You might be asked to attend our breast care unit to have:
Mammogram:
This is a special type of X-ray, used to examine the breast in detail. Both breasts will be examined. The breast is held gently but firmly between two plastic plates. Two X-rays are taken of each breast at different angles. Some patients find the mammogram uncomfortable and occasionally painful but this is usually only for a very short time.
Ultrasound:
An ultrasound scan is a painless test, which takes just a few minutes. A small device called an ultrasound probe is used, which gives off high-frequency sound waves. Special gel is placed on the breast and the probe is moved over the area being investigated. Images are then recorded on the ultrasound machine.
You may feel some pressure because sometimes the probe needs to be pressed firmly against your skin to get a clear picture.
Core biopsy:
During a core biopsy very small samples of tissue are taken from your breast for further examination. Local anaesthetic numbs the area before a needle is used to collect the sample. We aim to keep you as comfortable as possible through the biopsy procedure and you will be supported by the radiographers and radiography assistants. The biopsy can be done using ultrasound or mammogram as a guide. If mammogram guidance is advised you will be given an appointment on another day to have it done. The specimen of breast tissue taken is then sent to our laboratory to be examined. Your breast can bruise and be tender after a core biopsy, but this generally settles within a week.
You will be given an aftercare advice leaflet by our staff before you leave the department.
After your tests, you might be asked to return to the surgical outpatient department to discuss the results of the investigations with the doctor. If a biopsy is taken you will return to the clinic in 1 to 2 weeks' time to discuss the results. Otherwise, you will be contacted by letter with your investigation results.
If further tests or scans are needed and they can't be done on the same day, you may have to return for a further appointment.
Breast MRI
In addition to triple assessment, breast MRI (Magnetic Resonance Imaging) has a useful role in selected cases (young patients and implants) as a problem-solving tool to help diagnose breast cancer or to give further information.
MRI does not involve x-ray irradiation but uses a very strong magnetic field. It requires specially trained radiographers to perform the test and takes 45-60 minutes. All breast MRI examinations are carried out at the Royal Devon & Exeter Hospital and double-read by experienced breast-dedicated radiologists.
It is most often used to give further information following a mammogram and ultrasound. In many cases, an additional breast ultrasound is performed after the MRI to clarify its findings. It is sometimes used to assess the response of a cancer to chemotherapy or hormone treatment prior to surgery.
In addition to its role as a diagnostic tool, breast MRI is useful in screening younger women at a significantly increased risk of breast cancer either as a result of a very strong family history or a mutated breast cancer gene (BRCA1 or BRCA2), or following chest mantle irradiation for Hodgkin’s disease at a young age. MRI is often helpful for these women because it is effective in dense breast tissue and many young women have dense breasts.
However, mammography and ultrasound remain the most useful diagnostic breast imaging methods and even where MRI is recommended for women at high risk of the disease, it is used in conjunction with mammography and ultrasound for selected women. Breast MRI is a very specialised technique and the results take longer to process.
If the test has been performed for a suspicious or known breast cancer, you will be given an appointment to return to the clinic to discuss your results with a specialist. Following the Breast MRI examination, many patients are called back for a further ultrasound of the breast as this helps the radiologist to interpret the MRI findings. This is known as a “second look ultrasound”