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Breast Health Services

 

Digital Mammography
Breast Ultrasound
Breast MRI
Breast Biopsy
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Breast Health Information

What if I have a lump I can feel?
If you feel/have a thickening, swelling, pain, nipple discharge or retraction (the nipple or skin being pulled in), don't panic. The development of symptoms does not automatically mean that you have cancer. About 70 to 80 percent of breast biopsies result in a benign (non-cancerous) diagnosis.

However, you should always let your healthcare provider know if you develop any symptoms involving your underarms or breasts so that she or he may order the most appropriate test. Your healthcare provider may recommend a diagnostic mammogram, as opposed to a screening mammogram, and/or a breast ultrasound examination to gather information.

Here are the answers to some of the questions you may have about screening for breast cancer, TRA and the American Cancer Society (ACS) recommendations:

Who should have a breast MRI with their mammogram?
The American Cancer Society states that certain women with an especially high risk of developing breast cancer should get magnetic resonance imaging (MRI) scans along with their yearly mammogram.
Women who are considered to be at especially high risk meet at least one of the following conditions:

  • They have a BRCA1 or BRCA2 mutation
  • They have a first-degree relative (parent, sibling or child) with a BRCA1 or BRCA2 mutation, even if they have yet to be tested themselves
  • Their lifetime risk of breast cancer has been scored at 20%-25% or greater, based on one of several accepted risk assessment tools that look at family history and other factors
  • They had radiation treatments to the chest between the ages of 10 and 30 for Hodgkin’s Disease or similar cancer
  • They have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or may have one of these syndromes based on a history in a first-degree relative

How do I know if I have the BRCA1 or BRCA2 mutation?
This requires a genetic test and it is something you should discuss with your healthcare provider.

Does TRA already offer breast MRI?
Yes. TRA has offered breast MRI for several years. TRA also offers MR-guided breast biopsy for patients where it is appropriate.

Does a breast MRI require a referral? Will it be covered by my insurance?
Unlike screening mammography, a breast MRI (in conjunction with an annual mammogram) will require a referral from your physician or healthcare practitioner. As of this writing (4/07), it is premature to predict what insurance coverage will be for this exam, however we anticipate that women falling under the new ACS guidelines will be granted coverage. TRA’s referral coordinators are available to work with you and your physician ’s office to coordinate your benefits.

Do TRA radiologists read the mammograms themselves or do they use computer assisted diagnostics (CAD)?
Actually both. Here ’s why:

  • The radiology physicians who read mammograms at TRA are dedicated mammography experts. This means that the vast majority of the exams they interpret are mammograms. A full time TRA mammographer “reads” more than 5,000 exams per year.
  • TRA uses all digital mammography interpreted by the mammographer and supplements this with CAD. At TRA, each mammogram is studied by the radiologist for abnormalities. Only when the initial review of the images is complete does the radiologist employ the CAD. The CAD marks additional areas for the radiologist to pay close attention to. Most of these structures are normal, but occasionally CAD will draw the radiologist’s attention to another area that may be clinically significant.

With regard to the New England Journal of Medicine study that questions the accuracy of CAD, the mammographers at TRA, like mammographers in radiology practices around the country, will carefully evaluate the study results before making any changes regarding the use of CAD. The study data was gathered when CAD first came out, between 1998 and 2002 and improvements have been made in several areas since this time. Numerous other studies have shown an increased detection of early cancers by up to 30%, including cancers that are not yet invasive.

To summarize, currently at TRA, we stand behind our belief that best practices for screening mammography begin and end with dedicated board certified mammographers and great breast imaging using digital mammography. CAD was always intended only to augment, never to replace the expert mammography physician.

We’re committed to your breast health!
At TRA, we have invested our resources in both highly trained medical professionals and the latest technology—including digital mammography and breast MRI—in order to offer our patients the very best in breast health care. As radiologists, we regularly consult with physicians and other healthcare practitioners regarding their patients’ care. If you have further questions, we encourage you to visit the American Cancer Society website or speak with your healthcare provider.