Breast Care Center Imaging at Wake Forest Baptist in Winston-Salem, NC

Dr. Laura Golding, a breast imaging expert, outlines the primary breast screening and diagnostic imaging technologies: mammography, ultrasound, breast MRI and stereotactic biopsy.
Diagnostic Breast Imaging at Wake Forest Baptist: www.wakehealth....
The Breast Care Center: www.wakehealth....
TRANSCRIPT: I'm Lauren Golding, I'm an assistant professor in the Department of Radiology in the Section of Women's Imaging.
We have three main imaging ways to address breast cancer in women, the most important is mammography. That uses x-rays to give us an overall picture of the breast. We recommend that all women have a mammogram every year from age 40 to 80. Then there's ultrasound which uses sound waves to further characterize lesions we see in the breast. For example whether it's a cyst or a solid lesion. Thirdly, there's MRI, which uses nuclear magnetic resonance to give us more information about the physiology of lesions in the breast- whether they have increased blood flow, what their characteristics are. We often use that if we can't answer a question with mammography or ultrasound and occasionally to screen women who are high-risk for breast cancer.
Stereotactic biopsy is what women typically undergo when we find tiny calcifications in their breast that are suspicious or indeterminate and first the radiologist has to see those on the mammogram and decide that they're somewhat suspicious. And then we schedule the patient for stereotactic biopsy- which is just a procedure that uses x-rays to locate the calcifications in the breast and we can use those x-rays to guide our needle exactly to the spot in the breast where those calcifications are.
The radiologist locates the calcifications in the first place on the mammogram and that guides the needle to those calcifications within the breast and helps the woman to care for the breast after the biopsy.
So when a woman has a stereotactic biopsy she comes in to the room and the table has her lying on her belly with her breast hanging through an opening in the top of the table and we numb her up very well with lots of lidocaine and use the x-rays as mentioned before to target the calcifications. The whole procedure probably lasts probably about 30 minutes, but a lot of that is patient positioning. The needle part itself is maybe 15 minutes or so. Most women say it's better than they thought it was going to be. It's a little uncomfortable to lie on that table for so long, but it's usually not as painful as some women can expect. So we try to ease their anxiety in that way. We have fantastic technologists who hold their hand the whole time and the radiologist will walk them through every step of the way and make sure their questions are answered.
I think there are two big things that set our Breast Center apart. The first is that we're part of a big tertiary care center- we have the surgeons, the oncologists- the medical oncologists and the radiation oncologists, and the radiologists all working together for patient care. We get together two or three times a week to talk about all the patient cases and get everyone's input so everyone's on the same page. And I think it really is a benefit to the patient to have all of those doctors working together for her. The second thing is in that from the Imaging side of things, really it's our technologists. They are fantastic at making patients feel more comfortable in what can be a really stressful situation. There's lots of hand-holding and hugging and whatever seems appropriate, but they really do a good job at making them more comfortable.
So our Breast Imaging Team is made up of radiologists, which are doctors who are specially trained to read mammograms, ultrasounds, breast MR, and to do the breast procedures and the biopsies. And then we have breast technologists who are trained to actually produce the images to take the mammograms.
I think the most exciting thing that's upcoming from an Imaging standpoint is a new breast imaging technology called tomosynthesis and basically that's a new way of doing mammograms that gives us a 3-D picture of the breast. So it's showing a lot of promise in helping us to detect breast cancers maybe at an earlier stage or when they're smaller. And it also is helpful in showing when a spot that we see on a mammogram is just overlapping tissue. So less reasons for women to be called back from their screening mammogram.