Breast health

Breast biopsies are necessary to tell if a breast lump is benign (noncancerous) or malignant (cancerous) after the lump is found by a physical exam or mammogram.

Stereotactic breast biopsy

Stereotactic breast biopsies are performed when mammography reveals a mass or other abnormal area of tissue.

In a stereotactic breast biopsy, a specialized digital mammography machine pinpoints the suspicious area by using two intersecting coordinates to locate it. Then, a needle is used to obtain a tissue sample from that location.

Ultrasound-guided breast biopsy

An ultrasound-guided biopsy is used when the breast abnormality can be detected with an ultrasound.

In this biopsy, the ultrasound images will pinpoint where the breast abnormality is so cells can be collected and analyzed. The exam involves an ultrasound probe moving across your breast so the radiologist can carefully guide a needle to the precise location of the mass.

The breast cancer specialists of Sarah Cannon Cancer Institute at HCA HealthONE recommend an annual screening mammogram for women 40 to 74 years old. However, your decision to undergo screening should be made in consultation with your physician. If you are considered "high risk" for breast cancer, because you have a family history of breast cancer or personal risk factors, please consult your physician about when to begin screening.

MRI breast images allow physicians to see conditions, including some small breast lesions, which may not be visible with other breast imaging services. An MRI of the breast can be particularly helpful for women with breast implants or women with dense breast tissue, in which breast cancer can be harder to detect with traditional mammograms.

A breast MRI does not use X-rays. It uses magnetic waves to create cross-sectional, 3D breast images.

Breast ultrasounds are used to diagnose abnormalities found during routine physical breast exams. Breast ultrasounds also help further characterize certain mammography findings.

For example, an ultrasound for a breast abnormality can help determine whether a breast lump is fluid-filled (which could be a benign breast cyst) or solid (which could be either a cancerous or benign tumor).

Breast ultrasound does not use radiation. It produces images through high-frequency sound waves.

A mammogram is a low-dose, digital X-ray of your breasts. Having clear and accurate images of the inside of the breast is important to detect and diagnose breast disease.

Screening mammogram

During a screening mammogram, your technician will take two X-rays of each breast. This technology makes it possible to see changes (such as lumps) that are too subtle to find during a physical exam.

Diagnostic mammogram

A diagnostic mammogram is ordered when a change is discovered in one or both breasts. The change may include pain, nipple thickening, nipple discharge or a difference in breast shape or size. A diagnostic mammogram may also be performed if an unusual spot was found on a screening mammogram.

Tomosynthesis (3D mammography)

Our 3D mammography machine moves around the breast taking X-rays from multiple angles to allow us to see fine details that could be hidden. These images are then computer-generated into a 3D reconstruction of the breast.

This screening tool has been shown to give a clearer, more accurate look at the breast than traditional mammography. For that reason, it is beneficial for women with dense breasts.

Benefits of tomosynthesis include increased breast cancer detection rates, decreased unnecessary callbacks and fewer false positive results.

How to prepare for a mammogram

Women should prepare for a 3D mammogram the same way they would for a traditional mammogram. Here are some things to think about when preparing for a mammogram:

• Consider scheduling during a time when you expect your breast to be the least tender (perhaps avoiding the week before your menstrual cycle).
• Do not wear any deodorant, powder or lotion under your arms or on your breasts (it can impact the results).
• Wear a two-piece outfit so you only have to remove the top.

Can you have a mammogram if you're pregnant or breastfeeding?

If you are pregnant, you should not undergo a mammogram because of possible danger to the fetus. If your gynecologist or obstetrician feels it is important to have a breast screening test during your pregnancy, a breast ultrasound will be ordered.

If you are breastfeeding, your tissues may appear more dense than usual, making it harder for the radiologist to interpret the results.

Can you have a mammogram if you have a breast implant?

While it is safe to have a mammogram when you have a breast implant, be sure to tell the technologist before the procedure. The machine may require special adjustments for the best possible images.

As part of Sarah Cannon, the Cancer Institute of HCA Healthcare, our family of hospitals provides comprehensive cancer services with convenient access to cutting-edge therapies for people facing cancer in our communities. From diagnosis to treatment and survivorship care, our oncology expertise ensures you have access to locally trusted care with the support of a globally recognized network.

askSARAH helpline

Have cancer questions? We can help. askSARAH is a dedicated helpline for your cancer-related questions. Our specially trained nurses are available 24/7, and all calls are confidential. Contact askSARAH at (303) 253-3225.