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Breast imaging when you don’t have symptoms
A screening mammogram is a test designed to detect breast abnormalities in women before they are aware of a lump or any other symptoms. Early detection significantly increases survival, and is associated with less extensive treatment. You will be asked about your family history as this can be an indication of the likelihood of developing breast cancer.
You can self-refer for this procedure or you may be referred by your GP if you meet the following criteria:
- 40 yrs and over
- No mammogram within 12 months
The only universally accepted and effective method of breast screening for normal risk women over the age of 40 is by the use of an X-ray examination called a mammogram. This test uses a low dose of radiation to create a highly detailed image of the breast tissue.
Using state of the art high resolution digital technology, images of superior quality are created and then read by the Breast Radiologist to diagnose any abnormalities, and compared to any previous mammogram images that the patient may have had.
This is the process of using digital technology to produce a three dimensional (3D) view of the breast tissue. The Radiologist can “scroll” through the resultant images of the breast tissue without any overlapping (unlike conventional 2D images) This provides the Radiologist with more information and a greater accuracy of diagnosis
Breast imaging when you are showing symptoms
If you have found a lump or any other concerning symptoms in your breast, your doctor will advise the following process:
- Triple assessment led by Breast surgeons
- Depending on your age your doctor may undertake a mammogram (as above), an ultrasound, and/ or a core biopsy
- Tomosynthesis (As above)
- Access to MRI scans if required
An Ultrasound scan is performed when a change in the breast tissue is felt, or when an abnormality is detected on the mammogram. This modality is often performed in conjunction with Mammography and can be used if the breast tissue is dense, or if the patient is under the age of 40.
The Breast Radiologist uses a hand held transducer which is slowly moved across the breast; high frequency sound waves are emitted which, in turn, create a detailed image on a monitor. There are no known risks.
Your biopsy will be performed by the Radiologist usually using Ultrasound or possibly mammography guidance. While exam or imaging tests may suggest that breast cancer is present, tissue samples are ultimately needed to make the diagnosis, as well as determine the type of cancer and other characteristics.
Whichever type of imaging is utilized to guide the biopsy, the current standard of care at the completion of a biopsy is often the placement of a biopsy site marker. The marker is very small and the and the metal component is about the size of a sesame seed. This biopsy clip serves as a marker documenting where the tissue was sampled in the breast.
Ultrasound-guided breast biopsy does not involve exposure to ionizing radiation like x-ray (mammography) does. It is less invasive and usually leaves little or no scarring.
Ultrasound Guided Core Biopsy
After local anaesthetic is injected using a very small needle into the overlying skin and then breast at the site of the sampling, the Radiologist uses the ultrasound images to guide a biopsy needle to the concerning area. Subsequently a small amount of tissue is taken from this area of the breast. Several samples may be taken to ensure that a sufficient amount of tissue is tested. These samples are then sent to our Pathology lab for thorough and detailed examination. The results will be available usually within 48 hours, although this can be longer on occasions as sometimes the results have to be verified at a multidisciplinary team meeting.
Fine Needle Aspiration
This involves inserting a thin needle through the skin in order to collect a sample of cells or fluid. It is particularly helpful in distinguishing fluid-fileed cysts from solid masses. This procedure is performed by the Radiologist using the ultrasound machine to guide them.
Vacuum-Assisted Core Biopsy/Excision
The vacuum-assisted biopsy-excision technique is performed under local anaesthesia using either ultrasound or mammography equipment.
It is a tissue sampling technique using imaging guidance to remove slightly larger samples of breast tissue through a single, small incision in the skin. It is often a second line test and can be done instead of surgery to remove very tiny lumps in just a few minutes.
The Radiologist gently rotates the needle which aids the removal of the breast tissue; the suction of the biopsy machine is quite noisy, but the actual biopsy process does not take long. The tissue sample is collected and sent to the laboratory for testing. A 2 mm marker clip is routinely placed at the site of the biopsy. This is to ensure that we can identify the area that was sampled and return to the site if required. If we do not require to return to the site the marker clip remains within the breast with no adverse effects
Re-call from NHS routine screening
If you have recently been recalled via the NHS Breast Screening Program for further assessment but decide to have your assessment performed at Enhanced Breast Screening at OneWelbeck we can facilitate this. With your permission, we will request your previous screening imaging via the Image Exchange Portal (IEP) prior to your visit. We can offer full further assessment as clinically appropriate, using further tests such as tomosynthesis, magnification views, ultrasound scan, and needle biopsy if required. Biopsy results are usually available within 48 working hours.
During treatment for Breast Cancer
If you are having chemotherapy as treatment for breast cancer, it is recommended to have an ultrasound every 3-6 months to measure the progress of your treatment. At OneWelbeck, we can carry these out for you and provide the results to your consultant.
After treatment for Breast Cancer
Annual surveillance imaging
After treatment for Breast Cancer, it is recommended that you have regular imaging once a year to check that your symptoms have not returned. We can provide these scans and send the results to your consultant as necessary.