Routine Breast Imaging or Boob Attack!

Part of the GYN check up is an examination of the breasts.Lots of new controversy surrounding what to do, how to do it and when to get imaging. And what kind of imaging to do.

The young woman has a risk of a benign conditions and tumors. They are found either by the girl herself, or during a gyn visit. Most of the imaging that is done is through ultrasound, as that is helpful for a young (under 30) dense breast. After that the breast starts to accumulte fat, and therefore it is easier for the radiologist to differentiate normal tissue from abnormal. A screening baseline mammogram is done about age 35. From forty on, annual mammograms are still the best way to look at the breast.

What do we ask the radiologist for during these imaging examinations of the breast? We ask them for a consultation regarding your breast. Is there evidence that leads us to need a biopsy ( ie further investigation) or can this breast be evaluated in a normal or other interval? Now the radiologist takes this very seriously, and will ask for not just the routine two picture views, sometimes they will ask to add other modalities such as ultrasound, or other views, like standing on your head. This of course, is something that drives women crazy.

It's like this. You slam the car door on your finger. You go to the Emergency Dept to see if its broken. The radiology tech takes a picture of your finger. They take the film to the radiologist ( or if digital, send it) and ask if it is adequate. The radiologist says no, turn the finger this way and that until she/he decides it is broken or not. Same with the breasts only the radiologist is ususally not sitting there. These routine films take a number. And these days your radiologist may be in India or Austrailia with teleradiology.

At any rate if the views taken are not sufficient to answer the questions posed, they will request that the ordering physician go back and do it again, this way and that.They may want to do ultrasound, or recommend a biopsy either through ultrasound or needle biopsy. They will also compare the films to prior years to guide them what is normal for you.

So that's it. Don't panic if you need more films. Be thankful they are paying attention!

Until next time