BREAST ULTRASOUND, MRI AND BIOPSY
If a breast abnormality is detected on a mammogram, other imaging procedures such as breast ultrasound and breast MRI are often used to get a better view of the abnormality. For example, ultrasound is useful in characterizing masses and lumps in the breast, while MRI helps detect and stage breast cancer.
Sometimes we find a lesion that requires a biopsy to find out what it is. Fortunately, the vast majority of breast biopsies can be accurately performed with a needle and do not require surgery. Depending on the finding, a needle biopsy is performed using either stereotactic (mammogram), ultrasound, or MRI guidance.
Ultrasound uses sound waves to generate a picture of the breast tissue. No compression is necessary. Ultrasound is particularly useful in telling cysts from solid masses in the breast. Cysts are very common and totally benign; about half of all women have some cysts in their breasts at some point. Ultrasound is also helpful in characterizing masses and lumps.
Women who require minimally invasive needle biopsy of the breast can be confident in the services provided by the highly skilled and experienced radiologists at Medical Arts. These imaging-controlled procedures may be performed with mammographic (stereotactic), ultrasound, or MRI guidance.
Biopsies are performed under local anesthesia as an outpatient procedure. The incision is small and requires no stitches. There is no deformity of the breast or scarring on mammograms after a needle biopsy, and complications such as serious bleeding or infection are extremely rare.
In most patients, lesions will prove to be benign, therefore making surgery unnecessary. Patients diagnosed with breast cancer by image-guided biopsy will require fewer surgeries than those diagnosed by surgical biopsy. Today, minimally-invasive image-guided breast biopsies have largely replaced surgical biopsies.
Stereotactic-Guided Breast Biopsy. The stereotactic table is specially designed so that you can lie face-down with one breast positioned through a hole in the table. Two digital X-ray images are taken from different angles, allowing the radiologist to precisely localize the area to be biopsied.
Once the area has been located, the radiologist numbs the area with a local anesthetic and uses computer guidance for precise needle placement and collection of small tissue samples.
Ultrasound-Guided Breast Biopsy. The radiologist uses ultrasound to locate the area for biopsy and to direct the needle used in collecting breast tissue samples.
Both methods are as accurate as a surgical biopsy and are performed on an outpatient basis, taking less than 40 minutes to perform and requiring no stitches. Furthermore, the patient can resume normal, non-strenuous activities immediately after the procedure is done. The samples are sent to the pathology lab for analysis. Results are usually available within 48 hours.
Breast MRI is an extremely helpful imaging tool in evaluating mammogram abnormalities and identifying early breast cancer, especially in women at high risk. MRI does not replace screening mammography. Instead, it provides a powerful supplementary tool for detecting and staging breast cancer.
MRI is a technique using a very strong magnet and radio waves to pick up signals from the breast tissue. We use state-of-the-art equipment including a dedicated bilateral breast surface coil.
The patient lies face-down within the scanning field for approximately 25 minutes. The primary way that abnormal tissue stands out on MRI is because it gets more blood flow than the remaining tissue. We can detect blood flow by taking images before and after infusion of an intravenous substance (gadolinium) that is easily seen on MRI. We utilize a special computer-assisted detection (CAD) program designed for the processing and interpretation of breast MR images.
Breast MRI is most useful in screening for breast cancer in high-risk patients and evaluating the integrity of implants. Breast MRI is also employed in patients with a known breast cancer in whom there is a question about how extensive the disease is.
Medical Arts Radiology has been at the forefront of breast MRI and interventional procedures. Our integrated team of physicians correlates the patient’s breast MRI with other studies including mammography and ultrasound to provide the most accurate diagnosis.
Since MRI detects some abnormalities that cannot be seen on mammography or ultrasound, it is critical to localize or biopsy these lesions using MRI-guidance. Medical Arts Radiology is one of the few sites in Long Island where physicians are experienced with MRI guided interventions, including wire-localization and minimally invasive MRI-guided needle biopsy.