Breast ultrasound is particularly helpful in younger patients with dense breast tissue and in patients presenting with a lump. If under 40 years of age this may the only breast imaging required. It is performed generally by a breast imaging radiographer.
Mammogram is an x-ray of the breasts and is usually performed on both breasts and on patients over 40 years of age. It can be performed by either a mammographer or and assistant practitioner.
For an ultrasound patients may get an appointment through the post if their GP has sent them for imaging. The majority of patients are seen at the time they have their clinic appointment.
The test will be carried out whilst lying down. Gel is spread over the breast and a small hand held probe is gently pressed against the skin surface and then moved around so that the breast can be viewed from different angles. It is usually the area of concern that is scanned. The scan only lasts 5-10 minutes and has no known risks.
For a x-ray patients may get an appointment through the post if their GP has sent them for imaging or if they have had previous breast cancer or a family history of breast cancer. Other patients are seen at the time they have their clinic appointment.
During the mammogram the breast will be compressed between two perspex plates for a few seconds in order to visualise the breast tissue. This pressure may be uncomfortable however, the test is over quickly with the process only lasting for about 10 minutes. This may be followed by an ultrasound.
After imaging further tests may be required:
The procedure uses a needle which is quickly fired into the lump using a
biopsy device (which normally makes a loud clicking noise), removing a piece of tissue from the breast. The breast tissue can then sent away to be looked at under a microscope to see if there are any abnormalities.
After the biopsy, the area will be pressed for a few minutes to help stop any bleeding, and a dressing will be applied. Several samples are usually taken.
The procedure is carried out whilst lying down and will normally take 15-20minutes. A local anaesthetic will be used to numb the area so the amount discomfort during the test should be minimal.
Fine Needle Aspiration
Some women may have a procedure called fine needle aspiration instead of a biopsy. This involves removing a sample of cells from inside the breast using a very thin needle, similar to a blood test and the cells sent away to be looked at under a microscope and checked for any abnormalities.
The procedure is usually carried out while you are lying down and takes about 10-15 minutes.
A vacuum assisted core biopsy may be necessary. This test involved tissue being sucked through a needle after a local anaesthetic. The procedure is carried out whilst lying down or whilst sitting and it normally takes 45-60 minutes. It reduces the need to have surgery to determine what is going on in the breast.
Patients that have been referred by their GP are asked to contact the GP surgery for their results. If the patient has been sent via clinic the results are given to the patient at the time of the clinic visit or via a letter from the surgical team.
Descriptions/Definitions of Roles within Breast Services
The radiologist is a highly trained Doctor who has specialised in breast imaging. They will report the breast imaging that has been performed and issue this report to the referring team. They carry out biopsies under ultrasound and x ray guidance.
They work closely with the surgical team running the one stop breast clinics and theatres to provide an efficient and appropriate service to patients attending the clinic and having surgical procedures.
The team of radiographers have had additional training to allow them to perform high quality mammograms (mammographers) and some also perform Breast ultrasound examinations. Some of the advanced practitioner radiographers have had extended training to perform interventional procedures e.g.. biopsies.
Assistant Radiographic Practitioners (ARPs)
The assistant radiographic practitioners are not radiographers but are specifically qualified to perform routine mammograms. They also assist the radiographers and radiologists perform the interventional procedures. They attend to the needs of the patients who are attending the breast imaging department.
The radiographic assistants also assist the radiographers and radiologists perform the interventional procedures. They attend to the needs of the patients who are attending the breast imaging department and also work in the reception and help with the admin duties.
The admin staff work in reception and are able to provide assistance regarding appointments and information regarding the work load in the one stop clinics. They provide a liaison between the surgical clinics and the breast imaging department.