Breast Imaging
The Dubin Breast Center offers comprehensive breast imaging services including state-of-the-art, low-dose mammography with digital breast tomosynthesis (3D), and high-resolution breast ultrasound. We perform minimally invasive procedures, including biopsies using ultrasound, mammographic, stereotactic, tomosynthesis and magnetic resonance imaging (MRI) guidance. Our MRI services are coordinated through Mount Sinai’s Radiology Associates.
Our breast imaging facility provides patient-focused care to all individuals in a warm, culturally sensitive, and safe environment designed for optimal patient experience, comfort, and privacy. We designed the center with your well-being in mind. For example, our ultrasound rooms are equipped with specially designed examination tables that are both comfortable and easily accessible for all patients. Our breast imaging patient information is available in many languages, and we are open for screening in the evenings. If you need routine breast screening exams during daytime hours, we may suggest our nearby Center for Advanced Medicine, where we perform state-of-the-art imaging studies in an expedited fashion using the same mammography and ultrasound units; the studies are read by our Dubin Breast Center physicians.
For Your Imaging Appointment
- Be sure to ask your doctor to place an order in Mount Sinai’s electronic medical record system, or fax an order/prescription for your imaging exam prior to your arrival. Alternatively, please bring a copy of your referral to your visit.
- If you have had prior imaging, please bring a copy to your visit (preferably on disc in DICOM format) or have them sent in advance of your visit.
- Arrive 30 minutes prior to your exam time to allow for registration unless otherwise instructed.
- Do not use any powders or deodorant.
Meet Our Team
- Dr. Genevieve Abbey
- Dr. Lisa Abramson
- Dr. Salomon Blutreich
- Dr. Christine Chen
- Dr. Ilona Cohen
- Dr. Donna Eckstein
- Dr. Frimmit Forman
- Dr. Rayane Issa
- Dr. Ariel Kanevsky
- Dr. Lynn Ladetsky
- Dr. Katharine Maglione
- Dr. Laurie Margolies
- Dr. Lindsey Massaro
- Dr. Amy Melsaether
- Dr. Emily Sonnenblick
- Dr. Janet Szabo
- Dr. Nishi Talati
- Dr. Dayna Williams
Types of Breast Imaging Exams
Breast imaging results help your doctors develop an individualized treatment plan if an abnormality is found. To ensure we have all the information we need to determine precisely what is going on, we offer different types of breast imaging modalities. In some cases, we need to use more than one imaging modality to provide the most accurate diagnosis.
Our state-of-the-art imaging modalities include:
Mammography
A mammogram is an X-ray exam of the breast. Mammograms can be screening or diagnostic. Screening mammography is performed to detect breast cancer that is not clinically apparent. For average risk women we recommend yearly screening beginning at 40 years of age.
Diagnostic mammography is done if you have a lump or other symptom, or if there is a change in your screening mammogram. A diagnostic mammogram may include special views to obtain more information.
To perform a mammogram, we compress your breast between a plastic plate and a digital detector, which helps to spread the tissue apart. This process ensures there will be little movement, that the image will be clear, and that the mammogram can be performed with lower X-ray dose. While compression may be uncomfortable, it lasts for only a few seconds, and is necessary to produce a good mammogram image. Our technologists are sensitive to this and will work with you to minimize any discomfort as much as possible.
Digital breast tomosynthesis, often called 3D mammography, is used at the Dubin Breast Center. It shows breast tissue in thin layers so the radiologist can separate normal tissue from a possible growth. Patients who have 3D mammography are not called back as often for additional pictures since fewer cancers are masked by normal tissue. A 3D mammogram does not replace supplemental screening for those with dense breasts or other risk factors. Ultrasound or MRI can find breast cancers that are hidden on mammography, while mammography can find cancers that are not apparent on ultrasound and MRI. These exams are complementary. Factors including breast density, family history of breast cancer, genetic risk, or changes related to gender reassignment hormone therapy affect the methods used and timing of screening.
Breast Ultrasound
Like mammography, breast ultrasound can be screening or diagnostic. We perform diagnostic breast ultrasounds to evaluate any problems that may have been found during a screening or diagnostic mammogram, or physical examination. Breast ultrasound is also used as an adjunct to screening mammography for women with dense breasts.
To perform this test, a technologist will hold an instrument to your skin, which transmits sound waves through the breast. The computer picks up the echoes from these sounds waves and transforms them into an image that displays on the screen. This examination is painless and does not expose you to any radiation.
Breast Magnetic Resonance Imaging (MRI)
MRI is used to screen high-risk women, evaluate the breasts of some newly diagnosed cancer patients, and for other diagnostic indications. An MRI scan uses magnets and radio waves (instead of X-rays) to produce highly detailed, cross-sectional images of the breasts. We use a contrast material containing gadolinium, which we inject into your arm during the exam. This contrast makes it possible to see abnormalities in breast tissue.
Types of Breast Biopsies
Breast biopsies are performed to obtain a sample of tissue from a suspicious area of your breast. The tissue is examined under a microscope so we can make a diagnosis.
A radiologist who specializes in breast imaging will lead the team performing your biopsy. We will give you local anesthesia so that you remain awake but do not feel any pain. Then we will make a small incision and extract tissue samples. We will place a tiny tissue marker in the spot where we removed the tissue, and will take mammogram images so we can see the marker. One of our dedicated breast pathologists will examine the tissue sample. You can expect to receive your results within two business days; usually the radiologist will call you directly.
We regularly conduct several types of breast biopsies, including:
- Stereotactic /tomosynthesis guided breast biopsy involves use of a special mammography machine to guide the radiologist’s instruments to the suspicious area.
- Ultrasound-guided breast biopsy uses ultrasound imaging to show us the location of the suspicious area.
- Magnetic resonance imaging-guided breast biopsy uses magnetic resonance imaging (MRI) to guide us to the location of the suspicious area.
Types of Nuclear Medicine Exams
There are instances where a referral to our Nuclear Medicine colleagues is necessary. Typically, this is when we know or suspect that breast cancer may have spread beyond the breast or when we want to monitor your heart function during some forms of chemotherapy. Among the most common nuclear medicine exams ordered by Dubin Breast Center physicians are:
PET/CT
Positron Emission Tomography/Computed Tomography (PET/CT) scans are 3D images of your body that help to detect whether the cancer has metastasized (spread). This scan is sensitive and can find these changes earlier than other types of scans.
Bone Scan
Bone scans detect areas of abnormal bone growth due to fractures, tumors, infection, or other diseases of the bone. You may have a bone scan when we suspect that breast cancer has metastasized (spread). A bone scan is recommended when you cannot have a PET/CT or when you have a type of breast cancer that might show better on a bone scan combined with a CT.
Multiple-gated acquisition (MUGA)
Multiple-gated acquisition (MUGA) scans are used to evaluate your heart’s function so we can determine how well your heart pumps and moves your blood around your body. Often a MUGA scan is obtained before you start chemotherapy to make sure your heart is functioning well enough to withstand chemotherapy. It may be repeated to determine if we need to adjust your chemotherapy dose.
Please click here to learn more about Nuclear Medicine.
Types of Breast Localization
Breast localization is a procedure done to help locate the abnormality in the breast that will be removed during surgery. The type of localization depends on the localizing device, which is either a thin wire or a localizing seed. A breast-imaging radiologist leads the team that places the localizing device, using imaging guidance.
We cannot always feel every breast abnormality during a physical exam. Sometimes, we can only detect an abnormality on a mammogram, ultrasound, or magnetic resonance imaging (MRI) scan because the abnormality is small or located deep in the tissue. The wire or seed acts as a guide to assist your surgeon in finding the area of concern that was previously biopsied.
Breast seed localization involves a tiny seed, which is guided into your breast and implanted at the site of the abnormality. This can occur days before your surgery so you do not have to arrive at the hospital hours before surgery, as with needle localization.
Needle localization is performed by placing a wire in your breast. This can be performed on the day of surgery an hour or more before your surgical procedure. The decision to localize a breast abnormality using a wire or a seed is generally based on the preference of the patient and surgeon.
You should not apply deodorant, lotions, or talc to your skin before coming to the hospital for breast localization. The procedure will involve the following steps:
- We will take a few images to determine the best angle at which to introduce the needle or seed.
- We will clean your skin and inject a numbing agent into your breast.
- We will introduce a needle into your breast.
- We will insert a wire or seed into your breast through the needle.
- Once the wire or seed is positioned, we will remove the needle.
- We will take additional images to confirm correct placement.
- Following a wire procedure, we will escort you to the operating room.
- Following a seed procedure, you will be able to go home with a band-aid on your breast.
- There are no activity restrictions.