Breast Diagnostic Center
FOR SCHEDULING: (2 6 0) 4 8 3 - 1 8 4 7
Appointments are preferred and can be made by calling from 8 a.m. to 5 p.m., Monday through Friday.
How To Contact Us:
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Parkview N. Med. Office Bldg. 11123 Parkview Plaza Dr., Ste. 201 Fort Wayne, Indiana 46845 How to Find Us (view map)
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Carew Medical Park 1818 Carew, Suite 40 Fort Wayne, Indiana 46805 How to Find Us (view map) |
Francine's Friends Mobile Mammography Francine's Friends Schedule |
At the Breast Diagnostic Center, we are committed to providing the highest quality breast imaging services. We want you to feel well cared for in a pleasant environment and encourage you to actively participate in managing your breast health. Our Staff is focused on breast imaging. All exams are performed by technologists specially trained in mammography, registered with the ARRT and certified by the Indiana State Board of Health. Our radiologists are board certified and experienced in breast imaging.
We take pride in providing you with the utmost care in imaging and diagnosis. During your exam, the technologist will gladly answer questions and provide you with written materials about mammography and breast self-examination. Information and educational materials regarding breast health are available at the Centers. Feel free to ask our professional staff questions at any time.
Breast cancer will affect an average of one in seven women during their lifetime. It is the second most common cause of cancer-related deaths in women. Numerous studies prove that early detection is a vital component in the successful treatment of breast cancer. Early detection of cancer increases effective treatment options and the possibility of a cure.
Early detection is your best protection. Close to 90 percent of breast cancers can be detected early, when they are most treatable. All three of the following methods should be used:
- Monthly breast self-examination
- Yearly clinical breast exam by a health care provider.
- Mammograms according to the American Cancer Society guidelines:
- Baseline by age 40
- Age 40 and over: every year
Monthly breast self-exams (BSE) can help you know how your breasts normally feel and look, so you can notice any changes. Most breast changes or lumps are not cancerous, but only a health care provider can tell you for sure. BSE is recommended to be performed at the same time every month, a few days after your period ends.
You are looking for a lump or change that stands out as different from the rest of your breast tissue. If you find a lump or other change in your breast, examine the other breast. If both breasts feel the same, the lumpiness is probably normal. As you get to know your breasts better by doing breast self-exams, you should be able to tell the difference between your normal lumpiness and a possible change.
- skin irritation or dimpling
- nipple pain or retraction (turning inward)
- redness or scaliness of the nipple or breast skin
- a discharge other than breast milk
If you experience any of these changes, you should see your health care provider right away.
Mammography is a low-dose x-ray of the breast taken to detect breast disease that has been proven to detect cancer earlier than physical exam alone.
Mammograms play a central part in the early detection of breast cancer because they can detect changes in the breast that may be early signs of cancer, but are too small or subtle to be felt. The use of mammography has greatly enhanced the ability to detect breast cancers at earlier stages.
Screening mammography is an exam for women who have no symptoms of breast cancer. Diagnostic mammography may include additional views of the breast and is used when an abnormality is found during screening or in women who have breast complaints, such as a breast mass, nipple discharge, breast pain or skin irritation. A diagnostic mammogram requires a physician order.
A mammogram takes approxiamtely 15 minutes and can be scheduled by you or your physician. During the mammogram, two to four pictures of each breast may be taken. Compression is necessary to spread the tissue to allow better detection at the lowest radiation dosage.
Breast compression may cause slight discomfort for a brief time during each x-ray, but it should not be painful. To lessen this discomfort, you should abstain from caffeine intake for two weeks prior to your appointment. The Mammo pad is a foam pad which may lessen your discomfort. Just ask the technologist at the time of your mammogram.
Before scheduling a mammogram, the American Cancer Society (ACS) recommends that you discuss any new findings or problems in your breasts with your doctor. In addition, inform your doctor of any prior surgeries, hormone use, and family or personal history of breast cancer.
Do not schedule your mammogram for the week before your period if your breasts are usually tender during this time. The best time for a mammogram is one week following your period. Always inform your doctor or x-ray technologist if there is any possibility that you are pregnant
The ACS also recommends you:
- Do not wear deordorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium spots.
- Describe any breast symptoms or problems to the technologist performing the exam.
- If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam.
- Ask when your results will be available; do not assume the results are normal if you do not hear from your doctor or the mammography facility.
Now a new technology called full field digital mammography has proven to be more effective in detecting cancer in women under 50, women with dense breasts, and those who are premenopausal.
Digital mammography uses computers and specially designed digital detectors to produce an image that can be displayed on a high-resolution computer monitor, and transmitted and stored just like computer files. From a patient's point of view, having a digital mammogram is very much like having a conventional screen-film mammogram. Both film-based and digital mammography use compression and x-rays to create clear images of the tissue of the breast. During all mammography exams, the technologist positions the patient to image the breast from different angles and compresses the breast with a paddle to obtain optimal image quality. Unlike film-based mammography, digital mammograms produce images that appear on the technologist's monitor in a matter of seconds. There is no waiting for film to develop, which can mean a shorter time spent in the breast imaging suite. Another convenience of digital mammography over film-based systems is it can greatly reduce the need for retakes due to over or under exposure. This potentially saves additional time and reduces your exposure to x-rays.
Unlike other parts of the body, the breast is composed mainly of soft tissue. When breast tissue is x-rayed, it creates an image that looks something like a smoky haze, making it difficult to see tiny "spots," called microcalcifications, and other subtle signs of cancer.
With digital mammography, the radiologist reviews electronics images of the breast, using special high resolution monitors. The physician can adjust the brightness, change contrast, and zoom in for close-ups of specific areas of interest. Being able to manipulate images is one of the main benefits of digital technology. Because they are electronic, digital mammography images can be transmitted quickly across a network. Digital images can also be easily stored, copied without any loss of information, and transmitted electronically, eliminating dependence on only one set of "original" films.
In addition to Digital Mammography, the Breast Diagnostic Center uses Computer Aided Detection. This technology provides the radiologist with additional information to interpret the mammogram. Use of the Image Checker minimizes the chance that a very small cancer might be missed. Many breast cancers are so subtle they do not appear on a mammogram. Further analysis using the computer may find as many as 20% more small, early cancers than mammography alone. This ensures that you will receive the highest quality examination at the lowest possible radiation level.
Occasionally abnormalities in the breast will require aditional diagnostic procedures. The Breast Diagnostic Center provides a complete range of diagnostic services.
Ultrasound is a painless procedure where the breasts are scanned with high frequency sound waves to produce pictures of the breast tissue. Ultrasound testing allows the radiologist to determine whether a lump is solid tissue or fluid-filled cyst. Very dense breasts can often be examined better with ultrasound than with mammography. Exams for young patients and certain follow-up exams will be done primarily with ultrasound. Unlike mammography, you do not need to abstain from caffeine before an ultrasound exam. As with a diagnostic mammogram, your tests results will be explained to you following the exam.
The Breast Diagnostic Center is also staffed and equipped to perform image-guided interventional procedures to diagnose mammogram findings. These techniques include ultrasound guided breast biopsy and stereotactic guided breast biopsy.
- What is Ultrasound-Guided Breast Biopsy?
Ultrasound is an excellent way to evaluate breast abnormalities detected by mammography, the patient or her doctor, but in some cases it is not possible to tell
from the imaging studies alone whether a growth is benign or cancerous.
Ultrasound-guided breast biopsy is a highly accurate way to evaluate suspicious masses within the breast
that are visible on ultrasound, whether or not they can be felt on breast
self-examination or clinical examination. The procedure prevents the need
to remove tissue surgically and also eliminates the radiation exposure
that comes from using x-rays to locate a mass. After placing an ultrasound
probe over the site of the breast lump and using local anesthesia, the
radiologist guides a biopsy needle directly into the mass. Tissue specimens
are then taken using either an automatic spring-loaded or vacuum-assisted
device (VAD).
- How does the procedure work?
Ultrasonography uses sound waves at very high frequency to image internal structures,
including those deep within the body. Either pulsed or continuous sound
waves are directed at the area of interest using a hand-held device
called a transducer.The transducer also receives echoes of the sound waves in a pattern that reflects the
outlines of the internal structure mass. The transducer changes electrical signals into
ultrasound waves and converts the reflected sound waves back to electrical energy.
Unlike radiological procedures, the ultrasound method requires no exposure
to x-rays.
- When ultrasound is chosen to guide a breast,
one of the biopsy instruments used is a VAD. Nodules of tissue less than about
an inch in size can be totally removed using this equipment. These systems
use vacuum pressure to pull tissue into a needle and remove it without
having to withdraw the probe after each sampling—as is necessary
when the core needle method is used. Biopsies are obtained in an orderly
manner by rotating the needle, ensuring that the entire region of interest
will be sampled.
- The core needle method is used most commonly because it is the least expensive,
easy to perform and highly accurate for many lesions. An inner needle
with a trough extending from it at one end is covered by a sheath and
attached to a spring-loaded mechanism. When the mechanism is activated,
the needle moves forward, filling the trough with breast tissue.
The outer sheath instantly moves forward to cut the tissue and keep
it in the trough. It takes only a fraction of a second to obtain a sample
and for each sample it is necessary to withdraw the needle to collect
the tissue.
- How is the procedure performed?
With the patient lying on her back or turned slightly to the side,
the ultrasound probe is used to locate the lesion. Enough local anesthesia
is injected to be sure that she will feel no discomfort during the procedure.
Ultrasound also is used to guide the injection of anesthetic along the
route to the lesion and about the mass. A very small nick is made in
the skin at the site where the biopsy needle is to be inserted. The
radiologist, constantly monitoring the lesion site with the ultrasound
probe, guides a hollowcore biopsy needle or the vacuum-assisted needle
directly into the mass and obtains specimens. Usually at least four samples are taken.
In some cases it may be difficult to visualize the needle in the breast
tissue and considerable skill is needed to coordinate movements of
the ultrasound transducer with needle insertion. If the lesion is nearly or completely removed during the biopsy procedure, a clip is placed where the lesion was located to ensure that the site can be easily located for additional surgery if the lesion proves to be malignant.
- What will I experience during the procedure?
You will be awake during your biopsy and should have little or no discomfort. Generally the biopsy is completed in less than an hour. It is not necessary to close the tiny skin incision with sutures; a small compression dressing will do. Most patients are able to resume their usual activities later the same day.
- Who interprets the results and how do I get them?
The pathologist will examine the tissue specimens after they are processed. A definite
diagnosis will be available within a few days, the main question being
whether the breast mass is benign or cancerous. When the final biopsy
findings are available you may have a session with your physician to
discuss the results and decide together on the next step. If cancer
is diagnosed you probably will be referred to a tumor specialist or
surgeon.
Mammography is an excellent way to detect breast abnormalities, but in many cases
it is not possible to tell from the imaging studies alone whether a growth
is benign or cancerous. To make this determination it is necessary to
obtain a tissue sample for microscopic examination. As an alternative
to open surgical biopsy,
which removes a larger specimen for microscopic analysis, a hollow
needle may be passed through the skin into the suspicious lesion with
the help of special breast x-rays.
The sample of breast tissue obtained in this way can show whether
the lesion is malignant
or benign and the procedure is much less invasive than the surgical approach.
A special computerized mammography machine uses intersecting coordinates
to pinpoint the area of tissue change. This method is called stereotactic
biopsy or x-ray-guided biopsy. A pathologist examines the removed specimen and makes a final diagnosis so that treatment
planning can begin.
- How should I prepare for the procedure?
Even though most women who have a breast biopsy are found not to have
cancer, despite an abnormality on the mammogram, you may want to have
a relative or friend join you to lend support and drive you home.
If you are taking aspirin or a blood thinner, your physician may want
you to stop three days in advance of the biopsy.
- How does the procedure work?
In addition to the specialized equipment needed for x-ray-guided breast
biopsy, specially trained technologists and physicians perform the procedure.
The images are obtained not with x-ray-exposed film as in conventional
mammography,
but using computerized or digital imaging in place of a film cassette.
This reduces x-ray exposure to the breast and also permits the images to be viewed on
a computer monitor seconds after exposure—compared with the several
minutes needed to develop x-ray film. The principle of stereotactic
biopsy is that a lesion can be located precisely in three dimensions
by calculating its apparent change in position on angled x-ray images.
The first x-ray locates the abnormality in the breast, after which two
stereo views are obtained, each angled 15 degrees to either side of
the initial image. The physician then marks the lesion electronically
on the stereo images. The computer calculates how much the lesion's
position appears to have changed on each of the stereo views, and in
this way is able to determine its exact site in three-dimensional space.
- The biopsy instrument used in this procedure is called a vacuum-assisted device (VAD), which consists of an inner needle with a trough extending
from it at one end and an overlying sheath. When the sheath is retracted, a vacuum is used to pull breast tissue into the needle trough. The outer sheath rapidly moves forward to cut the tissue and collect it in the trough.
- An advantage of the VAD is that the needle is inserted only once into the breast
without having to withdraw the needle after each sampling. Biopsies are obtained in an orderly
manner by rotating the probe, assuring that the entire region of interest
will be sampled.
- How is the procedure performed
The first step is to clean the skin and inject a local anesthetic.
A small nick is made in the skin and the tip of the biopsy needle is
advanced to the previously calculated site of the lesion. At this point stereo
images are again obtained to confirm that the needle tip is actually
within the lesion. Usually six to 12 samples are collected when the VAD is used. Then a final set
of images is obtained. If they show that the lesion has been mostly
or completely removed, a small clip is left at the biopsy site so that
it can be easily located if the lesion proves to be cancer. Once the biopsy is complete
the skin opening is covered with a dressing; it need not be sutured.
You will be told to avoid strenuous activity for 24 hours after returning
home, but then usually will be able to resume normal activities.
- What will I experience during the procedure?
X-ray-guided breast biopsy can take 30 to 60 minutes or more.
Most women report little or no pain and no scar is left from the tiny
skin incision. Many women find that the major discomfort of the procedure
is from lying on their stomach for the length of the procedure. This
discomfort may be reduced by strategically placed cushions.
- Who interprets the results and how do I get them?
A pathologist must examine the specimens of tissue. A diagnosis requires processing numerous, high-quality
slides over a period of one to five working days. When your biopsy findings
are ready you may have a session with your physician to discuss the
results and decide on the next step. If cancer is found you may be
referred to a surgeon or tumor specialist.
A breast MRI is indicated when ultrasound or sterotactic guided biopsy is not appropriate because the abnormality may not be well seen by mammography or ultrasound. The Breast Diagnostic Center works closely with our affiliate facility, MRI Center, should you require Breast MRI and MRI-guided biopsy.
BDC offers bone densitometry, DEXA, with instant vertebral assessment, IVA, an examination of the vertebrae (the bones of the spine) performed at the time of the bone densitometry exam. DEXA evaluates the degree of osteoporosis. IVA uses very low dose radiation for vertebral fracture risk assessment to evaluate existing vertebral deformities, which increase the risk of a vertebral fracture. Vertebral fractures are common but 75% are not clinically recognized. Up to one quarter of Caucasian women over age 50 have at least one fracture. An existing spine fracture increases the risk of future spine fractures five-fold and doubles the risk of hip fractures. IVA helps your doctor determine your fracture risk and accurately evaluate your need for treatment. Ask your doctor if you need this examination. Both of these examinations require a doctor's order.
Francine’s Friends Mobile Mammography is a specially equipped motor coach staffed by radiologic technologists from the Breast
Diagnostic Center who specialize in mammography. The unit is furnished with the same FDA and Mammography Quality
Standards Act (MQSA)-approved digital equipment as the stationary sites.
Francine’s Friends Mobile Mammography unit has joined forces with many local partners to offer mammography services. We offer life-saving services to women in Fort Wayne and the surrounding area that might otherwise be unable to receive them because of financial or transportation issues. By traveling to various community and business sites, Francine’s Friends is able to bring mammography screening to women at locations more convenient to their home or work.
As a service to our patients, Fort Wayne Radiology files all primary and secondary insurance claims. To expedite
claims processing, we file a significant number of claims electronically and receive Anthem, Medicare and Medicaid
payments electronically. We are participating providers in the following networks:
- Aetna Health Plans
- Anthem (including HMO/POS)
- Central States/Teamcare
- Cigna- HMO and PPO
- Encore and Encircle
- HMO Health Ohio
- Indiana Health Network
- Lutheran Preferred
- Community Care Systems, Inc.(CCSI)
- Lutheran TRMA
- Advantage Preferred Plus (Medicare HMO)
- M-Plan (HMO)
- Three Rivers Preferred (PPO)
- Three Rivers Preferred
- Parkview Health Plan Services
- Goshen Preferred
- M-Plan
- Signature Care
- FrontPath
- Medicaid
- Medicare
- Physicians Health Plan
- Preferred Plan
- Sagamore
- Tricare
- United Health Care