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Happy Thanksgiving! Urgent Care at our West Des Moines and Ankeny locations will be closed on Thanksgiving Day.
Both locations will be open the Friday after Thanksgiving from 8 a.m.-3 p.m.

Breast Imaging

The Iowa Clinic Medical Imaging Department proudly offers both 2D and 3D mammography for your convenience. While 2D digital mammography remains the gold standard for early detection 3D images can offer better visualization

3D Mammography

Breast tomosynthesis, often referred to as 3D mammography, is a new technology that converts digital breast images into a stack of very thin layers to build a three dimensional mammogram. 3D mammography is most beneficial for women with:

  • Dense breast tissue per mammographic image
  • Patients with a greater than 20% lifetime risk of developing breast cancer per risk evaluation
  • Certain patients who have had an abnormal mammogram

3D mammography is slightly higher in radiation than the standard 2D mammogram. The radiation is roughly doubled when a 2D mammogram is done in conjunction with a 3D mammogram. Even this combined dose is still below the FDA-regulated limit for 2D mammography and has been found by the FDA to be safe and effective for patient use. Although 3D mammography may help to reduce the amount of call backs, there will still be call backs with follow up ultrasounds if needed.

Screening and Diagnostic Digital 2D and 3D Mammography

Digital mammography is superior at detecting breast cancer. A certified mammography technologist will take the mammographic images of the breast. The technologist will ask you several questions prior to your exam, to better understand your history and/or any problems you may be having. A board-certified radiologist will examine the images to look for masses and calcifications. Should further evaluation be necessary, you will be contacted either by Medical Imaging or your primary care provider.

While a screening mammogram is encouraged each year for women who do not have significant breast symptoms, your doctor may order a diagnostic mammogram if you have a personal history of breast cancer or you are experiencing:

  • a worrisome lump
  • changes in the breast skin
  • pain
  • nipple discharge

Diagnostic mammography may also be performed if your screening mammogram demonstrates a possible abnormality.
A diagnostic mammogram is not considered a preventive care service by most insurance companies. This exam may be subject to deductibles and co-insurance, so we suggest you contact your insurance provider with coverage questions.

What Should I Expect?

Screening Mammogram: Please allow up to 30 minutes for your screening exam.

  • Do not wear body powder or deodorant.
  • Do wear two-piece clothing for more convenience.

During your screening mammogram appointment, the radiologist may decide it is necessary to perform additional mammographic images and/or a breast ultrasound if warranted. Please see below to learn more about breast ultrasound.

When Will I Receive My Results?

If your mammogram is normal:

  • you will receive a letter in the mail with the results.
  • you may receive your results electronically by registering for our MyHealth Patient Portal.

Please be advised that you will not receive your results during your visit, as the Radiologist will need ample time to interpret your images.
If you have had a previous mammogram at a facility other than Iowa Clinic Medical Imaging, please let us know so that we may obtain the films for comparison. It is extremely important for the radiologist to have your prior films for comparison, as it enhances the doctor's ability to detect a subtle change or small abnormality on your current mammogram. Availability of prior films at your appointment also decreases the length of time it takes for you to get your results.

If your results require further follow-up, you will be contacted by your physician.

Diagnostic Mammogram: Please allow up to one hour for your exam.

  • Do not wear body powder or deodorant.
  • Do wear two-piece clothing for more convenience.

During your diagnostic mammogram appointment, the radiologist may decide it is necessary to perform additional mammographic images and/or a breast ultrasound to further assess your unique problem. Please see below to learn more about breast ultrasound.

When Will I Receive My Results?

Your results will be sent directly to your primary care physician. If you have had a previous mammogram at a facility other than Iowa Clinic Medical Imaging, please let us know so that we may obtain the films for comparison. It is extremely important for the radiologist to have your prior films for comparison, as it enhances the doctor's ability to detect a subtle change or small abnormality on your current mammogram. Availability of prior films at your appointment also decreases the length of time it takes for you to get your results.

Breast Ultrasound

What Is Breast Ultrasound?

Breast ultrasound is a non-invasive tool used to evaluate specific, often palpable areas of concern — such as a breast lump felt by a patient or physician and an area of concern seen on a mammogram. Breast ultrasound does not replace the need for mammography. Mammogram images are still needed to evaluate the entire breast. An ultrasound examination produces images of your breast using inaudible sound waves in a frequency range far above the range of human hearing.

What Should I Expect?

Your exam will be performed by a mammography-certified, female technologist at one of our diagnostic breast center locations. After you check in, you will be escorted to a private dressing room, where you will be asked to undress from the waist up. You will be given a gown that opens in the front. The technologist will ask you several questions, so she can better understand your history and/or any problems you may be having.

An ultrasound is most often performed in conjunction with a diagnostic mammogram. During your ultrasound procedure, the technologist will ask you to lie down on a table and position you appropriately. A small wand will be passed over the surface of your breast, producing a painless sensation of light pressure on your skin. A picture of the breast tissue will be seen on the ultrasound screen.

A breast ultrasound test usually takes between 15 and 30 minutes. More time may be needed if a physical breast exam is needed or if a biopsy is planned. A physician specialized in breast imaging will review your images and may also want to obtain more ultrasound views of some areas of your breast.

When Will I Receive My Results?

Your primary care physician will receive the results of your exam within 48 hours of your visit.

Breast Biopsies

Needle Biopsy Of The Breast

Biopsies are the only definitive way to confirm if breast tissue is benign or cancerous. Needle biopsy is a safe, minimally invasive procedure used to get a sample from an abnormal breast lesion. Small amounts of breast tissue are removed through a needle, and the tissue is studied under a microscope by a pathologist, who will then provide a diagnosis. There are various methods by which a needle biopsy can be performed. An ultrasound-guided biopsy is a technique most often used to guide a breast biopsy when a breast abnormality is visible on ultrasound.

A stereotactic breast biopsy allows for a needle biopsy to be performed on lesions which are more conspicuous on mammography than on ultrasound. This type of biopsy utilizes x-ray images (mammograms) of the breast tissue to guide the biopsy needle to the area of interest. Stereotactic biopsies are most commonly performed on tiny breast calcifications, but may also be utilized on breast masses in certain situations.

An MR-guided biopsy is guided in real-time by magnetic resonance (MR) imaging. It is the latest development and an important advance in diagnosing breast cancer. It is useful when an ultrasound or stereotactic-guided biopsy is not appropriate because the area of concern is not well seen by mammogram or ultrasound, but is discovered or is most conspicuous on MRI.

What Should I Expect?

We realize a biopsy may be an emotionally distressful experience. However, patient comfort, in addition to an accurate diagnosis, is our priority. Our radiologists and staff are trained to make this procedure as comfortable and quick as possible. A needle biopsy can be performed with local anesthetic and minimal discomfort. With this procedure, no stitches are required and most women can resume normal daily activity immediately. Keep in mind that more than 80% of all breast abnormalities are benign or non-cancerous.

If it makes you feel more comfortable, you may want a relative or friend to join you to lend support and drive you home. Please:

  • do not take aspirin or Ibuprofen for 5-7 days prior to biopsy.
  • prior to your appointment, let the staff know if you are taking any blood thinners.
  • wear a supportive bra to help maintain the post-biopsy dressing.
  • wear a two-piece outfit, preferably one that buttons up the front.

No change of eating habits is required.

Ultrasound Guided Biopsy: You will lie on your back or turn slightly to the side. The ultrasound wand is used to locate the lesion. Local anesthetic is injected to ensure that you will be comfortable. The radiologist will then create a small nick in the skin through which the biopsy needle will be inserted, and several samples of tissue will be obtained for evaluation. When the tissue sampling is complete, a small marking clip may be left at the site of biopsy, so it can be easily located for future follow up if surgery becomes necessary.

Stereotactic Breast Biopsy: This minimally invasive procedure requires you to be positioned lying face down on a specially designed table used specifically for breast biopsies. Your breasts are actually positioned through an opening in the table. We will then clean the skin and inject a local anesthetic. A tiny incision less than a quarter of an inch is made without causing any significant alteration in the appearance of the breast. The radiologist will remove several samples of tissue through this incision. When the tissue sampling is complete, a small marking clip may be left at the site of biopsy, so it can be easily located for future follow up if surgery becomes necessary.

MR-Guided Biopsy: During an MR-guided biopsy, a local anesthetic is injected into the breast to numb it and contrast material is given intravenously. You will be positioned face down on your stomach and your breast(s) will be positioned into a cushioned opening containing a special breast-imaging coil. Using computer software, the radiologist determines the position and depth of the lesion for biopsy. When the tissue sampling is complete, a small marking clip may be left at the site of biopsy, so it can be easily located for future follow up if surgery becomes necessary.

If you have minor claustrophobia or anxiety, you may want to ask your physician for a prescription for a mild sedative. Do not take this medication prior to your arrival or signing paperwork. Avoid eating a large meal immediately prior to the exam and plan to arrive about 30 minutes before your appointment time.

When you arrive you will be asked to complete paperwork regarding your history and symptoms. You will be asked to remove all jewelry, since these items disturb MRI signals. It is very important that any prior breast films (mammograms, ultrasound or MRI) be available to the radiologist for comparison. If you have had these at a facility other than Iowa Clinic Medical Imaging, please bring them with you on the day of your appointment. If you have any of the items listed below, call 515-244-5109 so we can make arrangements for you before your appointment. Many of these items are contraindications to having an MRI as they are not compatible with the magnetic field present around all MRI machines.

  • Cardiac Pacemaker
  • Artificial heart valve prostheses
  • Aneurysm clips
  • Eye implants or metal ear implants or any metal implants activated electronically, magnetically or mechanically.
  • Copper 7 IUD
  • Shrapnel or non-removed bullet
  • Pregnancy
  • Weight over 350 lbs
  • Claustrophobia
  • Any metal puncture(s) or fragment(s) in eye

What Instructions Do I Follow After The Procedure?

After your biopsy, do not participate in any strenuous activity or take aspirin for 48 hours. You may take Tylenol or Ibuprofen (Advil, Nuprin, Motrin) if needed for any discomfort. The outer dressing may be removed after 24 hours. Do not get the area wet until this is done. The steristrip may be removed five days after the biopsy. You may bathe carefully with the steristrips in place, being careful not to loosen them. You may have some discomfort or bruising at the skin incision site. Watch for excessive bleeding, pain, or fever. Should any of these occur, contact our office. If calling between 8 a.m. and 5 p.m., the number is 515-244-5109.

When Will I Get The Results?

Biopsy samples are sent to a Pathologist, who will analyze and provide your physician and Iowa Clinic Medical Imaging with a diagnosis. You will be notified of your results within several days of your biopsy appointment.

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