Preparing for Your Breast Radiology Visit

Overview

The Breast Imaging Section offers comprehensive imaging and consultative services for diagnosis and follow-up of breast abnormalities. Asymptomatic normal risk women can be screened for breast cancer with standard 2-D mammography. 3-D mammography (tomosynthesis) is also offered. Those at high risk for breast cancer may also undergo screening breast MR. For diagnosis of breast abnormalities in symptomatic patients or patients having abnormal screening studies, the section offers tailored diagnostic mammography, breast ultrasound, breast MR, sonographically guided, stereotactic and MR guided breast biopsy, as well as localization of occult lesions in preparation for surgical removal. Opportunities to participate in research studies in breast imaging, including protocols examining dedicated breast CT and tomosynthesis, are also available to eligible UCD patients.

Diagnostic Mammography

General Information:

• Diagnostic exam is done when you or your doctor notices a problem, such as a lump, unusual nipple discharge, nipple retraction, skin thickening or dimpling.
• A diagnostic exam may also be done as a follow-up from a recent screening mammogram.

Pre-Procedure Information:

• Please arrive 20 mins prior to your scheduled appointment.
• On the day of your exam, do not use powder, perfume or deodorant, and wear a two-piece garment.

During your exam:                                              

• The technologist will target a specific area with a compression paddle to compress an area of your breast using mammography/tomosynthesis.
• Breast compression is important to obtain quality images for the radiology doctor (Breast Imaging Specialist), and also decreases your radiation dose.
• The radiology doctor will review these initial images and determine if further imaging by mammogram, ultrasound is needed or an MR needs to be scheduled.
• Please allow 2 hours for this appointment

Post-Procedure Information:

• The radiologist/ technologist will review your results with you after your exam is completed and discuss the next steps and follow up if necessary.
• The results will also be sent to your physician.

Screening Mammography

General Information:

• Mammography uses low dose radiation to create images of the breast.  Mammography is used to find breast cancer. It is the only imaging that has been shown to save lives for breast cancer. All UC Davis Health mammography locations have digital mammography.  
• Tomosynthesis is a mammography technique which sweeps in an arc and acquires images at different angles.  The computer processes the images into one-millimeter slices which allows the radiologist to scroll through the breast tissue.  These images provide more information for the radiologist. 
• Screening mammograms are for women who have no breast symptoms or changes in their breasts.
• We recommend mammography yearly beginning at age 40.  A clinical breast exam is recommended annually by your physician, preferably before your yearly mammogram. 

Pre-Procedure Information:

• Please arrive 20 minutes prior to your scheduled appointment. 
• On the day of your exam, please no powder, perfume or deodorant, and wear a two-piece garment.  Please do not wear earrings or necklaces to your appointment.

During Procedure:

• For a routine mammogram we typically take two images of each breast from different angles.
• Your breast will be compressed for all images and compression is released after each image. This is necessary to obtain quality images for the radiology doctor (Breast Imaging Specialist) and also decreases radiation dose. 
• The entire exam will take approximately 10-15 minutes. 
• The technologist will review the images in the exam room before you leave to verify they have all the information for the radiology doctor (Breast Imaging Specialist).

Post-Procedure:

The radiology doctors (Breast Imaging Specialist) will read your images and the results will be sent to your physician, along with a letter to you.

• If you have MyChart with UC Davis, your results will be posted within three days after read.
• The radiologist may need you to return for more images either by mammography/tomosynthesis or an ultrasound.  For more information please refer to the Diagnostic Exam section. 

Pre-Surgical Localization

General Information:

Pre-Surgical Localization procedure is performed prior to your surgery.  This is done to help your surgeon locate the finding that will be taken out at time of the surgery. We will place a wire or a radioactive seed using mammography/tomosyntheses/ultrasound or MRI. If your surgeon has requested a radioactive seed, then a radioactive seed will be placed up to 7 days prior to your surgery date.  The radiology doctor (Breast Imaging Specialist) will determine if mammography, ultrasound or MRI guidance is needed.   

Pre – Procedure:

• This exam is done in Radiology, Ambulatory Care Center (ACC), Lower Level Suite 0500.
• The procedure will take approximately 60 minutes.

During Procedure:

Using the imaging guidance determined by the radiology doctor (Breast Imaging Specialist), the area is identified.  Your breast will be placed in compression and the area will be cleaned. The radiologist will place a small needle through which a wire will be placed.  Adjustments to the wire with different views will be done before a final two view mammogram is done to confirm the position of the wire for the surgeon. If a seed is being placed, then the seed will be placed and the needle removed before a mammogram. The wire will be secured using tape and gauze before going to the main hospital where the wire will be removed during surgery. The seed will remain in your breast until the surgeon removes it during surgery.

Post – Procedure Information:

• Transport will be arranged to take you to the main hospital.

MRI Breast Biopsy

General Information:

Pre-Procedure Information:

• Do not take aspirin or aspirin products 7 days before the biopsy.
• Do not take blood thinning products 7 days before the biopsy. (check with your doctor before discontinuing blood thinners)

For example: Coumadin, Plavix

• Do not take anti-inflammatory products 3 days before the biopsy.

For example: Motrin, Advil, Ibuprofen

• Do not take Vitamin E products 7 days before the biopsy. A multi-vitamin is ok.
• Wear a two piece garment pants should have no metal on them. Do not wear any jewelry to your appointment.  (Certain yoga pants have metal).

On the day of your biopsy:

• Please arrive 45 minutes prior to your appointment time.
• Please plan to be here for 2 hours.
• You may eat and drink the day of the procedure.
• We will do a gentle mammogram after your procedure.

During your procedure:

• An IV will be started for contrast injection. You will lie on your stomach on the MRI table.
• The table rises so the radiologist and technologist can work from below.
• The technologist will locate the area and place your breast into compression
• Your skin will be cleaned and the radiologist will then inject a local anesthetic. You may feel a sting and minimal burning. 
• It is very important not to move during the procedure.
• The technologist will take an image to confirm the area is positioned correctly.
• A small nick is made in your skin, and a needle is inserted through the nick.
• Once the procedure is complete, you will be brought out to the recovery area and the technologist will hold compression on your breast for 20 minutes.
• After the technologist is done with the compression, we will bring you to a mammogram room and perform a mammogram to confirm the biopsy clip location.
• We will then bandage the area and go over your post-procedure instructions.

Please click here for additional Breast MRI information.

Post Biopsy Instructions:

1. To reduce any swelling or bruising at the biopsy site, place an ice pack on top of the dressing.  Place the ice pack for 10 to 15 minutes at a time and then remove it.  Do this 4 or 5 times this evening until you are ready to go to bed.  You may discontinue ice once you go to bed. Many patients find that a package of frozen peas or corn works as an ice pack because it conforms nicely to the shape of the breast.
2. Do not shower or bathe for the first twenty-four hours.  You may sponge bathe but keep the dressing dry.
3. After twenty-four hours you may remove the outer dressing.  Leave the steri-strips (band-aid like dressing) in place for 3 to 4 days and then you may remove them.  You can shower with the steri-strips on the skin.
4. Do not participate in strenuous activities for 48 hours following the biopsy.  Strenuous activity may cause bleeding at the biopsy site. If you should have bleeding at the site, 20 minutes pressure needs to be applied preferably by another person to stop the bleeding. Bruising at the biopsy site is normal.
5. Watch for excessive bleeding, redness, skin changes, swelling or pain.  Bleeding under the skin could present as a hard area (lump) that could take up to 6 weeks to resolve.  If this area or hardness does not resolve after 6 weeks, contact your Primary Care Physician. 
6. If you need medication for discomfort, we suggest Tylenol (if you are medically able to take it).  Please do not take aspirin or aspirin related products such as Aleve, Motrin, ibuprofen, etc., until 24 hours after the biopsy.
7. The results of the biopsy will be called to your doctor, usually 3 to 5 working days from the time of your biopsy
8. If you have any questions, please contact UCD Mammography at 734-0686 between 8:00 a.m. and 4:00 p.m.

Stereotactic Breast Biopsy

General Information:

Stereotactic breast uses mammography/tomosynthesis guidance.  It is minimally invasive, and is performed on an outpatient basis.  The procedure is performed using local anesthetic with minimal discomfort and recovery time. Patients are awake throughout the procedure and there is no general anesthesia used.

Pre-Procedure Information:

• Do not take aspirin or aspirin products 7 days before the biopsy.
• Do not take blood thinning products 7 days before the biopsy. (check with your doctor before discontinuing blood thinners)

For example: Coumadin, Plavix

• Do not take anti-inflammatory products 3 days before the biopsy.

(for example: Motrin, Advil, Ibuprofen)

• Do not take Vitamin E products 7 days before the biopsy. A Multi-Vitamin is ok.
• Wear a two piece garment.

On the day of your biopsy:

• Please plan to be here for 90 minutes.
• You may eat and drink the day of the procedure.
• We will do a mammogram after your procedure.

During your procedure:

• You will lie on your stomach on a special table with an opening which your breast is placed through. The table will rise so the radiologist and technologist can work from below. 
• The technologist will locate the area and place your breast into compression.
• It is very important to lie still during the procedure.
• The technologist will take an image to confirm the area is positioned correctly.
• Your skin will be cleaned and the radiologist will then inject local anesthetic.
• A small nick is made in your skin, and a core needle is inserted through the nick.
• Once the radiologist has taken adequate samples, a marking clip will be placed at the biopsy site.
• After the procedure is complete your entire breast will be put in compression for about 15 minutes.
• After compression, we will bring you to a mammogram room and perform a mammogram to confirm the biopsy clip location.
• We will then bandage the area and go over your instructions.

Post Biopsy Instructions:

1. To reduce any swelling or bruising at the biopsy site, place an ice pack on top of the dressing.  Place the ice pack for 10 to 15 minutes at a time and then remove it.  Do this 4 or 5 times this evening until you are ready to go to bed.  You may discontinue ice once you go to bed. Many patients find that a package of frozen peas or corn works as an ice pack because it conforms nicely to the shape of the breast.
2. Do not shower or bathe for the first twenty-four hours.  You may sponge bathe but keep the dressing dry.
3. After twenty-four hours you may remove the outer dressing.  Leave the steri-strips (band-aid like dressing) in place for 3 to 4 days and then you may remove them.  You can shower with the steri-strips on the skin.
4. Do not participate in strenuous activities for 48 hours following the biopsy.  Strenuous activity may cause bleeding at the biopsy site. If you should have bleeding at the site, 20 minutes pressure needs to be applied preferably by another person to stop the bleeding. Bruising at the biopsy site is normal.
5. Watch for excessive bleeding, redness, skin changes, swelling or pain.  Bleeding under the skin could present as a hard area (lump) that could take up to 6 weeks to resolve.  If this area or hardness does not resolve after 6 weeks, contact your Primary Care Physician. 
6. If you need medication for discomfort, we suggest Tylenol (if you are medically able to take it).  Please do not take aspirin or aspirin related products such as Aleve, Motrin, ibuprofen, etc., until 24 hours after the biopsy.
7. The results of the biopsy will be called to your doctor, usually 3 to 5 working days from the time of your biopsy
8. If you have any questions, please contact UCD Mammography at 734-0686 between 8:00 a.m. and 4:00 p.m.

Ultrasound Guided Breast Biopsy

General Information:

Ultrasound Guided Breast Biopsy is minimally invasive procedure used to biopsy a finding in your breast or armpit with ultrasound.  The procedure is performed using local anesthetic with minimal discomfort and recovery time. Patients are awake throughout the procedure.

Pre – Procedure:

• Do not take aspirin or aspirin products 7 days before the biopsy.
• Do not take blood thinning products 7 days before the biopsy.

For example: Coumadin, Plavix (check with your doctor before discontinuing blood thinners)

• Do not take anti-inflammatory products 3 days before the biopsy.

(for example: Motrin, Advil, Ibuprofen)

• Do not take Vitamin E products 7 days before the biopsy. A Multi-Vitamin is ok.
• Wear a two piece garment.

On the day of your biopsy:

• Please plan to be here for 90 minutes.
• You may eat and drink the day of the procedure.
• We will do a gentle mammogram after your procedure.

During Procedure:

• You will lie down on the procedure table, similar to when you had the ultrasound at your appointment during your diagnostic exam (see Diagnostic mammogram).
• The radiologist will confirm with the ultrasound the area that will be biopsied.
• Your skin will be cleaned, and covered with sterile towels.
• The radiologist will inject local anesthetic.
• A small nick is made in your skin, and a needle is inserted through the nick.
• Once the radiologist has taken adequate samples, a marking clip will be placed at the biopsy site.
• The technologist will hold compression over the biopsy site for 15 minutes.
• After compression, a mammogram will be done to confirm the biopsy clip location. 
• We will then bandage the area and go over your instructions.

Post – Procedure Information:

• To reduce any swelling or bruising at the biopsy site, place an ice pack on top of the dressing.  Place the ice pack for 10 to 15 minutes at a time and then remove it.  Do this 4 or 5 times this evening until you are ready to go to bed.  You may discontinue ice once you go to bed.

Post Biopsy Instructions:

1. To reduce any swelling or bruising at the biopsy site, place an ice pack on top of the dressing.  Place the ice pack for 10 to 15 minutes at a time and then remove it.  Do this 4 or 5 times this evening until you are ready to go to bed.  You may discontinue ice once you go to bed. Many patients find that a package of frozen peas or corn works as an ice pack because it conforms nicely to the shape of the breast.
2. Do not shower or bathe for the first twenty-four hours.  You may sponge bathe but keep the dressing dry.
3. After twenty-four hours you may remove the outer dressing.  Leave the steri-strips (band-aid like dressing) in place for 3 to 4 days and then you may remove them.  You can shower with the steri-strips on the skin.
4. Do not participate in strenuous activities for 48 hours following the biopsy.  Strenuous activity may cause bleeding at the biopsy site. If you should have bleeding at the site, 20 minutes pressure needs to be applied preferably by another person to stop the bleeding. Bruising at the biopsy site is normal.
5. Watch for excessive bleeding, redness, skin changes, swelling or pain.  Bleeding under the skin could present as a hard area (lump) that could take up to 6 weeks to resolve.  If this area or hardness does not resolve after 6 weeks, contact your Primary Care Physician. 
6. If you need medication for discomfort, we suggest Tylenol (if you are medically able to take it).  Please do not take aspirin or aspirin related products such as Aleve, Motrin, ibuprofen, etc., until 24 hours after the biopsy.
7. The results of the biopsy will be called to your doctor, usually 3 to 5 working days from the time of your biopsy
8. If you have any questions, please contact UCD Mammography at 734-0686 between 8:00 a.m. and 4:00 p.m.

Breast Ultrasound

General Information:

• Breast ultrasound is a safe and painless imaging test that uses soundwaves to produce pictures of your breast tissue.

Pre – Procedure:

• Please arrive 15 mins prior to your appointment.
• Wear a two piece garment.

During Procedure:

• You will lie down for the exam, with your arm raised above your head.
• The technologist will place warm gel on the area and press firmly with the transducer.
• The technologist will take images and show them to the radiologist.
• The radiologist may come in and sometimes reimage themselves.
• At the conclusion of your exam the radiologist/technologist will go over your test results and any follow up needed.

Post – Procedure Information:

• Follow-up with your physician if needed.