Breast Screenings and Diagnostics

Breast cancer can be successfully treated, especially if it’s detected early. Early detection, including regular screening mammograms, can save your life. Franciscan recommends the guidelines of the American Cancer Society (ACS). The ACS guideline states that every woman, starting at age 40 and as long as she is in good health, have an annual screening mammogram.

Digital Screening Mammography

A mammogram is a digital X-ray of the breast using low-dose radiation to create images of breast tissue. These images are visible on a computer screen and are immediately available for analysis by a board certified radiologist, specializing in mammography. Digital screening mammography is used to detect tumors, cysts and other breast problems that may be too small to detect with the fingertips.

Traditional digital mammography, takes two-dimensional (or 2D) X-rays of the breast for screening and diagnostic purposes. 2D digital technology continues to be an effective and viable screening and diagnostic tool and is used in the vast majority of breast cancer screenings.

3D mammography, or digital breast tomosynthesis (or ‘tomo’), is a new screening and diagnostic breast imaging technology to improve the early detection of breast cancer. It is used in combination with conventional 2D to provide an enhanced 3D image of the breast. 3D improves early detection of breast cancer by between 10 – 30% and increases accuracy which reduces the need for additional screenings.

Digital Diagnostic Mammography

After a mammogram is taken, the images are analyzed by a board certified radiologist specializing in mammography, who determines whether further screening tests are necessary.

Breast Ultrasound

Ultrasound uses high-resolution sound waves to create moving images of the body’s soft tissues, which are viewed on a computer screen.

Ultrasound is used as a follow-up tool for diagnosing and sometimes treating breast masses if a mammogram reveals that there may be a problem.

It is also used to view areas not accessible by mammography, such as the area closest to the chest wall, and to assist surgeons and radiologists in obtaining biopsies (cell samples).

A breast ultrasound is completely painless. Images are created by passing a hand-held device called a transducer over the breast.

Breast MRI (magnetic resonance imaging)

An MRI uses radio waves and high-powered magnets to create soft-tissue images visible on a computer screen. Highly sensitive, MRI screenings are usually for women who may be at risk of breast cancer or for cancer patients already undergoing treatment.

Breast MRIs require a referral by an oncologist, surgeon or breast specialist. They may be used to determine how far the cancer has spread or to evaluate breast implants for leakage or rupture.

Image-guided breast biopsy

If a breast lump or unusual growth is detected during a breast exam or imaging screening, cell or tissue samples are taken to determine whether they are benign (harmless) or cancerous. Biopsies can be performed using a number of techniques, but all involve the removal of the cells in question for microscopic examination and analysis by a pathologist (disease specialist).

Several methods are used to take image-guided breast biopsies.

In stereotactic breast biopsy, a machine much like the ones used to create regular mammograms takes electronic images of breast tissue from two different angles. These images are visible on a computer screen. Radioactive ions (X-rays) emitted by the machine guide the surgeon’s tool to the precise site of the abnormal growth. Cells are gathered from this site with a hollow needle or tiny vacuum device, to be analyzed in a lab. The procedure does not require hospitalization or general anesthesia.

In ultrasound guided biopsy, the surgeon or radiologist is guided to the site of abnormal growth by the computerized images created with ultrasound. A number of biopsy procedures are then performed, such as needle or vacuum-assisted biopsy, to obtain cell or tissue samples for a pathologist to analyze.

Needle localization breast biopsy

This procedure uses two types of needles, a fine-gauge needle or a large, hollow needle, to obtain fluid or tissue samples:

Fine needle aspiration (FNA), involves the use of a long, thin needle, inserted through the outer skin of the breast, to extract fluid (from a cyst or infected area) or cells from the abnormal area. The procedure takes about 30 minutes and is similar to drawing blood.

Core needle biopsy uses a large hollow needle to take individual tissue samples from an area of abnormal growth. The needle is inserted through the outer skin of the breast. Several core samples, each slightly larger than a grain of rice, may be taken for laboratory analysis.

Bone Density Scan

Bone density scans, or DXA scans, use a special type of X-ray technology to assess a person’s bone mineral density. This can detect osteoporosis (bone loss) and is an important indicator for a person’s risk of developing the condition. DXA scans help doctors develop the best treatment for stopping bone loss in persons who already have osteoporosis. A DXA scan can also track the effectiveness of osteoporosis treatment and assess a person’s risk of developing fractures.

Franciscan offers the most comprehensive breast health services in the South Sound at a number of facilities, including the Franciscan Breast Center at St. Francis in Federal Way, a Center of Excellence accredited by the American College of Radiology. In Tacoma, the Carol Milgard Breast Center offers both screening and diagnostic breast imaging services and screening mammograms are available at the Milgard Medical Pavilion at St. Anthony Hospital in Gig Harbor and St. Elizabeth Hospital in Enumclaw. Call to make an appointment.

Franciscan Breast Center at St. Francis, Federal Way 253-944-4025
Franciscan Medical Pavilion - Bonney Lake 253-573-7320
Milgard Medical Pavilion at St. Anthony, Gig Harbor 253-530-2655
St. Elizabeth Mammography, Enumclaw 360-802-8570
Carol Milgard Breast Center, Tacoma 253-759-2622
Highline Medical Center, Burien 206-248-8900

Read more about procedures for breast cancer treatments available with Franciscan Cancer Care.

Learn about other Women’s Care Services offered throughout CHI Franciscan Health.