The Diagnostic Center for Women offers a variety of Breast Imaging services using state of the art equipment. These services include screening mammograms, diagnostic mammograms, breast ultrasound and now Breast MRI.

For continuity of care and for your convenience, we also offer breast biopsy services in the comfort of our Center. These include stereotactic core and ultrasound guided core biopsies, fine needle aspirations and cyst aspirations.

Digital Mammography

Digital mammography is a specialized form of mammography that uses digital receptors and computers instead of x-ray film to help examine breast tissue for breast cancer. The electrical signals can be read on computer screens, permitting more use of images to allow radiologists a clear view of the results.

3D Mammography, clinically known as, Digital Breast Tomosynthesis (DBT), obtains multiple images of the breast and reconstructs them to create a 3D image of the breast rather than a single image. This technology improves the detection of small cancers and has been shown to reduce the number of patients recalled for more imaging due to false positives. This is used for screening patients, and can also be utilized as an additional screening tool if a patient’s 2-D mammogram shows dense breast tissue.

Screening mammography is used to detect breast changes in women who have no signs or symptoms of observable breast abnormalities. American Cancer Society, American College of Radiology and Society of Breast Imaging recommend annual screening mammograms begin at age 40. The goal is to detect cancer before clinical signs are noticeable.

Diagnostic mammography is used to investigate suspicious breast changes, such as a breast lump, breast pain, an unusual skin appearance, nipple thickening or nipple discharge. Additional exams, such as a breast ultrasound, may be performed to aid in diagnosis.

Breast Ultrasound

A breast ultrasound uses sound waves to create a picture of the tissues inside the breast. Unlike a mammogram, a breast ultrasound shows all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. A breast ultrasound should not replace a mammogram, but it is helpful to see whether a breast lump is filled with fluid, known as a cyst, or if it is a solid lump. It does not use x-rays or other potentially harmful types of radiation.

Breast Biopsy

A breast biopsy is a quick, accurate, and minimally invasive procedure that evaluates a suspicious area in the breast to determine if it is cancer. A small sample of breast tissue is removed for laboratory testing to identify and diagnose abnormalities in the cells to see if additional surgery or treatment is necessary.

This is a minimally invasive procedure that provides accurate results for lesions that are best seen on mammogram images. During this procedure, the patient may be sitting or lying down. The breast is placed in compression (like a mammogram). Digital images are taken and stereotactic coordinates are used to localize the lesion within the breast. The breast radiologist will give local anesthesia and make a small skin nick. A needle is then placed in the breast and multiple specimens are obtained. These specimens are sent to a pathology lab to determine if the lesion is benign (not cancer) or malignant (cancer). At the completion of the procedure, a permanent biopsy marker is then inserted into the biopsy cavity for future reference.

This is a minimally invasive procedure that provides accurate results for lesions that are best seen on ultrasound images. During this procedure, the patient lies on their back or side. The breast radiologist will confirm the location of the lesion using an ultrasound probe. Local anesthesia is given into the skin and around the targeted lesion. A biopsy needle is then guided directly into the lesion under ultrasound guidance. Multiple tissue specimens are then obtained. These specimens are sent to a pathology lab to determine if the lesion is benign (not cancer) or malignant (cancer). At the completion of the procedure, a permanent biopsy marker is then inserted into the biopsy cavity for future reference.

An MRI-guided breast biopsy uses magnetic resonance imaging to evaluate breast tissue. Certain tissue characteristics that are not easily seen on ultrasound or mammography can be detected by MRI. The images are used to locate suspicious regions of breast tissue and visually assist in taking samples. Since MRI uses magnetic fields to obtain images, there is no radiation exposure.

Fine Needle Aspiration

During a fine-needle aspiration, a thin needle is inserted into a breast lump to withdraw fluid. This procedure is often done using ultrasound to guide accurate placement of the needle. If the fluid comes out and your lump goes away successfully, your doctor can make a breast cyst diagnosis.

Cyst Aspiration

This is a simple procedure performed to drain a symptomatic or questionable cyst within the breast tissue. In this procedure, local anesthesia is used to numb the skin. Then the breast radiologist guides a thin needle into the cyst using ultrasound guidance. The fluid is then withdrawn into a syringe. The fluid is usually discarded (not tested) unless blood is found.

Breast MRI

A Breast MRI is an imaging test that helps determine if a lump in the breast is cancerous or benign. This test uses a magnetic field and pulses of radio waves to make pictures of the breast. The Breast MRI may show problems in the breast that cannot be seen on a mammogram, ultrasound, or CT scan. The picture shows your breast’s normal structure, and identifies tissue damage or disease, inflammation, or a lump.

Diagnostic Center for Women is now offering fast breast MRI to average risk women with dense breasts.
What is Fast breast MRI (Abbreviated Breast MRI)? It is a faster more affordable breast MRI protocol that takes approximately 5-7minutes as oppose to conventional breast MRI which takes 15-20 minutes.

Cryoablation

Patients diagnosed with a fibroadenoma (a benign breast tumor) now have the option to choose cryoablation as treatment, which is both highly effective and minimally invasive. Many women choose cryoablation over surgical excision due to the fact that it’s an in-office procedure with a shorter recovery time.

How does cryoablation of fibroadenomas work?
Cryoablation is a minimally invasive, in-office procedure that takes about 10-20 minutes and requires only local anesthesia. It is very similar to a breast biopsy. Ultrasound is used to direct the cryoprobe, which resembles a thin needle, to the location of the fibroadenoma. The tip of the probe gets extremely cold creating an ice that surrounds the tumor and destroys it. The body then absorbs the damaged tissue over time, replacing it with healthy tissue.
Step-by-Step Procedure with Video

What are the benefits of cryoablation compared to surgery?
• Cryoablation is quick and is an in-office procedure
• Cryoablation requires minimal recovery and downtime
• Cryoablation uses local anesthesia as oppose to general anesthesia
• Cryoablation uses a tiny 3mm incision and is less likely to create scarring or affect the cosmetic appearance of the breast

Who is cryoablation appropriate for? 
• Painful, uncomfortable, or symptomatic fibroadenomas
• Growing fibroadenomas
• A women with a fibroadenoma who would like it removed due to personal preference

To request a consultation with one of our board-certified breast interventional radiologists please call 305.740.5100 or email cupegui@femwell.com. A member of our team will get back to you within 1 business day.

Patient FAQs

Genetic Testing for Hereditary Cancer Risk

Hereditary cancer is caused by an inherited genetic mutation. Approximately, 10-15% of most cancers are due to inherited genetic mutations. In these families, it is typical to see a recurring pattern of cancer across two to three generations—like multiple individuals diagnosed with the same type of cancer(s) and individuals diagnosed with cancer much younger than average.

A mutation can greatly increase your risk for developing cancer. Mutations in the genes that increase risk for cancer are not that common, but when present they significantly increase the chances someone might develop cancer in his or her lifetime.

For example, a BRCA1 mutation can increase a woman’s chance of breast cancer up to 81% and ovarian cancer up to 54% by age 80.

Your provider may adjust your screening plan if you have a mutation.

Knowing that you have a mutation that increases your risk of developing cancer allows you and your healthcare provider to create a personalized screening plan, which increases the chance of early detection.

The Diagnostic Center for Women is partnering with Color to offer comprehensive genetic testing for 8 different types of cancer (Breast, Ovarian, Colon, Uterine, Melanoma, Stomach, Pancreatic and Prostate) to any person who is interested in learning if they have an increased risk for hereditary cancer.

Download our Genetic Counseling Deck

The Hereditary Cancer Test analyzes 30 genes—including BRCA1 and BRCA2—to help women and men understand their risk for common hereditary cancers. Women and men who use Color will learn about their genetic risk for hereditary breast, colorectal, melanoma, ovarian, pancreatic, prostate, stomach, and uterine cancers. This information is important to their own health, as well as the health of their relatives.

Color carefully selected our 30-gene panel based on scientific studies showing strong association with risk of the most common types of hereditary cancer. In certain genes, only specific positions known to impact cancer risk are analyzed. Color results reports include references to relevant literature and appropriate medical guidelines as available.

The 30 genes on Color’s panel are: APC, ATM, BAP1, BARD1, BMPR1A, BRCA1, BRCA2, BRIP1, CDH1, CDK4*, CDKN2A(p14ARF), CDKN2A (p16INK4a), CHEK2, EPCAM*, GREM1*, MITF*, MLH1, MSH2, MSH6, MUTYH, NBN, PALB2, PMS2**, POLD1*, POLE*, PTEN, RAD51C, RAD51D, SMAD4, STK11, TP53

* Only positions known to impact cancer risk analyzed: CDK4: only chr12:g.58145429-58145431 (codon 24) analyzed, EPCAM: only large deletions and duplications including 3’ end of the gene analyzed, GREM1: only duplications in the upstream regulatory region analyzed, MITF: only chr3:g.70014091 (including c.952G>A) analyzed, POLD1: only chr19:g.50909713 (including c.1433G>A) analyzed, POLE: only chr12:g.133250250 (including c.1270C>G) analyzed.

** PMS2: Exons 12-15 not analyzed.

No. Color test is not designed to test for the presence of a cancerous tumor, and it will not tell you if you do or do not have cancer. It may tell you if you have an increased chance to develop cancer in your lifetime.

Color is not currently available for individuals under the age of 18.

The information you provide about your personal and family health history is used along with your Color genetic test results to better interpret and personalize your report. Your results will incorporate the information you provide, along with nationally published screening and prevention options to discuss with your healthcare provider and create a personalized screening and prevention plan.

The quality of every sample is checked multiple times as it moves through the sequencing and interpretation process.

Occasionally, a sample will not pass quality control checks. This can happen for a variety of reasons, such as an insufficient amount of DNA, or contamination (for example, from food or bacteria in your mouth). If this occurs, we will contact you right away to discuss the next steps.

Don’t worry. Many individuals do not have access to the health history of all or part of their biological family. On the health history form, you can make estimates when possible or indicate that you do not have access to this information. Color will work with the information available to provide you with a personalized risk profile.

If an individual has a mutation, there is a 50% chance that each of their first-degree relatives also has the same mutation. To increase access to this important information, Color and the BRCA Foundation have partnered to offer genetic testing to parents, siblings, and adult children of people with mutations for a special price.

Most mutations are inherited from your mother or your father. This means that your relatives on that side of the family may also have the same mutation. Additionally, each of your siblings and each of your children has a 50% chance of inheriting this mutation.

Knowing that you have a mutation allows you and your healthcare provider to create a personalized screening plan, which increases the chance of early detection.

Learning that you haven’t inherited a family mutation is useful information as well, as it means your children will not inherit it.

Color’s emphasis is on providing you with the highest quality results possible, and that means giving individual attention to every sample. Our average turnaround time is currently 3-4 weeks from the day your sample is received at the laboratory, but the actual time will be subject to the data associated with each unique sample. If you purchased multiple tests, some results may be available sooner than others.

We will notify you via email each step of the way: when your kit has shipped, when you’ve successfully activated it, when your sample has arrived back at the lab, and when your results are ready.

Genetic counselors are medical professionals with specialized training in genetics at the graduate level, similar to a nurse practitioner. They are experts at understanding and explaining how genetics plays a role in health and disease, including cancer. To learn more about genetic counseling and search for a local genetic counselor by ZIP code, you can visit the National Society of Genetic Counselors website (www.nsgc.org).

Your consultation with a genetic counselor from Color’s clinical team is complimentary with your Color purchase. You are encouraged to make an appointment with a Color genetic counselor to discuss your results.

HIPAA:

HIPAA is the Health Insurance Portability and Accountability Act enacted in 1996. This law governs how protected health information (PHI) can be used. Color rigorously follows the standards established by HIPAA, which is the same standard followed by hospitals and other healthcare institutions. Our adherence to HIPAA means that all personally-identifiable health information is encrypted and stored safely. At Color, the only individuals with access to results are those who need it in order to provide services to you. For example, the genetic counselor with whom you make an appointment will have access to your results so that you can fully discuss any questions related to your results.

GINA:

In 2008, a federal law called the Genetic Information Non-Discrimination Act (GINA) was passed to prohibit medical insurance companies and employers from discriminating against individuals on the basis of genetic information, which is defined to include genetic test results, family cancer history, and the fact that genetic testing occurred.
For example, Section 202(a)(1) of GINA provides that it is unlawful “to fail or refuse to hire, or to discharge, any employee, or otherwise to discriminate against any employee with respect to the compensation, terms, conditions, or privileges of employment of the employee, because of genetic information with respect to the employee.”

GINA does not extend to life, disability, or long-term care insurance, which may be governed under state law. Protection against these types of insurance discrimination may vary by state. Individuals may consider purchasing these policies prior to undergoing genetic testing.

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