We provide our radiology services at:
- St. Joseph Regional Medical Center (Mishawaka & Plymouth campuses)
- St. Joseph Regional Medical Center – Medical Imaging
- Community Hospital of Bremen
- Legacy Vein Clinic
- XRC Interventional Radiology Clinic
X-Ray Consultants, P.C. (XRC) is committed to furthering women’s health within our community. We understand women’s special needs and preferences and have dedicated an area of our center to specialize in women’s services, specifically digital mammography and ultrasound.
Mammography, along with breast self-examination, is the best defense against breast cancer. Early diagnosis and treatment saves thousands of lives annually. A measure of our commitment to breast health is demonstrated in two mammography sub-specialists in our radiology group: Brett A, Stephens, MD, and Linda L. Tuthill, MD. We also utilize only FDA and ACR-certified, state-of-the-art equipment. Furthermore, we use the most advanced full-field digital mammography system with an R-2™ Image Checker, a computer-assisted diagnosis device, as an adjunt to our radiologists to ensure that no area has been overlooked.
Mammography itself is a safe, low-dose x-ray of the breast(s). There are two kinds of mammograms: screening and diagnostic. Screening mammograms involve two x-ray views of each breast. In the event an area of concern is identified, the patient may be called back for special additional views. Diagnostic mammograms require more views and are usually indicated in situations where patients have had prior breast surgery, implants or fibrocystic disease. In either exam, screening or diagnostic, the breasts will be temporarily and gently compressed in order to obtain the best possible image.
Mammograms are brief; usually no more than 20 minutes in duration and there is no advance preparation other than to refrain from using any deodorant, powder or lotion on the breasts or under the arms on the day of your exam. Patients should also wear a 2-piece outfit so that they only need to remove their top in the room. Lastly, they should bring in the name of the facility where their previous mammograms have been performed, should we need them for comparison.
Stereotactic breast biopsy and needle localizations are also performed in our center. Stereotactic biopsies involve the precise targeting and tissue sampling of suspicious area(s) of the breast under local anesthesia. In cases where a more conventional surgical biopsy is to be performed, patients are sometimes sent to one of our three hospital locations prior to the surgery so that the exact area can be pinpointed and marked with a wire (“needle localization”) to aid the surgeon.
The facts about breast density
Are your breasts dense?
Dense breasts are normal; up to 40% of American women have them. It simply means that a woman has more fibrous, glandular tissue in her breasts than fatty tissue. Younger women typically have denser breast tissue. Older women, especially post-menopausal women, have less dense breast tissue. But if a woman takes postmenopausal hormones, her breasts may remain dense.
Breast density is measured during annual screening mammogram
All mammography reports from XRC contain a classification of breast density based on the Breast Imaging Reporting and Data System (BI-RADS) breast composition categories:
Why is breast density important?
While the reasons are not yet fully understood, women with denser breasts are at an increased risk for breast cancer. In addition, clinical studies have shown that women with dense breasts can benefit from a supplemental form of screening in addition to mammography.
For women classified as BI-RADS 3 (heterogeneously dense) and BI-RADS 4 (extremely dense) may benefit from a supplemental screening in addition to 2D or 3D mammography. Supplemental screenings can include breast MRI, ultrasound and a new form of screening called molecular breast imaging (MBI).
Breast MRI is generally recommended for women who are determined to be at high risk for breast cancer (e.g. another family member was diagnosed with the disease). For most women with dense breasts, Molecular Breast Imaging (MBI) is a safe and highly effective form of imaging that is not affected by breast density. Research has shown that when used in conjunction with mammography, MBI may detect cancers two to three times more often than mammography alone.
Why haven’t I heard of breast density before?
The issue of breast density has only recently emerged into the national spotlight, and the majority of clinical research on the subject is less than ten years old. Seventeen states, including Indiana, have breast density notification laws, and that number is growing.
The clinical evidence is clear, and this is not a medical “fad.” Breast density is not only a risk factor for breast cancer, but it can also impact a woman’s ability to achieve early detection using traditional methods. It is widely agreed that early detection is the key to surviving breast cancer, so any issue that can impact a woman’s confidence in her healthcare strategy must be considered.
Learn the facts for yourself. Talk to your doctor. If you need more information, we are here to help or you can visit the following:
American Cancer Society
“Breast Density and Your Breast Mammogram Report”
National Cancer Institute
“What is the Breast Imaging Reporting and Database System (BI-RADS®)?”
DEXA Bone Densitometry
Osteoporosis (softening of the bones) is a disease gaining attention as more people live longer; however, it is not a condition that is limited to natural aging. In many instances it is associated with post-menopausal estrogen deficiency, secondary conditions that adversely impact bone metabolism and can sometimes even be traced to childhood, if environmental or clinical conditions impeded the development of peak bone mass.
The optimum method of diagnosing primary or secondary osteoporosis is with a Total Body Assessment performed on a dual-energy x-ray absorption (DEXA) scanner. Many DEXA scanners measure the bone density of just the spine and femurs, which is appropriate for primary osteoporosis but less than optimum for secondary conditions or for evaluating bone growth.
The digital fan-beam DEXA scanners at our three hospital locations lead the industry in bone densitometry. It can perform a noninvasive total body bone assessment, as well as lean and fat tissue components, including fat percentage, and lean tissue mass. The accurate measurement of total, as well as regional bone and soft tissue composition is clinically relevant in a number of scenarios.
A DEXA exam is fast, inexpensive and requires no prior preparation. Clothing does not need to be removed. It can play a major role in monitoring bone and body mass health.
Ultrasound is a fantastic imaging modality, not just because of the high-quality images it produces but because it’s also simple, painless and does not involve ionizing radiation. The working principle behind ultrasound is similar to that of sonar, which is used by the U.S. Navy. First a conducting gel is applied to the body part being examined. Then a transducer, a wand-like instrument, is moved across the gel. The transducer emits high frequency sound waves which penetrate through the gel and the patient’s skin. As the sound waves penetrate various body parts, they are bounced back, like echoes, and returned to the transducer. The transducer then relays these signals to the ultrasound machine which constructs an image.
Ultrasound is useful in a number of body locations. It is most commonly employed in imaging the pelvis and abdomen, although it is also frequently used in the area of the neck and in extremities. It can also be enhanced by a special Doppler system to image moving blood flow within vessels.
Many ultrasound studies require a special preparation, such as a full bladder to better visualize structures like the uterus and ovaries. For a full description of the preparation instructions necessary for exams, please click here.