Knoxville Comprehensive Breast Center offers precise delivery of breast health care. The pinnacle of this delivery is the service that our Clinical Breast Radiologists provide. These physicians are Board Certified Radiologists who specialize in breast imaging and its clinical correlation. At other breast health care centers the breast examinations, screening mammography and other tests are performed by different physicians resulting in fragmented care, with an increased likelihood that information is lost and increased health care costs. This is simply not the case at Knoxville Comprehensive Breast Center.
Digital Diagnostic Mammography
The Digital Diagnostic Mammography is used to investigate suspicious breast changes such as a breast lump, breast pain, an unusual skin appearance, nipple thickening or nipple discharge. It's also used to evaluate abnormal findings on a screening mammogram.
A marker is placed over any area of concern by the technologist prior to performing the mammogram. Additional specially focused views may be performed as needed under the direction of the Clinical Breast Radiologist. Patients with an abnormal screening mammogram or an abnormal mammogram from an outside institution also will be scheduled for a diagnostic visit. The Clinical Breast Radiologist may request additional specialized mammographic views to supplement the standard mammogram. The radiologist also determines whether additional information from ultrasound or needle biopsy is necessary.
Because of the direct involvement of the radiologist, diagnostic mammography is performed on site at the Knoxville Comprehensive Breast Center.
Benefits Demonstrated for Specialized Mammogram Interpretation
A recent study (Radiology September 2002) confirms what radiologists have suspected: specialized breast radiologists detect more breast cancers and more early-stage cancers than their general radiologist counterparts. The specialists are able to do this while recalling fewer patients after screening mammograms. These results were expected, given that specialized breast imagers (such as Dr. Kozlowski and Dr. Wunderlich) read more mammograms and breast ultrasounds per year. Many breast radiologists read more mammograms in one month then the number of mammograms required to be read by radiologists in one year by the FDA. Breast radiologists do more needle biopsies and obtain direct pathologic correlation of what they have seen on the imaging study. Additionally, they attend more breast imaging conferences. Many breast centers do not have mammography-specialized radiologists; it is important to identify the general radiologist with a special interest in mammography.
Related Links & Additional Resources:
Imaginis.com: Digital Mammography
American Cancer Society: New Study to Compare Film and Digital Mammography Method
American Cancer Society: Mammograms and Other Breast Imaging Procedures
Ultrasound
The Clinical Breast Radiologists of the Knoxville Comprehensive Breast Center make extensive use of high resolution breast ultrasound in many situations. It is invaluable in evaluating children, teenagers and young women who have lumps without exposing them to radiation while their breasts are developing. At KCBC, we regularly find masses in women with mammographically dense breasts, which are obscured on the mammogram. Questioned physical findings and mammographic findings are often clarified with breast ultrasound by our experienced staff. Ultrasound is also useful in evaluating lumps in the underarm or the post-mastectomy chest wall, areas not accessible to x-ray. Ultrasound is more sensitive than the mammogram in demonstrating silicone leaks from implants. The Clinical Breast Radiologists make extensive use of ultrasound for accurate guidance of needles for cyst aspirations and needle biopsies.
While breast ultrasound is now being practiced more widely, it is highly operator dependent. Our staff has had extensive training and experience in the application and interpretation of high resolution breast ultrasound and performs it regularly. Our sonographers' diagnostic abilities are enhanced by their performance of a physical examination and knowledge of the mammographic findings prior to scanning the breast. This enhances our ability to find subtle lesions. Furthermore, our Clinical Breast Radiologists' extensive experience in correlating imaging findings with the pathology findings of our needle biopsies enhances their diagnostic abilities in interpreting the ultrasound studies.
MRI
An AURORA® Dedicated Breast MRI System was installed in October 2002 at the Knoxville Comprehensive Breast Center. This FDA approved unit is one of only six in the entire country. The Dedicated Breast MRI is specifically designed for a woman’s anatomy. Both breasts are screened simultaneously versus the single breast method of a traditional MRI. The table allows feet first entry, which reduces the anxiety commonly associated with MRI screenings.
This tool will further enhance the early detection of breast cancer. It will be particularly helpful for women who have equivocal breast imaging studies and women who are at high risk for breast cancer. It will also be valuable for women who have been recently diagnosed and treated for breast cancer to answer questions about possible residual malignancy. Additionally, breast MRI is one of the most sensitive techniques in evaluating possible rupture of silicone implants and will be useful in evaluating women with questioned implant abnormalities.
What is Magnetic Resonance Imaging?
MRI is a sophisticated technology that uses a computer, magnetic field and radio waves - instead of x-rays - to produce images of the soft tissues in the body. MRI has been safely used for decades to provide information to help in the early diagnosis and treatment of disease. MRI of the breasts has emerged as a new technique in the evaluation of breast disease. When used in conjunction with conventional x-ray mammography, breast MRI can provide valuable information for the detection and characterization of breast disease. MRI doesn't replace mammography - it's a different imaging technique that provides additional information.
What is a Breast MRI Exam like?
The Aurora is designed specifically for your comfort as a woman. During the exam, you will lie on your stomach with your breast placed in openings in the Aurora examination table so that they are suspended away from your chest. Unlike conventional x-ray mammography, breast MRI doesn't require your breast to be compressed, so you shouldn't experience any discomfort. Plus, you'll enter the machine feet first, which reduces feelings of claustrophobia sometimes associated with full-body MRI scanners. You'll receive an injection (usually in the arm) of a contrast enhancement agent called gadolinium that helps to highlight various structures in breast tissue. The gadolinium is administered through a small intravenous catheter which is placed by a certified technologist. An initial scan will be taken and then repeated after the gadolinium is administered. For best results, you should lie very still, relax and breathe normally. The technologist can see and hear you at all times. The entire exam takes about 45 minutes.
Nationally recognized breast centers currently perform breast MRI for a number of reasons including:
- Diagnosis of breast implant rupture
- Surgical planning
- Staging of breast cancer and treatment planning
- Post-surgery and post-radiation follow-up
- Dense breast tissue evaluation
- Monitoring of high-risk patients with a non-radiation alternative
How do I prepare for the test?
No special preparation is required. You can eat and drink as you normally would, engage in regular activities, and take any prescription medication. Plan to arrive about 30 minutes before your appointment time. You'll be asked to change into a gown since belts, zippers, snaps and thread in clothing may contain metal that disturb MRI signals. We'll ask you questions before you enter the MRI exam room to confirm that you don't have any metal in or on your body. You'll have to remove all metallic objects such as jewelry, glasses, hairpins and dentures (personal belongings can be locked in a locker). Please be sure to tell the technologist if you have metal implants, a cardiac pacemaker, permanent dental bridges, braces or other metal objects.
What about after the test?
There are no side or after-effects with MRI, so you can resume your normal activities as soon as your exam is over. The radiologist will interpret your MRI scan and report the findings to your doctor.
Does Insurance cover Breast MRI?
Most major insurance carriers cover Breast MRI. If your health plan requires you to have a written referral for this type of exam, please be sure to obtain necessary paperwork prior to your appointment so that we can bill your carrier directly.
Additional Resources:
Aurora Imaging Technology, Inc. is committed to expanding the fight against breast disease by advancing breast imaging. As a diagnostic tool, the AURORA® Dedicated Breast MRI System is ideal for a wide range of indications in breast disease management. visit site