During your appointment with Dr. Broukhim, she will perform a complete physical examination and one or more imaging exams in order to evaluate each patient's individual breast health. The results of this examination allow Dr. Broukhim to detect any abnormalities within the breast tissue and to determine a patient's individual risk for cancer. These risks, as well as personalized prevention techniques, will be discussed between doctor and patient to allow the patient a full understanding of their breast health.
Breast exams are recommended on a regular basis, especially for patients over the age of 40 or those with an increased risk of developing breast cancer. It is important to notify your doctor if you are pregnant, breastfeeding, have breast implants or have any symptoms such as breast pain. In between clinical exams, women should examine their own breasts on a monthly basis in order to detect any lumps in their earliest stages. Dr. Broukhim will instruct you on how to perform a self-exam.
Dr. Broukhim works with skilled radiologists to perform mammograms, ultrasounds and other imaging exams that allow for the most accurate and detailed evaluation of breast tissue. These exams may be performed on a regular basis to screen for breast cancer or for diagnostic purposes that target certain areas of the breast.
After films are processed by the lab, Dr. Broukhim and her team will thoroughly evaluate the images in order to detect any abnormal areas of breast tissue, such as a lump, cyst or microcalcifications, which may require additional imaging or a biopsy procedure to determine whether or not the tissue is cancerous.
A breast ultrasound, also known as sonography, is a diagnostic procedure that uses high-frequency sound waves to produce images of the breast tissue and examine it for solid masses and other abnormalities. This procedure is often performed after early signs of cancer appear during a mammogram or breast self-exam. Ultrasounds are not typically used as a regular screening exam, as they are not effective in detecting all of the early signs of breast cancer.
During the ultrasound procedure, you will lie on your back with your arm raised above your head. The ultrasound technician will apply a cool gel to the breast so that the transducer can pick up the sound waves more accurately. The transducer is moved back and forth over the breast as an image of the breast tissue appears on a computer monitor. The exam usually takes 15 to 30 minutes to perform, and may be performed in conjunction with a biopsy.
A breast cyst is a fluid-filled pouch that commonly develops in the breast and can lead to discomfort, although they are usually noncancerous. Breast cyst aspiration is performed to determine whether or not the cyst is noncancerous and reduce the size of the cyst by draining the fluid through a needle. It is often performed after a cyst is felt during a physical exam or detected during a mammogram.
During the aspiration procedure, a needle is injected through the skin and into the cyst under ultrasound guidance to ensure proper placement. The fluid is drained from the cyst with a syringe, and part of a solid cyst may be removed as well. This is performed under local anesthetic to numb the injection site. The removed fluid is then sent to a lab for testing. Aspiration may cause discomfort, bruising and infection, but is considered a safe procedure.
An ultrasound-guided CORE biopsy is recommended after a nodule is seen on a mammogram and/or ultrasound examination. During this procedure, the patient lies on her back on a table while the physician locates the abnormality on ultrasound and makes a mark in pen on the skin indicating where the needle should be inserted. The skin is sterilized and numbed with local anesthetic. A small incision is made in the skin and the needle is inserted.
The surgeon then scans the breast with a hand-held ultrasound transducer that allows her to see the tip of the needle and confirm that it is in the correct spot. The equipment will click a few times during the procedure. Small areas of tissue are removed painlessly from the abnormal area and sent for testing.
Results are available from pathology within 24-48 hours. There is usually minimal post-biopsy discomfort, but Tylenol is recommended for any pain. Strenuous activity should be avoided for 24 hours.