The unit offers rapid diagnostic breast imaging both full field digital mammography and ultrasound.
The different ways of examining the breast are outlined below:
Screening mammography is used to detect breast changes in women who do not have any breast symptoms.
Sometimes, tiny specks of calcium can be detected on a mammogram which can be a sign of precancerous change. The object of screening mammography is to pick up these early abnormalities before any breast lump can be felt. This gives a two to three year lead in on diagnosing a breast cancer and removing that small area of tissue can mean that a full blown breast cancer is prevented.
In the NHS breast screening starts at sometime between the age of 47 and 53 and is once every three years. We do not have a breast screening programme at The London Breast Clinic. However we are happy to offer a breast screening service following discussion and examination with one of our consultants as it is important for us to discuss the advantages and disadvantages of screening mammography prior to the procedure.
We do have 3 dimensional tomosynthesis mammograms available at The London Breast Clinic which offer the most accurate test currently available. This means that if any abnormalities are identified on screening then the consultant can organise rapid and appropriate investigation which are available here at The London Breast Clinic.
Full field digital mammography is a diagnostic, low dose X-Ray examination, using dedicated equipment, for examining the breast. It is usually offered to women over 40 (or 35 with a strong family history and referred by a clinician) and is used routinely in screening programmes. It is also the first investigation for symptomatic purposes, including for those with a family history of breast cancer or on hormone replacement therapy. In order to perform a mammogram, the breast is compressed between two perspex x-ray plates, some women find this uncomfortable, and a very small number may find it painful. Mammography with tomosynthesis is carried out by a radiographer and the image of the breast is then reviewed by a consultant breast radiologist, who will produce a report for the consultant breast surgeon.
Tomosynthesis is an advanced form of mammography that allows mammograms to be viewed in a “3 dimensions” making small cancers easier to visualise.
Download our patient pamphlet What to expect from your Tomosynthesis exam.
Mammograms are not a 100% accurate which is why we would suggest that a full history is taken and the patient is also examined prior to the procedure.
Abnormalities are assessed with on-site full field digital mammography, ultrasound stereotactic/perforated plate cytology or core biopsy, together with localization and surgical excision if necessary.
Ultrasound is used where there is an abnormality in a part of the breast and will differentiate solid lesions from cystic ones. Increasingly this technique is used in conjunction with mammography, as both techniques give complementary information. In patients under 35, ultrasound is the usual diagnostic investigation used in conjunction with clinical examination as a screening technique. It uses high frequency sound waves to produce pictures of internal tissues and organs.
A special gel is spread onto the breasts and a transducer, a small hand held microphone, which emits sound waves, is passed over the area. The echoes are converted into an image of the breast tissue, which is then reviewed by a consultant radiologist, who will produce a report for the consultant breast surgeon. Ultrasound scans are painless.
Ultrasound can also be used by a consultant radiologist to guide the needle to the area of abnormality to have cells taken for fine needle aspiration cytology.
In order to establish a tissue diagnosis, a slightly thicker needle than for FNAC is inserted into the breast, to remove a small tissue sample for histological examination. Local anaesthetic is used to make the area numb before the biopsy is taken.
A small cut is then made in the breast and the core biopsy needle inserted to take samples.
It can be performed clinically, by feeling the position of the lump, or if the area is very small or cannot be felt, this test can be performed using ultrasound or X-Ray guidance (Stereotactic core biopsy). The tissue is sent away for examination (histopathology) and the results are usually available within 48-72 hours.
In certain circumstances it renders surgical excision unnecessary if the lesion is confirmed as benign. It may be carried out by either a consultant breast surgeon or consultant radiologist.
Should surgery, for an impalpable abnormality, be required, guidance is provided, for the consultant breast surgeon, using either wire placement or ultrasound guided skin marking, whichever is most appropriate.
Quality control is very important to us all at 108 X-ray and Imaging. We adhere to a number of quality control measures, which include:
- Comprehensive quality control procedures applied daily to all x-ray equipment.
- Modern, dedicated mammography equipment maintained in accordance with the strict standards applied by the UK National Breast Screening Programme.
- Compliance with professional guidelines for specialist training and research activities, including recognised external quality assessment schemes, for our team of nationally recognised consultant radiologists.
- Regular audit and discussions held by our multi-disciplinary teams reflecting the best practice within NHS National Breast Screening Programme guidelines.
- Audit is also undertaken by an external Radiation Protection Centre. Please view April 2017 report here.