Mammography

ultrasound-breast-biopsy-Alaska
Mammography plays an important role in the early detection of breast cancer. A mammogram is a low-dose X-ray of the breast that is used to detect many breast changes too small or too deep to feel.

Mammography is part of a life-long breast-care program that includes breast self-exam, clinical breast exam and mammography. Providence Imaging Center, in conjunction with the American College of Radiology and Society for Breast Imaging, recommend annual screening mammography starting at age 40. This results in the most lives saved from breast cancer.

3D Mammography–also known as breast tomosynthesis–is now available at Providence Imaging Center in Anchorage, Alaska.

3D mammography is an extraordinary breakthrough in cancer screening and detection. Our new breast tomosynthesis system delivers greater clarity, more certainty and is bringing a new dimension to breast health. This innovative new technology allows doctors to see breast tissue detail in a way never before possible to help find breast cancer at its earliest stages, when it is most treatable. Additionally, data indicates that it has the potential to reduce the need for follow-up breast exams. *

* FDA PMA submission P080003

As of January 1, 2014, Providence Imaging Center installed Selenia Dimensions mammography machines in our Anchorage imaging center. As part of our ongoing commitment to you, we are proud to offer the latest in breast cancer screening, 3D mammography — the most exciting advancement in breast cancer detection in more than 30 years.

A 3D mammogram consists of multiple breast images taken in just seconds to produce a 3D image. The doctor looks through the tissue one millimeter at a time seeing detail inside the breast in a way never before possible. Our radiologists bring specialized breast imaging expertise, including Drs. Heather Tauschek, Denise Farleigh, David Moeller, Mark Alder, and Chris Kottra.

Learn more about 3D mammography below while viewing the FAQ section and video segment that follow.

Frequently Asked Questions about 3D Mammography

What is a 3D mammography breast exam?

3D mammography is a revolutionary new screening and diagnostic tool designed for early breast cancer detection that can be done in conjunction with a traditional 2D digital mammogram.

During the 3D part of the exam, the X-ray arm sweeps in a slight arc over your breast, taking multiple breast images. Then, a computer produces a 3D image of your breast tissue in one millimeter slices, providing greater visibility for the radiologist to see breast detail in a way never before possible. They can scroll through images of your entire breast like pages of a book.

The additional 3D images make it possible for a radiologist to gain a better understanding of your breast tissue during screening, significantly improving early breast cancer detection and providing the confidence to reduce the need for follow-up imaging.

Why is there a need for 3D mammography breast exams? What are the benefits?

With conventional digital mammography, the radiologist is viewing all the complexities of your breast tissue in a one flat image. Sometimes breast tissue can overlap, giving the illusion of normal breast tissue looking like an abnormal area.

By also looking at the breast tissue in one millimeter slices, the radiologist can provide a more accurate exam. In this way, 3D mammography finds more invasive cancer missed with conventional 2D mammography. It also means there is less chance your doctor will call you back later for a “second look,” because now they can see breast tissue more clearly.

What should I expect during the 3D mammography exam?

3D mammography complements standard 2D mammography and is performed at the same time with the same system. There is no additional compression required, and it only takes a few seconds longer for each view.

Who can have a 3D mammography exam?

While 3D mammography is approved for all women who would be undergoing a standard mammogram — any woman can request it — guidelines set by our medical director, Dr. Heather Tauschek, recommend that the following women should be the first to consider a 3D mammogram:

  • women who are screened for the first time (baseline mammogram)

  • women with dense breast tissue

  • women with a history of breast cancer

 Please call Providence Imaging Center in Anchorage at (907) 212-3151 (toll-free at 888 458-3151) to schedule your annual screening mammogram appointment.

Learn more about 3D mammography when you watch the youtube video below:

Mammography plays an important role in the early detection of breast cancer. A mammogram is a low-dose X-ray of the breast that is used to detect many breast changes too small or too deep to feel.

Mammogram Patient with MachineScreening mammography can assist in the early detection of breast cancer, even before your health care provider can see or feel changes in the breast.

Providence Imaging Center, in conjunction with the American College of Radiology and Society for Breast Imaging, recommend annual screening mammography starting at age 40. This results in the most lives saved from breast cancer.

However, we recognize that screening is a choice, and some patients may choose to undergo fewer screening mammograms. If you are a patient who wishes to undergo fewer mammography examinations, the American Cancer Society recommends annual screening mammography between age 45 and 54 and a screening mammogram every other year starting at age 55. On occasion, a health care provider may recommend that a woman younger than 40 obtain a mammogram.

Diagnostic mammography is used to evaluate a lump or other symptom noted by you or your doctor.  It is also used to further evaluate an abnormality noted on a screening mammogram.

Providence Imaging Center employs a nurse to answer questions about mammography.  She can be reached at (907) 212-3607 Monday through Friday.

A screening mammogram* is appropriate for most women, including women who have a history of lumpy or fibrocystic breasts, breast tenderness, strong family history of breast cancer, previous benign biopsy and a milky or greenish nipple discharge. Please report any unusual symptoms when scheduling.

Mammogram Screening Patient

A screening mammogram consists of a total of four images – two pictures of each breast, one from the top-to-bottom and one from the side.

It is important to see your health care provider for a physical breast examination in addition to annual mammography. If this is scheduled prior to your mammogram appointment and an abnormality is noted by your health care provider, she or he can order a diagnostic mammogram, saving you time by allowing Providence Imaging Center to do a complete work up on your first visit.

*Learn whether you may be eligible for a free screening mammogram.

Women who have symptoms such as a dominant lump, mass, lesion, or clear or bloody nipple discharge should be scheduled for a diagnostic mammogram. Others who may need this exam include women who have had breast cancer, a recent biopsy or a recent mammographic abnormality.

Mammogram Machine

A diagnostic mammogram consists of at least four images – two pictures of each breast, one from the top-to-bottom and one from the side. Special consideration is taken at the area of concern, which is usually marked.

A signed order from a health care provider is needed to schedule a diagnostic mammogram.

Providence Imaging Center incorporates computer-aided detection (CAD) into its breast cancer screening program. Digital mammography images are analyzed using a sophisticated software program, which highlights areas on the mammograms that contain features associated with cancer.

The CAD marking system is built into the digital mammography equipment used at Providence Imaging Center, and is used on mobile mammograms as well. The radiologist reviews the images conventionally then reviews the special CAD markers, if any, displayed on the monitor.

Whether you are having a screening or a diagnostic mammogram, please do not wear deodorant, talcum powder or lotion under your arms or on your breasts on exam day. For convenience, wear a two-piece outfit.

Mammography Technologist and PatientOnce checked in and registered, you will be escorted to a dressing room. Here, you will remove your shirt and bra, before putting on a mammography cape or a front-opening smock. If desired, you may request a robe. A locker is available to secure your personal items.

You will wait in the Women’s Lounge, located next to the mammography rooms.  There are magazines, information pamphlets, and a telephone for patient use.

Your mammography technologist will escort you to the mammography room. Once inside, she will obtain a short medical history from you.  She will individually position each breast on a special platform and compress it with a paddle, made of plastic. Breast compression is needed in order to:

  • Provide uniform breast thickness so that all of the tissue can be visualized
  • Spread out the tissue so that small abnormalities won’t be obscured by overlying breast tissue
  • Allow the use of a lower X-ray dose since a thinner amount of breast tissue is being imaged
  • Keep the breast in place, in order to eliminate blurring of the image due to motion
  • Reduce X-ray scatter to increase the image’s sharpness.

On occasion, women may be asked to return to Providence Imaging Center for additional views, which can be called coned-down magnification views. These views are used to examine an area of concern more closely. One or more images may be obtained.

Preparation is the same as for a screening or diagnostic mammogram.  If you are asked to come in for additional images , please do not wear deodorant, talcum powder or lotion under your arms or on your breasts on exam day. For convenience, wear a two-piece outfit.

Providence Imaging Center in Anchorage utilizes different procedures to obtain a sample of breast tissue. An image-guided biopsy allows the radiologist to sample the area of concern without surgery. Mammographic or ultrasound guidance is used to find the area.

The radiologist removes samples of breast tissue using a special needle. These tissue samples are sent to the pathologist for review. The patient’s healthcare provider will receive a pathology report several days after the biopsy and will review the results with the patient.

Stereotactic Breast Biopsy Patient

Three biopsy procedures are done at the Providence Breast Procedure Center
Stereotactic Biopsy: you will lie on your stomach on a padded table.  Your breast will go through an opening in the table. The radiologist will perform the biopsy from below.  It is important that you lie very still during the procedure. Your breast will be compressed just as it was for your mammogram.  Mammogram images will be obtained, and a computer will be used to locate the biopsy area.

 

Ultrasound Guided Biopsyyou will lie on your back on a padded table with one arm raised above your head.  You will be able to watch the ultrasound screen as the radiologist performs the procedure if you wish.


Tomosynthesis / 3D Biopsyyou will lie on your back or on your side or be sitting on the table. Your breast will be compressed just as it is for a mammogram. Mammogram images will be obtained and a computer will be used to locate the biopsy area. It is important that you hold very still during the procedure.

How to prepare for an image-guided biopsy

There are no diet restrictions; eat and drink as usual.  Take your usual medications on the day of your appointment.

If you take daily aspirin or any anticoagulant such as coumadin, heparin or plavix, please notify our staff. There may be special instructions for you.

Please advise us if you have any allergies prior to your appointment.  Lidocaine is the local anesthetic normally used for ultrasound guided biopsy and lidocaine with epinephrine is normally used for the stereotactic/3D biopsy. 

A two piece outfit will be more comfortable.  Please wear or bring a supportive bra.

What to expect during the procedure

We are ACR Accreditation for Stereotactic Breast BiopsyDuring a stereotactic breast biopsy you will lie on your stomach on a padded table.  Your breast will go through an opening in the table.  The radiologist will perform the biopsy from below.  It is important that you lie very still during the procedure.  Your breast will be compressed just as it was for your mammogram.  Mammogram images will be obtained, and a computer will be used to locate the biopsy area.

Your skin will be cleaned before the radiologist administers lidocaine, a local anesthetic.  This will numb an area about the size of a quarter.  A very small incision will be made and several tissue samples will be obtained.

During the procedure you will be informed about what is occurring.  If you experience discomfort, the radiologist can administer more local anesthetic during the procedure.

After the procedure

  • The radiologist or technologist will apply pressure to the biopsy area for several minutes to stop any bleeding.  Your incision will be closed with a steri strip and a sterile dressing.  You will be given a small ice pack to put in your bra for a few hours to help prevent bruising.
  • Please avoid lifting anything over 10 pounds for the next two days after the procedure to further prevent bleeding or extended bruising.
  • Take a non-aspirin pain reliever like Tylenol, Advil, Motrin, etc., if you experience any discomfort.  Avoid aspirin for about 48 hours.
  • Remove the gauze dressings and shower the morning after your biopsy.  Leave the steri strips in place; they should began to peel off on their own in four to five days.
  • Check the biopsy area daily.  If you notice excessive pain, bleeding, swelling, drainage, redness, or the area is warm to the touch please call the nurse at Providence Imaging Center.  The nurse is available M-F 8 a.m. – 4 p.m.
  •  You should be able to drive or return to work following your biopsy.

Note:  You may notice some bruising of the biopsy area which should go away in about a week.  You may also have a very small amount of bleeding.  If bleeding occurs after you leave the Procedure Center, apply continuous direct pressure over the incision site for five minutes and replace the bandages. It is common to feel a small lump after the biopsy. It will slowly reabsorb.

Results and follow-up

Your clinician’s office should contact you with the results of your biopsy about 3-5 working days after the procedure.  A diagnostic mammogram and/or a breast ultrasound is often recommended at six months post biopsy.  

If you have any questions about your procedure or results, call the nurse at
Providence Imaging Center, 212-3607.

Breast Biopsy Instructions (downloadable PDF)

Ductography is most commonly used to evaluate either clear or bloody discharge and is typically recommended by the patient’s healthcare provider or the radiologist. Creamy, white or greenish discharge is usually not an indication for this study.

How to prepare for a ductogram

  • There are no diet restrictions, eat and drink as usual
  • Take usual medications on exam day
  • Wear a two-piece outfit

What to expect during the ductogram

The radiologist will review the mammogram films prior to the procedure and additional mammogram films may be obtained.  The radiologist will squeeze the nipple to identify the nipple discharge and the duct from which it originates. Squeezing or pressure will be felt associated with identifying the nipple discharge. A very small tube is inserted into the duct. Most women will experience brief discomfort as the tube is placed into the duct opening.  In some women, placement of the tube is difficult and may be unsuccessful. Once the tube is in place, most women experience no further discomfort with the procedure. Dye will be injected into the duct through the tube.  Mammogram films will be obtained with the tube and dye present.

After the procedure

At the end of the procedure, the tube will be removed. There may be some nipple discharge following the procedure. The dye is clear, but sticky. The technologist will provide gauze to place inside the bra to protect the patient’s clothing. The patient may return to normal activity.

Results and follow-up

The radiologist will review and evaluate the ductogram films. A report will be sent to the patient’s healthcare provider, who will contact the patient with the results.  Depending upon the results, the patient may be referred to a surgeon for additional evaluation.

For questions about the procedure or results, contact the PIC nurse at (907) 212-3607.

Ductogram Instructions (downloadable PDF)

Wire localization, also referred to as needle placement, is used to identify the exact location of abnormal breast tissue for the surgeon. The wire serves as a marker, letting the surgeon know which area needs to be removed.

What to expect during a wire localization

Using the mammogram as a guide, the radiologist will locate the area of concern, numb the area with a local anesthetic, and then insert a thin wire into the breast so that the tip rests in the suspicious area. The wire is kept in place with a gauze dressing. A second mammogram is taken to confirm that the wire is located in the correct area.

After the procedure

The technologist or radiology assistant will take the patient to surgery.

Results and follow-up

The patient’s surgeon will receive a report of the wire localization procedure. For questions about the procedure or report, contact the PIC nurse at (907) 212-3607.

The results of your screening or diagnostic mammogram will be sent to the health care provider you indicated within several business days after your appointment.

Providence Imaging Center will also send you your mammogram results within a couple weeks after your appointment.

Stereotactic Breast Biopsy and Ductogram Results
Your clinician will receive the results of your biopsy procedure within several business days of the procedure.

Questions
Call the Providence Imaging Center nurse at (907) 212-3607 with any questions about your mammography procedure or results.

Learn more about mammography and how to get it covered; general breast cancer topics; and women’s advocacy partners by clicking the links below.

Digital Mammography Brochure (downloadable PDF)

Free Mammography for Qualifying Women

Do you want to get a screening mammogram, but lack insurance coverage? Maybe you have insurance, but it doesn’t cover preventive services such as a mammogram, or you have a high deductible.

Providence Imaging Center (PIC) is pleased to offer women ages 40-64 who meet certain income guidelines, a mammogram at no charge.

The State of Alaska pays for approved breast and cervical health screenings for eligible women statewide with its Breast and Cervical Health Check program (BCHC). BCHC pays for clinical breast exams, pelvic exams, Pap test and screening and diagnostic mammograms appropriate to your age and medical history. BCHC can pay for approved screening exams. If any exam results are abnormal, BCHC can also pay for approved diagnostic tests to rule out problems, including cancer.

Providence Imaging Center is proud to partner with BCHC by providing services to hundreds of qualifying Alaskan women. Simply ask one of our friendly schedulers for more information, or let BCHC know that you would like to have a mammogram scheduled with us. Their helpful staff will quickly determine if you are eligible for funds. Many women who are uninsured or underinsured have received help. BCHC’s toll-free number is (800) 410-6266.

Other Information and Support Links

Since opening in 1986, Providence Imaging Center in Anchorage has led the way in breast imaging services in Alaska. In August 2005, we introduced digital mammography in our three mammography suites, and offer this state-of-the-art technology in a mobile mammography coach as well. We were the first to offer stereotactic breast biopsy, breast MRI, computer-aided detection, sentinel node evaluation for breast cancer patients, and mobile mammography in the state. In January 2014, we replaced our mammography units with the Selenia® Dimensions® 3D mammography system from Hologic, becoming the first standalone outpatient imaging center in Anchorage to offer breast tomosynthesis.

Providence Imaging Center’s mammography, breast ultrasound, breast MRI, ultrasound-guided breast biopsy and stereotactic breast biopsy programs are accredited by the American College of Radiology (ACR), resulting in a special designation as Alaska’s first Breast Imaging Center of Excellence. We are the only facility with this designation in Anchorage, and have been since 2007. This review process ensures patients and referring health care providers that Providence Imaging Center’s radiologists, technologists and equipment meet the ACR’s high standards.

Get an Annual Mammogram Reminder

Mammographysaveslives.org has an excellent way to remind yourself to get that annual mammogram. Simply visit their Web site to sign up for reminder.

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