If you have a condition or symptom with your breast but don’t yet know the cause, your doctor may order tests to gather more information. Common tests include biopsy and state-of-the-art imaging. Once your tests are complete, you and your doctor will discuss the results, confirm your diagnosis and decide on next steps.
You may have one or more of these tests to help your doctor confirm diagnosis:
Mammograms use an x-ray to evaluate breast changes such as lumps, pain, nipple discharge or changes in the size or shape of your breast. At Dartmouth-Hitchcock we use a mammography technique called “tomosynthesis” to visualize the breast in 3 dimensions in order to increase breast cancer detection rates and minimize the need to call you back for additional images. To acquire an image, your breast is positioned on a flat plate. Another plate compresses your breast tissue. You may be asked to lift your arm or use your hand to hold your other breast out of the way during the imaging.
Ultrasounds use sound waves to take images of the breast. This is a non-invasive method of evaluation and diagnosis. It is often used as a follow-up test after an abnormal finding on a mammogram, MRI, or clinical breast exam. In instances where a needle biopsy has been recommended, ultrasounds can be used to help guide the procedure.
Magnetic Resonance Imaging (MRI)
A breast MRI test uses magnetic fields and radio waves to capture detailed images of the breast tissue. During the procedure you will lie on a padded platform on your stomach with cushioned openings for your breasts. The platform then slides into the center of a tube shaped MRI machine. You will not feel the magnetic fields or radio waves around you, but you will hear a loud thumping sound. You will be asked to lie very still during the procedure, The MRI technicians will work with you to help this procedure be as comfortable as possible.
During a biopsy a small sample of tissue is removed from your breast for testing. There are two primary types of biopsies you might experience:
Minimally Invasive Biopsy
A minimally invasive breast biopsy uses a special needle to sample an abnormal area in the breast. Most commonly, this will be performed in radiology with image guidance. Image-guided biopsy utilizes a mammogram, ultrasound or MRI to guide the needle and to ensure that the tissue sampling is accurate. Image-guided needle biopsy usually requires a very small (2-5mm) incision, but does not typically need stitches or sutures. Results of the biopsy are usually available within two working days, and recovery from the procedure usually occurs within 48 hours.
A surgical biopsy requires a small incision in the breast to remove a small sample of tissue or a breast lump. You are given some form of anesthesia to prevent discomfort and will have a surgical scar.