Diagnosis

In some cases, women find a lump during self-exams or a physician discovers a lump during a clinical exam. Mammography, however, can detect evidence of a breast problem when no palpable lump exists.

To determine if cancer is present, a breast imaging radiologist or a surgeon performs a biopsy to remove cells from the suspicious area. A pathologist examines the tissue for the existence of cancer cells.

Biopsy samples also are examined for the presence of receptors for hormones such as estrogen and progesterone. If these hormones exist, they are referred to as ER-positive or PR-positive. Cancers with these receptors are more likely to respond to hormone therapy.

Imaging Tests

Additional imaging tests may be used to determine the spread of cancer and to develop an individualized treatment plan. These tests include:

• X-ray
• Bone scan
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)

Magnetic Resonance (MR) Guided Core Needle Biopsy

Using an MRI technology as guidance, the breast imaging radiologist removes small slivers of abnormal tissue for analysis. This outpatient procedure is conducted under local anesthesia. It involves a puncture wound that requires no stitches.

A breast imaging radiologist inserts a needle into the cyst to retrieve a sample of fluid. This outpatient procedure, performed under local anesthesia, can help determine if a lump is a cyst or a solid mass.

Needle Localization

Immediately before breast surgery, a breast imaging radiologist inserts a wire to mark the location of non-palpable breast abnormalities. This enables surgeons to precisely locate the abnormality during surgery. The wire is removed during surgery.

Stereotactic Core Needle Biopsy

This outpatient procedure is usually performed to examine indeterminate calcifications seen on a mammogram. It involves only a puncture wound that requires no stitches, and is done under local anesthesia. Using digital mammography as guidance, the breast imaging radiologist removes small slivers of tissue containing the calcifications for analysis.

Surgical Biopsy

Some women may need surgery (involving light anesthesia) to remove all or part of the lump to examine for cancer cells. This is performed by a breast surgeon.

Ultrasound Guided Core Biopsy

This outpatient procedure, which involves only a puncture wound to insert a needle, may spare some women from having a surgical biopsy. Guided by ultrasound, the breast imaging radiologist takes small slivers of tissue from the solid breast lesion for analysis. The procedure is done with local anesthesia.

For a complete list of imaging procedures available at Greenwich Hospital, visit Radiology Services.