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Modern Breast Diagnostic Services



Breast Examination

Self-examinations are simple and quick. You should perform them in two different ways each month. The first is as follows:

  1. Lie down on your back with a pillow under your right shoulder and your right arm behind your head.
  2. Use the pads of your three middle fingers on your left hand to feel for lumps or thickening in your right breast. (Pads are the top third of each finger.)
  3. Press firmly enough to know how your breast feels. Learn what your breast feels like most of the time. A firm ridge in the lower curve of each breast is normal.
  4. Move around the breast in a set way (i.e. circular or up-and-down) to make sure that you have covered the entire breast.
  5. Repeat steps 1-4 on the left side.

The second examination is done using the same techniques, this time while standing in front of a mirror, or in the shower with wet, soapy hands.

In addition to feeling for lumps, other signs to watch for that may indicate cancer include: 

  • Dimpling of the skin
  • Changes in breast size or shape or in the nipple
  • Redness, swelling, warmth or darkening
  • Itchy, scaly rash or soreness
  • Discharge - clear, greenish or bloody
  • New, localized pain

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Image-Guided Biopsy

In order to ensure precise delivery of biopsy services for the diagnosis of cancerous and non-cancerous tumors, doctors previously had to rely on data from previous testing that may have changed before the time of treatment. Image-guided biopsies use two and three-dimensional imaging to guide the biopsy needle to the specific target location, for more effective treatment and a minimized risk of damage to surrounding tissue. The imaging procedures are performed simultaneously to provide real time data to the doctor. This also avoids the need for open surgical biopsies.

There are several different types of imaging technologies that may be used during a biopsy procedure, including ultrasound, mammography, MRI of the breast and others. Dr. Joel Benowitz will decide which type is best to help visualize your treatment area.

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Core Needle Biopsy

A core needle biopsy removes only one sample of breast tissue per needle insertion. The removed breast tissue is sent to a lab for review under a microscope, and results are usually available after one to two days. Most procedures take less than an hour to perform, and patients can return home shortly after. 

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Sono-Guided Vacuum-Assisted Biopsy

Sonotome (ultrasound-guided) biopsy is a 10-15 procedure performed with local anesthesia, and involves a vacuum-assisted needle inserted through a small incision in the skin. Tissue samples are taken and a titanium clip is inserted to mark the location in case surgery is required. Typically the entire abnormality is removed. The results of this procedure are available within 24 to 48 hours.

 

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Stereotactic Breast Biopsy

Stereotactic vacuum-assisted biopsy is recommended when a mass (usually a calcium deposit but sometimes a nodule or small tumor) can be seen with mammography but not ultrasound. The abnormal area in the breast is compressed with a paddle, sterilized and numbed with local anesthesia before a vacuum-assisted needle is inserted. Tissue is removed swiftly and painlessly with suction, and a titanium clip is inserted in the breast to mark the area in case surgery is required. In most cases the entire abnormality is removed. 

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Evaluation of High-Risk Patients

While all women are at risk for developing breast cancer, some may be at a higher risk due to certain genetic and environmental factors. Patients at a high risk include those who:

  • Are over the age of 50
  • Have a family or personal history of breast cancer and gynecological cancers
  • Had their first child after the age of 30
  • Had a late onset of menopause
  • Have no children
  • BRCA I & II Positive
  • Halo Pap Test Positive
  • Hormone Replacement Therapy

While it is important for all women to undergo regular screenings for breast cancer both at home and by their doctor, women at high risk may be screened earlier and/or more frequently. Screening for breast cancer may include self-exams, mammograms, sonography, MRI of the breast, genetic testing and breast biopsy. Dr. Benowitz will determine which screening exams are most appropriate for each individual patient.

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Lymph Node Staging With Sentinel Node Evaluation

Since breast cancer often spreads to the axillary lymph nodes as the disease progresses, testing for cancer within the lymph nodes can help identify the stage of breast cancer and determine the most appropriate treatment option. Cancerous tissue that has spread to the lymph nodes is likely to spread to other areas of the body such as the bone, liver, lungs or brain.

Staging is typically performed through a sentinel lymph node evaluation, which involves removing a cluster of lymph nodes from the underarm area, which involves removing the first one to three lymph nodes near the breast to test for cancerous cells.

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Breast Surgery Consultation

Choosing your individual treatment approach after a breast cancer diagnosis is a serious decision that should not be made without a careful consideration of all options. Dr. Benowitz takes the time to discuss all surgical and non-surgical treatment options with each patient during a one-on-one consultation. This gives patients the opportunity to learn about the details, risks and benefits of surgical treatment, as well as ask Dr. Benowitz about any questions or concerns they may have.

During this consultation, Dr. Benowitz will help you decide which type of surgery is best for you, based on the type, severity and location of your cancer, as well as your age, overall health and personal preference. He will also provide information on supplementary treatments such as chemotherapy and radiation therapy.

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Services

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  • Surgical Consultations
  • Breast Sonography
  • Mammographic Evaluation
  • Image-Guided Breast Biopsy
  • Breast Conservation Surgery
  • Oncoplastic Surgery
  • Mastectomy
  • Reconstruction