HSG. You may have some cramping and a thick discharge for a few hours. Use sanitary pads, not tampons, until the discharge is gone. Follow the instructions of your healthcare provider following the procedure Call your healthcare provider right away if you have bleeding, pain in your abdomen or a temperature above 100 degrees F. Your doctor will discuss the results of your HSG with you after the radiologist has looked at all the images.

GALACTOGRAPHY

Galactography is a procedure done to view the shape of and any internal structure of the mammary ducts. It is done to evaluate a duct or ducts that are actively draining fluid or blood. The test requires active draining or very recent draining in order for the radiologist to localize the openings which are barely visible when normal.

The radiologist will examine the breast for visible duct openings. He will disinfect the skin of and around the nipple. Then a very thin tube (catheter) will be inserted a short distance into the dilated duct and contrast (dye) will then be injected with very little pressure. There may be some mild discomfort. A mammogram is then performed on the breast. This will be done for each dilated opening. The radiologist will view the images and a report will be sent to your physician.

 


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