Breast Imaging and Procedures

Breast cancer is much more treatable when detected in its early stages. Mammograms, a set of breast images taken with low dose X-rays, are effective routine screening tests that have been proven to find breast cancer early. For women with an average risk for developing breast cancer, a mammogram is the best breast cancer screening test available.

We offer state-of-the-art digital mammography equipment, including 3-D mammography, an innovative screening and diagnostic breast imaging tool that improves the early detection of breast cancer.

A routine screening mammogram is taken on a regular basis, usually annually, to screen for changes in the breast. Several images of each breast are taken, from the top facing down and from the side.

A diagnostic mammogram is taken when an area of concern has been found in the breast. Though similar to a screening mammogram, diagnostic imaging usually includes extra breast images and additional manipulating of the breast tissue in order to examine the concerned area more closely.

Our mammography technical staff are all registered with specific credentials for mammography.

We provide the latest in ultrasound technology, a highly trained medical staff, and a comfortable environment for our patients. We also perform breast ultrasounds to provide guidance for biopsies and other interventions. The breast imaging department is accredited with the American College of Radiology. Our breast ultrasound staff are all registered with specific training in breast ultrasound.

Our highly trained breast health specialists perform breast Magnetic Resonance Imaging (MRI) for patients on the most advanced equipment in the comfortable setting of our BreastCare Center. We use breast MRI as a screening tool in high risk patients, and also as a diagnostic tool to gather further information about a patient with a specific breast problem.

Once a breast lump or breast abnormality has been detected, your doctor may want you to have a breast biopsy. A biopsy is the only way to achieve an accurate diagnosis of a breast problem. A percutaneous (through the skin) biopsy uses a needle to remove cells (fine needle aspiration) or pieces of tissue (core biopsy).

Approximately 1 million breast biopsies are performed each year, with 60 to 80 percent of them showing benign (non-cancerous) results. This means that up to 80 percent of the patients who undergo these procedures will not need to have breast surgery.

Nipple Sparing Mastectomy and Hidden Scar Technique Preserve Breasts During Surgery

Two new procedures offered at BID Needham are helping to preserve breasts for patients undergoing breast cancer surgery.

Nipple Sparing Mastectomy

Nipple sparing mastectomy is a surgical approach that removes breast tissue while preserving the skin, nipple and areola. For patients whose cancer is not located near the nipple or areola, this approach is as effective as traditional procedures and offers a more satisfying cosmetic result. This surgical technique can be used for therapeutic and preventive mastectomies.

Hidden Scar Surgery

For breast conserving surgery (lumpectomy), hidden scar surgery places the surgical incision in a discrete location along the edge of the areola, under the breast or in the axilla (arm pit). Most patients undergoing breast surgery are eligible for this surgical approach and it is used to remove both benign and malignant breast masses. Lighted instruments illuminate the surgical field, improving a surgeon’s vision in the area of concern. This technique is safe often leads to a better cosmetic outcome.

For nipple-sparing mastectomy, hidden scar technique can also be utilized by ensuring that the incision is under the breast.

Ted James, MD offers this innovative surgical treatment option.

Radar Localization Technology Improves Care Before Breast Tumor Removal

For patients preparing to undergo breast tumor removal surgery, a tradition surgery called for wire localization to locate breast tumors before a surgery. Using this often-uncomfortable technique, surgeon would place a wire in the breast, which protruded from the breast, often for several hours, to mark the tumor’s location. In order for the wire to remain in place, patients would restrict their movements for hours before surgery. A breast surgeon would then follow the wire and remove the tumor. In some cases, wires could move away from the tumor, making it more difficult to remove all of the cancerous tissue. When this happens, patient might require a second surgery.

SAVI SCOUT Radar Localization Technology

Advanced technology known as radar localization technology, now offered at BID Needham, eliminates the need for wire localization. Technology known as SAVI SCOUT uses a reflector about the size of a grain of rice to keep track of the tumor’s location prior to surgery. It can be placed in the tumor up to 30 days before surgery. The reflector isn't externally visible, and placement does not restrict a patient’s movements. Just before surgery, the reflector is activated, and safe, nonradioactive radar waves are used to detect it within the breast.

This innovative technology allows surgeons to accurately pinpoint tumors prior to performing a lumpectomy. With this pinpoint precision, surgeons can go straight to the breast abnormality and more effectively remove the entire tumor while limiting the amount of healthy breast tissue that is removed. This new technology also reduces the amount of time that a patient will spend in the hospital compared with the traditional procedure.

A stereotactic core biopsy removes suspicious calcifications of tissue from the breast for further examination. Both a computer and mammography are used in this type of biopsy to locate the area of concern in the breast.

A stereotactic core breast biopsy is a safe and accurate alternative to a surgical biopsy. This procedure takes between 30-60 minutes and can be performed in the comfort and convenience of our BreastCare Center. The biopsy is performed by one of our Breast Imaging radiologists, along with a radiology technologist and the Program Nurse Navigator.

During the procedure, the patient is sitting in a chair. Imaging equipment compresses the breast, just like during a mammogram, to keep it immobile. The imaging system uses X-ray to create stereo pictures from two different angles. The radiologist identifies the concerning finding on these mammogram images to perform the biopsy.

Once the location is pinpointed, a local anesthetic is used to numb the area, then a small incision is made in the breast and the core biopsy needle is inserted to take a tissue sample for diagnosis.

Images of the concerning area are taken throughout the biopsy. Our breast pathologists then examines the tissue samples to make a final diagnosis. Our Program Nurse Navigator, whom the patient would have met at the time of the biopsy, contacts the patient with the results. She will also answer any further questions the patient may have based on the biopsy results and helps to coordinate any further appointments if needed.