Women's Services

Overview

We offer the highest level of breast cancer services with the first all digital screening and diagnostic mammography service in the region. Our diagnostic imaging center is an ACR Breast Imaging Center of Excellence. We also have the largest number of local sites offering breast MRI services. We performed the first MR guided breast biopsies and needle localizations in the Charlotte region. Our physicians are also expert in the imaging evaluation of infertility as well as evaluation and treatment of fibroids with Uterine Artery/Uterine Fibroid Embolization (UAE/UFE).

Just about everyone knows someone who has been diagnosed with breast cancer. According to the American Cancer Society, one in eight women will be diagnosed with the disease. The good news is that breast cancer is treatable, if found early. The five-year survival rate currently exceeds 95 percent, thanks to regular clinical breast examinations, monthly self exams and annual screening mammograms. The key is catching breast cancer in the early, treatable stage.

Mecklenburg Radiology Associates has designed a specialty breast program that includes subspecialists who have an interest in mammography, breast MRI, ultrasound and breast biopsy.

Mammography

Mammography is a specialty, low-dose x-ray that examines breasts. It is used to help diagnose breast cancer and other breast diseases. All Presbyterian hospitals, outpatient centers and Lake Norman Regional Medical Center locations perform the latest in digital mammography, replacing the old film process. Plus, MRA radiologists use a recent enhancement called computer-aided detection (CAD) that uses high technology to look for disease.

Digital mammography, or full-field digital mammography (FFDM), uses solid-state detectors that convert x-rays into electrical signals, similar to those found in digital cameras. The electrical signals are translated into images of the breast that can be seen on a computer screen or printed on special film similar to conventional mammograms. Digital mammography is helpful diagnosing disease in patients under age 50, women of any age with very dense breasts and pre- or peri-menopausal women.

Computer-aided detection (CAD) systems use the mammographic image and apply a software program that searches for abnormal areas of density need for further analysis, mass or calcification that may indicate the presence of cancer. The CAD system highlights these areas on the images, alerting the radiologist to the need for further analysis.

Screening or Diagnostic Mammogram – Which One to Use? Mammography is critical to early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. A screening mammogram is for a woman who is asymptomatic, meaning that neither she nor her physician have found any signs of breast abnormalities.

Current guidelines from the U.S. Department of Health and Human Services (HHS), the American Cancer Society (ACS), the American Medical Association (AMA) and the American College of Radiology (ACR) recommend screening mammography every year for women, beginning at age 40. The National Cancer Institute (NCI) recommends that women who have had breast cancer and those who are at increased risk due to a genetic history of breast cancer should check with their physician to see if they should begin screening before age 40.

A diagnostic mammogram is ordered when a patient presents with abnormal clinical findings—either a breast lump or lumps—that have been found by the woman or her doctor. Diagnostic mammography may also be done following an abnormal screening mammography to better determine if there is a problem.

Breast MRI

"Breast MRI is amazing technology. We are approaching a time when it will be more routinely used in evaluation of women with or at risk for breast cancer. Mecklenburg Radiology Associates is already prepared for this as we supervise a network of breast MRI scanners across the greater Charlotte area that offer the highest possible quality scans. We also have a group of physicians trained to interpret breast MRI from some the best training programs in the country, including Penn, Stanford, Duke and Washington University in St. Louis."
- Erik Insko, MD, Radiologist, Mecklenburg Radiology Associates

MRI is a non-invasive way of looking into the body without the use of x-ray. Instead, it uses magnets and radio waves to create images. Breast MRI combines state-of-the-art three-dimensional imaging with computer-aided detection (CAD) to look deep into the breast to uncover abnormalities. While breast MRI is not a replacement for mammography or ultrasound imaging, it is a very helpful tool in evaluating patients with very high known genetic risks for breast cancer and in:

  • Imaging dense breasts often found in younger women and those with fibrocystic breast changes when mammography and ultrasound fail to detect or characterize a palpable abnormality
  • Determining the extent of a known cancer. MRI is the most sensitive and specific method for complete local staging of breast cancer.
  • Differentiating between surgical scar and recurrent cancer in patients who have already been treated for breast cancer
  • Identifying mammographically occult cancer in high-risk patients
  • Evaluating response to cancer treatment

Breast MRI does not take the place of screening mammograms, as recommended by the American College of Radiology and American Society of Breast Surgeons. Women who have breast MRI should continue to have an annual mammogram.

Breast Ultrasound

Breast Ultrasound or sonography uses high-frequency sound waves to produce pictures of the breast and does not expose the patient to radiation. Images are captured in real-time, showing movement and blood flow in the vessels. This painless test evaluates blood flow or lack of flow in a breast mass, providing clues as to the cause of the mass. It is very helpful as a supplementary test to help determine the nature of a breast abnormality that was seen on mammography. The procedure can often determine if the suspicious area is solid, which may or may not indicate a cancerous site, or a fluid-filled sac, such as a cyst. The modality may also be helpful for women with dense breasts, have silicon breast implants, are pregnant or have genetic risks for breast cancer.

A small handheld instrument called a transducer is passed back and forth over the breast. The picture produced by ultrasound is called a sonogram or ultrasound scan.

Breast Biopsy

Mammography is first step in evaluating breasts, but in some instances, it cannot tell whether a growth is benign or cancerous. MRI and ultrasound may be used as a next step, but a biopsy allows for a definite determination. Instead of a surgical biopsy, many women are opting either stereotactic biopsy, ultrasound-guided biopsy or MRI-guided biopsy. In these less invasive methods, a hollow needle is passed through the skin into the lesion with the help of imaging equipment. The small sample is analyzed to see if the lesion is malignant or benign, so that treatment can begin.

Bone Densitometry

We offer bone density testing at all of our hospital locations as well as Presbyterian Breast Center, Presbyterian Imaging Center Ballantyne, and Presbyterian Imaging Center University.

Osteoporosis is a chronic condition that occurs when there is a depletion of bone calcium and protein. The results are loss of bone mass, increased bone fragility and increased risk of fracture. Nearly 80 percent of those affected by the disease are women; however, men are also at risk for developing the condition. Currently more than 10 million people in the United States have osteoporosis and another 34 million are at high risk for the disease. Nearly 1.5 million adults have fractures, which are a direct result from the condition, making it one of the most common diseases affecting older adults. The only way to accurately diagnose osteoporosis is with a bone mineral density (BMD) test.

Our partner hospitals and outpatient facilities use the "gold standard" by the International Society of Clinical Densitometry (ISCD). The DXA – dual energy x-ray absorptionmetry – scan measures the spine, hip and total body, producing computer-generated images of various skeletal sites, yielding precise bone density measurements that are unmatched by other screening equipment. The painless, non-invasive scan, which takes a few seconds, quickly identifies if a patient is at risk for fractures. Mecklenburg Radiology Associates' radiologists are subspecialty trained to interpret bone density studies, ensuring that patients get the most accurate results.

The ISCD recommends screening for:

  • Women over age 65
  • Men over age 70
  • Anyone with a fragility break
  • A patient with a disease, condition or medication associated with osteoporosis
  • Anyone who is considering therapy for osteoporosis, if bone density testing would facilitate the decision
  • Women who have taken hormone replacement therapy for an extended time
  • A patient who is undergoing treatment for osteoporosis, to monitor the effects of the therapy

February 2013

CT Calcium Scoring

Dr. Erik Insko explains how a CT calcium score might save your life.

January 2013

New Open MRI Scanner at Presbyterian Orthopedic Hospital

Dr. Kevin Carroll explains how the new High-Field True Open Magnetic Resonance Imaging machine works.

More than 30 Highly Trained Radiologists and 10 Physician Assistants on Staff