Breast Care Center
The Breast Care Center at UofL James Graham Brown Cancer Center is proud to have received the “Breast Imaging Center of Excellence” designation by the American College of Radiology. This means that our breast imaging services meet the highest standards of the radiology profession.
As part of Kentucky's first accredited Breast Center through the Nationally Accredited Program for Breast Centers (NAPBC), our Breast Care Center has been the gateway for a multidisciplinary approach to breast cancer diagnosis and treatment for nearly a decade. We provide convenient, comprehensive outpatient screening, diagnostic and interventional services for patients.
Why is it important to go to a dedicated breast center like the Breast Care Center at UofL Brown Cancer Center?
Both screening and diagnostic mammograms, and other related breast cancer screening and diagnostic procedures, are available.
- Expertise: Each of the radiologists are fellowship-trained in Breast Imaging and practice solely in the breast imaging subspecialty.
- Excellence: Our subspecialty trained physicians perform every ultrasound examination. At many facilities an ultrasound technologist will perform the ultrasound and send results to the radiologist on site or even at another location.
- Convenience: Results and recommendations of your diagnostic exam will be given to you in person by the radiologist at the end of your visit. If a biopsy is needed, it will be scheduled prior to you leaving the center.
- Communication and Collaboration: We use a multidisciplinary approach. This means that a comprehensive team of clinical experts from Surgery, Medical Oncology, Radiation Oncology, Plastic Surgery, Radiology and Pathology evaluates each new breast cancer case weekly and jointly develops a customized treatment plan for each person.
- State-of-the-art diagnostic and interventional technology including: 3D mammography (tomosynthesis), digital mammography, ultrasound, breast MRI (3T and 1.5T). Procedures performed include: ultrasound biopsy, stereotactic biopsy, MRI biopsy, galactography, cyst and fine needle aspirations, wire and seed localizations, and clip placement.
The Breast Care Center offers:
Patients can self-refer for screening mammograms, and don’t need a referral from a physician. Screening mammograms are routinely administered to detect breast cancer in women who have no apparent symptoms.
Women should begin annual screening at age 40. Women at a higher risk for breast cancer due to hereditary or personal risk factors may need earlier or additional screening.
Diagnostic mammograms require a referral from a physician. They are used when results from a screening mammogram come back suspicious of possible cancer or after some signs of breast cancer alert the physician to check the tissue, such as a lump, breast pain, nipple discharge, thickening of skin on the breast, changes in size or shape of the breast.
Digital breast tomosynthesis, otherwise known as “tomo” or 3D mammography, is available at UofL Brown Cancer Center’s Breast Care Center. It is offered as an addition to 2D screening mammography. It has been shown to increase cancer detection rates (particularly for invasive cancers) up to 15 percent, and reduce recall rates up to 30 percent compared with standard 2D digital mammography alone.
The Breast Care Center works in conjunction with the Kentucky Cancer Program to offer the Mobile Screening Unit, providing the community access to prevention and early detection programs for several different cancers including cervical, colon, lung and breast cancers. The Mobile Screening Unit has offered screening mammograms at the Kentucky State Fair every year since 1990, and serves the community throughout the year visiting churches, workplaces, health fairs and other special events.
Breast MRI (magnetic resonance imaging) uses radio waves and strong magnets to make detailed pictures of the inside of the breast.
Breast MRI is often used in women who already have been diagnosed with breast cancer, to help measure the size of the cancer, look for other tumors in the breast, and to check for tumors in the opposite breast.
For certain women at high risk for breast cancer, a screening MRI is recommended along with a yearly mammogram. MRI is not recommended as a screening test by itself because it can miss some cancers that a mammogram would find.
Although MRI can find some cancers not seen on a mammogram, it’s also more likely to find something that turns out not to be cancer (called a false positive). False-positive findings have to be checked out to know that cancer isn’t present. This can mean more tests and/or biopsies. This is why MRI is not recommended as a screening test for women at average risk of breast cancer, because it would result in unneeded biopsies and other tests for many of these women.
Ultrasound is useful for looking at some breast changes, such as lumps (especially those that can be felt but not seen on a mammogram) or changes in women with dense breast tissue. It also can be used to look at a change that was seen on a mammogram.
Ultrasound is useful because it can often tell the difference between fluid-filled cysts (which are very unlikely to be cancer) and solid masses (which might need further testing to be sure they're not cancer).
Ultrasound can also be used to help guide a biopsy needle into an area so that cells can be taken out and tested for cancer. This can also be done in swollen lymph nodes under the arm.
What is a biopsy?
To determine whether an abnormality in the breast is benign (non-cancerous) or cancerous, it is necessary to obtain a tissue sample for microscopic evaluation.
A biopsy is most helpful when mammography or ultrasound shows a mass, suspicious calcifications, or an area of abnormal tissue change. A breast biopsy is performed to remove some tissue from a suspicious area in the breast and examine it under a microscope to determine a diagnosis.
How do I prepare for a biopsy?
There are no diet restrictions on the day of your procedure, so eat and drink as usual. Wear a supportive bra and refrain from using lotions or powder.
If you take blood thinners such as Aspirin, Heparin or Coumadin, please let your radiologist know. You may continue to take your other daily medications on the day of your procedure. Also let the radiologist know if you have any drug allergies.
What is the difference between a stereotactic biopsy and an ultrasound guided biopsy?
- Stereotactic biopsy
- In a stereotactic biopsy, a special computerized mammography machine pinpoints the area of concern. You will be asked to lie down on a special procedure table and place the breast though an opening. The breast is lightly compressed to immobilize it throughout the procedure.
- A connected computer produces detailed images of the abnormality to be biopsied, which guides the doctor to collect a sample of tissue.
- Ultrasound guided biopsy
- Minimally invasive breast biopsies using ultrasound imaging are performed while you are lying on your back or side. Using ultrasound guidance, the doctor will identify the abnormal area of concern. While viewing the images on a computer monitor, the doctor will guide a small probe into the breast to collect a sample of tissue.
What happens when the test is performed?
For both types of biopsies, once in position the skin will be cleaned and numbing medication will be administered.
The biopsy needle is then inserted into the breast and tissue samples are removed. Only the necessary amount of tissue needed to ensure an accurate diagnosis will be removed.
Once complete, a small marker will be placed inside the breast where the tissue was removed so it can be identified in future mammograms. Firm pressure will be applied afterward to stop any bleeding. No stitches are needed due to the small size of the skin entrance site.
Mammogram images will be taken of the breast to confirm placement of the marker. A dressing will be applied and post care instructions will be provided.
Expect to be at the Breast Care Center at least an hour and a half.
What are the risks?
At the site of the biopsy, there is a risk of bleeding and forming a hematoma (a collection of blood). Most patients have minimal discomfort with these procedures.
Any procedure in which the skin is penetrated carries a risk of infection. In the rare event than an infection develops, antibiotics would be prescribed. Your specific procedure and any additional risks will be discussed with you on the day of the procedure.
What must I do after the procedure?
You should avoid strenuous activity for 48 hours after the procedure, which includes no heavy lifting more than 10 pounds. Temporary bruising and soreness is normal. You should contact the Breast Care Center if you experience excessive swelling, bleeding, drainage, redness or heat in the breast. Ice may be applied to the area, as needed, for the first 24-48 hours following the procedure.
When will I know the results?
After the biopsy, the tissue sample is taken to the pathology lab. Results generally take 3-5 business days to return. You will then receive a phone call from the radiologist or nurse with your results.