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COMMON PROCEDURES PERFORMED AT THE CENTER
1. ULTRASOUND- Diagnostic/
Therapeutic
The Center utilizes an ultrasound to evaluate an area of thickening
or a palpable lump in the breast or an evaluation of a lump seen on
a mammogram. It differentiates between solid and fluid filled structures
and provides us with helpful information regarding the management.
It is used to resolve a painful or enlarging cyst, or drain an abscess.
The ultrasound is utilized to position the Mammotome (breast biopsy
or excision) and for positioning the Cryoablation needle in benign breast
tumors.
2. ULTRASOUND GUIDED BIOPSY
Our physicians at the Center have been using this technology, to obtain
tissue for the pathologist, for the past 7 years, in the office setting
and avoiding open surgeries.
a) FNA (Fine Needle Aspiration)- A small needle obtains a sample of
cells from the suspected area. These cells are then smeared on a slide
and fixed. The slide is then stained and evaluated by our pathologist.
It is quick, but the limitation is the size of the tissue sample.
b) CORE BIOPSY- The core biopsy needle is slightly thicker; it is
spring-loaded and provides a larger tissue sample of the breast lump
for our pathologist. It is quick and can be done in the office with
minimal discomfort.
c) MAMMOTOME- is a special devise, which combines cutting and vacuum
to obtain tissue samples from the area of concern. This Center utilizes
the Mammotome for biopsy and in select situations to completely eradicate
the lump. This is our preferred biopsy tool.
3. STEREOTACTIC BREAST BIOPSY
Some lesions can only be seen by a mammogram. The Center obtains samples
of these lesions by combining the stereotactic imaging of the suspected
lesion (for computer targeting) and then directing the Mammotome to
the target for obtaining the tissue.
The patient lies prone for the procedure while our surgeon and technologist
image and obtain tissue samples.
4. CRYOABLATION
This technology is used at the Center for the treatment of benign
breast tumors. The technology utilizes a needle, which is placed in
the center of the lesion with ultrasound guidance. The needle is then
cooled. The lesion is destroyed by cooling and then is gradually absorbed
by the body. The procedure is done under local anesthesia through a
small (2mm) incision, thus avoiding expensive hospitalization and painful
recovery.
5. DUCTAL LAVAGE
This is an emerging test for high-risk patients. It combines massage
of the breast, followed by application of a suction devise on the nipple.
If discharge is obtained, a small catheter is placed in the duct. The
duct is then rinsed with saline solution and the specimen is collected
and sent to pathology for evaluation.
The limitations are discomfort to the patient, technical difficulty
to cannulate the duct and the controversy about management of abnormal
findings. We hope that further research and technological advances will
provide us with more specific guidelines.
6. WIRE LOCALIZATION /CLIP PLACEMENT
Some lesions need to be localized prior to surgical excision. The
Center uses imaging to place a wire or coloring dye to identify the
area during surgery.
Select cancer patients receive chemotherapy prior to surgery. The physician
at the center will place a clip to mark the area for removal after the
chemotherapy, as some cancer may completely resolve with chemotherapy
but still need to be excised to prevent recurrence.
7. MAMMOSITE
Our center is one of the few to provide an opportunity for partial
breast radiation to some breast cancer patients. After the cancer is
resected, a small catheter (Mammosite) is placed at the site. Radiation
is then delivered to this targeted area. This spares radiation to the
remainder of the breast and surrounding tissues. The entire treatment
is completed in 5 days instead of 6 weeks. Our Center places these catheters
in the office setting for your convenience.
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