DIAGNOSTIC IMAGING

Microcalcifications

Calcifications (calcium deposits) or microcalcifications (small calcium deposits) are the smallest particles visible on a mammogram. Calcifications are a normal occurrence in aging breast tissues, which have gone through changes such as cysts, injuries or mastitis (infection). However, they can also be a sign of cancer, so radiologists closely study the findings of microcalcifications found during mammography.

Clustered microcalcifications (four or more microcalcifications close together) would also require further evaluation. A finding of clustered calcium deposits, or calcifications that follow the path of a duct, would be examined closely by a radiologist, who would study their shape and placement. These calcium deposits are the smallest structure that mammography can visualize. Therefore, special close-up mammography views ¾ compression or magnifications ¾ will be taken to give the radiologist the best possible diagnostic picture. Calcifications associated with a malignancy have a pattern, with irregular shaped edges and an asymmetrical (do not look alike) shape. Often there will be a pattern of density (thickness of tissue) surrounding the calcifications on the mammogram. Sometimes the calcifications will take the shape of a duct, which will alert the radiologist to the possibility of intraductal disease.

After looking for any problems, the radiologist will make a recommendation regarding treatment. If the calcifications are suspicious, your physician may choose to wait for several months and re-examine with mammography to see if there are any changes in the area. Then, a biopsy can be performed to evaluate the breast.

Remember; do not wear any deodorant, powder or perfume on or near your breasts when you go for your mammogram. These may cause spots or shadows resembling microcalcifications to appear on your mammogram.

For further information, call The Elliot Breast Health Center at (603) 668-3067 or the Elliot Breast Diagnostic Center at (603) 663-4490.

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Understanding The Role of Ultrasound In Evaluation of Breast Lumps

Ultrasonography, commonly referred to as ultrasound, is a harmless test that uses high-frequency sound waves sent from a transducer, an instrument that resembles a microphone. As the transducer moves over the breast tissue, a picture on a monitor shows the internal structures of the breasts. These pictures, unlike a mammogram, use no radiation and allow the physician to observe the breast structures in motion. This test does not require any surgery or needles. You do not need to do any advance preparation and the test is painless.

Ultrasounds are usually used when an abnormality has been found in a breast during a mammography exam. The test determines if the suspicious area is solid tissue or a cyst filled with fluid. Ultrasound accurately locates and correctly distinguishes the makeup of a lump more than 95 percent of the time. Breast cysts are easily identified by ultrasound. This test is also very useful to diagnose lumps found in pregnant women for whom mammography is not advised, and for women with very dense breasts.

Ultrasound can aid the physician in locating a cyst to withdraw fluid or to perform a needle biopsy of a lump. Being able to see the lump while withdrawing fluid or performing a biopsy increases the accuracy of the procedure. Ultrasound visualization also allows the physician to monitor the area immediately following the procedure to observe any changes.

There is no preparation for ultrasound and there is no discomfort associated with the test (unless you cannot lie flat without discomfort). You will need to lie on a table undressed from the waist up for then the sonographer will apply a gel or oil substance to the breast to improve the transmission of the sound waves. The transducer will be moved over the breast while photographic images are displayed on a video monitor. A radiologist who specializes in reading ultrasound images (sonograms) will interpret the films. The results of your ultrasound will be sent to the referring physician.

Ultrasound is not recommended by the American College of Radiology as the best method of detecting cancer by screening, but rather as an add-on procedure after mammography has located an area that needs further evaluation. It is best used to clarify results of a mammogram or when mammography is not suitable because of pregnancy or other reasons.

For additional information, call The Elliot Breast Health Center at (603) 668-3067 or the Elliot Breast Diagnostic Center at (603) 663-4490.

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