the Breast Clinic
Testing & Investigations
Dependant on the symptoms that you have presented with, or needs identified during the consultation, the next step will likely involve a clinical examination, and further investigations including one or more of the following:
- Clinical examination
- Mammogram
- Ultrasound
- Core Biopsy
It may be necessary to have further investigation requiring additional tests or diagnostic procedures, which may include:
Mammogram
A mammogram is an X-Ray of the breast and is offered to anyone over the age of 40 years. A mammographer positions one breast at a time onto the machine where compression is applied. This is important as it spreads the breast tissue out to help achieve a clear picture. Two X-rays of each breast are taken. The procedure should not be painful and only takes a few minutes.
Digital Breast Tomosynthesis (DBT)
Digital breast tomosynthesis (DBT) is an advanced form of mammography that creates a 3D image of the breast by taking multiple low-dose X-ray images from different angles. The procedure is the same as a mammogram and just takes a few seconds longer.
Ultrasound
Ultrasound is performed by a Consultant Radiologist. It is safe and painless and uses sound waves to produce pictures of the inside of the body. Ultrasound imaging involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High frequency sound waves are transmitted from the probe through the gel into the body. The probe collects the sound waves that bounce back, and a computer uses this information to create an image.
Magnetic Resonance Imaging (MRI)
A breast MRI (magnetic resonance imaging) scan is an imaging test that uses powerful magnets, radio waves and a computer to create pictures of the breast and surrounding tissue. It does not use radiation (X-Rays). You will lay face down on a table whilst it scans. A breast MRI may be done in combination with mammograms and ultrasound. It is not a replacement for mammography. Breast MRIs are very sensitive and further ultrasounds may be recommended to assess additional areas in either breast seen on MRI.
CT Scan
A CT scan is a test that takes detailed pictures of the inside of your body. It is usually used to diagnose conditions or check how well treatment is working.
Core Biopsy
This is a procedure to remove small amounts of tissue from an area of interest in the breast. It is usually undertaken with the guidance of ultrasound or mammogram machine to ensure accurate sampling. The skin is cleaned with antiseptic then some local anaesthetic is injected under the skin. A small incision is made in the skin and small amounts of tissue are removed and sent to the Histopathology Department for analysis. A tiny titanium marker clip is usually positioned into the biopsy site. This makes it easier to find the area again in the future. Further mammograms are taken to check the position of the marker clip.
Clinical Breast Examination
This involves a physical examination of the breasts, the base of the neck and under the arms by a trained health care professional.
Vacuum Assisted Biopsy (VAB)
A vacuum-assisted breast biopsy is a minimally invasive procedure that uses gentle suction to remove larger tissue samples for testing, guided by imaging like mammography, ultrasound, or MRI. It’s performed after a local anesthetic is injected, and a small incision is made to insert a hollow needle that collects tissue through suction.
Vacuum Assisted Excision Biopsy (VAE)
This is a procedure where mammograms, or less often ultrasound, are used to locate an area in the breast that requires removal. A previous breast biopsy will have shown an area that needs further sampling. Previously excision of these lesions required an operation under a general anaesthetic, but technology now allows for some lesions to be removed under local anaesthetic. This procedure is similar to that of a vacuum assisted biopsy. This type of biopsy may require a visit to the Breast Screening Unit at Princess Anne Hospital.