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Mammography and Women’s Imaging

mammography

TRG’s mammography and women’s imaging services are designed to meet the unique healthcare needs of women in convenient community-based locations. Our goal is to provide outstanding medical imaging services, emotional comfort, and time efficiency for women facing often-stressful medical procedures. We provide imaging expertise and the most advanced medical equipment available for obstetric and breast imaging. Our radiologists, highly-experienced sonographers and technologists, mammographers and dedicated nursing staff work together in conjunction with our referring physicians to coordinate patient care, and evaluate individual need, whether it be routine or high risk.

Breast Imaging

What is digital mammography?

Digital mammography and tomosynthesis was first available to women in the U.S. in 2000. Unlike conventional mammography, digital mammography sends the X-ray image to a detector rather than to film. This detector then sends the acquired image to a computer processor. Digital mammography has proven to diagnose more breast cancers in women who have dense breast tissue and those who are pre-menopausal. Digital mammography uses less radiation and for some women, the workstation can produce images that would have required an additional exposure. Mammography is the most accurate screening tool in the early detection of breast cancer.

What is tomosynthesis?

Tomosynthesis is an advanced type of digital mammography that allows a 3D visualization of the breast, to better detect and characterize early signs of breast cancer. Tomosynthesis is especially useful for women with denser breast tissue, which can obscure abnormalities on standard digital mammography. All of TRG mammograms are obtained using tomosynthesis technology.

What is CAD?

Computer-aided detection (CAD) is computer software that helps the radiologist identify abnormalities in the breast. CAD reviews the digital image and will mark the suspect areas for the radiologist’s further review. CAD can be thought of as a second set of eyes when reviewing your mammogram.

What should I expect?

Your technologist will take two views from the top and then two from the side of your breast. Women who have implants will require additional views. Your breast will be compressed during the exposure between two plates. This step is very important- By compressing breast tissue to a uniform thickness, the image is more consistent and there is less likelihood that structures in the breast will overlap. The time the breast is compressed is very brief. On occasion, the radiologist will ask the technologist to do additional views of your breast to better visualize breast tissue. After the exam, our radiologist will review the images. If there are questionable findings they may recommend your physician order ultrasound or MRI to access the questionable area.

How should I prepare?

If you experience monthly breast tenderness, we recommend that you schedule your visit during a less painful time of the month. We recommend that you do not use deodorant or talc powder prior to your visit.

How do I get the results?

After your study is complete, one of our TRG radiologists will evaluate your study and report the findings to your physician. Once your physician has your results they will compare them with their clinical findings to develop your care plan.

Breast Ultrasound

What is a breast ultrasound?

Breast ultrasound is frequently used to evaluate breast abnormalities found during a screening, diagnostic mammogram, or breast exam. Ultrasound is excellent in identifying whether a questionable area in the breast is cystic, fluid-filled, or a solid structure. These findings will determine whether a biopsy tissue sample is required for diagnosis.

What should I expect?

Breast ultrasound is performed by a sonographer. You will lie on a table and the technologist will apply a clear gel they will pass a transducer or probe over the breast to acquire images of the area. The gel provides a “smooth pavement” for the transducer’s travel and can be easily removed.

How do I get the results?

After your study is complete, one of our TRG radiologists will evaluate your study, compare it with your mammogram and report the findings to your physician. Once your physician has results they will compare them with their clinical findings to develop your care plan.

Breast MRI

What is magnetic resonance imaging?

MRI is a powerful diagnostic imaging tool. Unlike X-ray, MRI images are produced by using two natural and harmless forces: magnetic fields and radio waves, not radiation. With the use of computers, the data acquired from your scan is transformed into two-dimensional images of your body. The procedure is painless and has no known side effects. MRI can “see” through hard bone to the soft tissues in your body like muscles and internal organs. These images are very precise, showing differences between normal and abnormal tissues.

What is MRI breast imaging?

MRI technology produces very detailed images of breast tissue and surrounding anatomy. It is used to determine the extent of disease in the breast, whether there is disease in the other breast, and as a surgical planning tool. Breast MRI is not recommended in lieu of mammography and ultrasound but as an additional diagnostic tool. Recently, screening breast MRI was recommended for women who are considered to have high-risk factors.

When should breast MRI be ordered?

Breast MRI is recommended for:

  • An abnormal mammogram or ultrasound
  • A positive breast biopsy
  • A recent diagnosis of breast cancer
  • Patients who have a strong family history of breast cancer and have dense breast tissue
  • A follow-up evaluation for patients having chemotherapy
  • Implant patient
  • Patients who have had radiation treatments to the chest

What should I expect?

Breast MRI is a series of images that are performed while you are lying face down with your breast positioned in a breast coil. Breast MRI patients require an injection of contrast agent. MRI contrast is safe; however, there is always the remote possibility of allergic reaction. Contrast enhances the breast tissue and helps to identify cancerous areas. Breast MRI normally takes 45 minutes to an hour to perform. Afterward, you can return to your normal daily activities.

How should I prepare?

If you are still having monthly menstrual cycles, breast MRI should be scheduled on or as close to 7th day after your cycle begins. MRI is extremely sensitive to the hormonal changes of the breast. Scheduling as such lowers the likelihood of an inaccurate result. Women taking hormone replacement may be asked to stop them for a period of time.

All breast imaging procedures can be performed at Providence Seaside as well as these locations:

Providence St. Vincent Medical Center

Providence Newberg Medical Center

Women’s and Obstetric Imaging

UFE is performed at:

Providence St. Vincent Medical Center

Hysterosonography can be performed at:

Providence St. Vincent Medical Center

Providence Newberg Medical Center

UFE

What is uterine fibroid embolization?

Uterine artery embolization (UFE) is a non-surgical treatment for uterine fibroids. Fibroids are non-cancerous tumors that may cause heavy menstrual cycles, pelvic pain, and pressure to other internal organs. UFE is performed through an artery in the groin. The interventional radiologist threads a very fine tube into the artery that supplies blood to the fibroid and injects particles into the artery to block the flow. Once the blood supply is blocked, the fibroid is deprived of oxygen and shrinks in size.

How do I prepare for the procedure?

Do not eat or drink anything past midnight the evening prior to your procedure. You will receive instructions that include your time of arrival to St. Vincent Medical Center. After your registration, you will be taken to a room for pre-procedure preparation. Here, one of our staff will start an IV, take your vital signs, verify your consent for the procedure and answer questions related to the proceeding. Prior to your study, you will be given a sedative to help you relax and manage your pain, but you will be conscious during the embolization.  

Our interventional radiologist will place a small tube into an artery in your groin and take a series of images that will identify the artery feeding the fibroid. Embolization particles are then injected into the artery branches. Once the particles are in place, the tube is removed. Once the procedure is over, you will remain overnight in the hospital. During your stay, the staff will manage your pain, administer antibiotics, and continue IV fluids. Barring any complications, you will be discharged from St. Vincent the morning after the procedure. Most women experience mild to moderate cramps the first several days but are able to return to their normal activities in a week. Prior to your discharge, you will receive detailed instructions. It is important to read and follow these closely. Excessive pain, and /or fever are not normal and need to be addressed immediately.

How does it work?

Your uterus is an organ with many blood supplies. When a fibroid grows in the uterus, it is fed by one or many blood supplies. By blocking the supply with injected particles it starves the fibroid, causing it to eventually shrink.

What complications could I experience?

Most patients experience some pelvic pain and cramping, most of which can be managed with oral pain medications. Occasionally, women experience nausea. It is not uncommon to experience spotting for the first month after the embolization. Serious complications related to UFE are rare. Less than 1 % of those women having the procedure experience serious complications.

Will this procedure help me?

Statistically, 80-85 percent of the women who undergo UFE have a reduction in their fibroid symptoms.

Hysterosonography

What is hysterosonography?

Hysterosonography, also know as sonohysterography or saline infusion sonography, is an ultrasound scan of the uterus. The procedure is a minimally invasive technique that provides real-time images of your internal organs and blood flow to the uterus. This procedure is often used to investigate uterine abnormalities in women who experience multiple miscarriages or are infertile.

Hysterosonography is a valuable technique for evaluating unexplained vaginal bleeding that may include:

  • Congenital defects
  • Masses
  • Adhesions or scarring
  • Polyps
  • Fibroid tumors
  • Uterine atrophy

Doppler scanning or ultrasound that measures blood flow during the procedure is helpful when evaluating:

  • Blockages to blood flow, such as a clot
  • Plaque formation in the uterine vessels
  • Tumors and congenital abnormalities

How should I prepare for this procedure?

Hysterosonography is best performed one week after your last menstrual cycle. This cyclic phase is when the endometrium or uterine lining is thinnest and most likely in its normal state. This procedure should not be performed if you are pregnant. There is no special preparation prior to the exam, but some patients may be advised to take an over-the-counter pain reliever shortly before the procedure to minimize any potential procedural discomfort.

What should I expect?

Hysterosonography is performed with the installation of sterile saline into the uterus through a catheter. The fluid distends the uterus and outlines anatomy and abnormalities. The ultrasound procedure is performed vaginally, much like a gynecological exam. The initial phase of the exam is done prior to the catheter insertion. Once images are taken, the radiologist will insert the catheter into the uterine cavity and the ultrasound transducer is reintroduced. Saline is then injected via the catheter while being viewed by the ultrasound probe. The examination is usually completed in 30 minutes. During the hysterosonogram there may be occasional cramping, often the result of saline introduction. A vaginal sonogram is generally more comfortable than having a gynecological exam. After the examination is completed, you should be able to resume your normal activities.

How can I get the results?

After your study is complete, the images will be evaluated by one of our women’s imaging specialists. A final report will then be sent to your physician who can discuss the results with you in detail.

Pelvic MRI

Your MRI procedure can be performed at:

Providence St. Vincent Medical Center

Providence Newberg Medical Center

Providence Seaside Diagnostic Imaging

What is a pelvic MRI?

A pelvic MRI is a magnetic resonance study of the female pelvis and reproductive organs. It is often used to assess women who suffer from chronic pelvic pain but have no diagnosis or who are experiencing dysfunctional uterine bleeding. A pelvic MRI is suggested when an ultrasound does not identify the problem. It may also be a better option since an MRI provides better visualization of the organs for masses in the pelvis.

What should I expect?

You will be asked to lie down on an MRI table. The table will move into the MRI scanner. Once the technologist has positioned you in the scanner, a series of MRI scans will be performed. The technologist will be instructing you during each scan. After the technologist reviews the scans, making sure that they are sufficient for interpretation, they will be sent to the radiologist for their interpretation.

How should I prepare?

Prior to your examination, you will be asked a series of health history questions that are critical before entry to the scanner. Patients who have a pacemaker or other metal medical devices implanted in their body may be prevented from entry. The screening process may take place more than once just to safeguard your procedure.

How do I get the results?

After your study is complete, one of our TRG radiologists will evaluate your study and report the findings to your physician. Once your physician has your results they will compare them with their clinical findings to develop your care plan.

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"I highly recommend the Ruth Spear breast center at St. Vincent, the staff, and the doctors.  I feel the excellent care I received was critical to my recovery / survival of breast cancer."