Though breast cancer is the most common cancer and the second-leading cause of cancer death among American women, 96% of breast cancers detected early can be successfully treated. While high-quality mammography (an X-ray of the internal structure of the breast) is the most effective technology available for breast cancer screening, new breast imaging technologies are in development to detect and diagnose breast health.
New Haven Radiology offers:
- Breast Ultrasound
- CT or CAT Scan
- Magnetic Resonance Imaging (Breast MRI)
- Mammograms (including digital mammography)
- Positron emission tomography (PET)
Increased public awareness, improved early detection through screening mammography and more effective treatment with improved radiation, chemotherapy, and newer monoclonal antibody agents have contributed to significant decrease in mortality from breast cancer. Breast cancer, however, remains the most common cancer among women in the United States, other than skin cancer. It is the second leading cause of cancer death in women, after lung cancer. In 2009 there were 192, 370 new cases of invasive breast cancer, 40, 170 deaths and at present about 2 million breast cancer survivors in the United States (www.cancer.org).
The radiologists and staff of the breast imaging section at the Hospital of St Raphael are totally committed to employing all the latest imaging tools at our disposal for the early detection of breast cancer. More advanced imaging modalities available are also utilized when necessary to decrease mortality from breast cancer. The radiologists and staff at the HSR are known in the community as fully recognizing the importance of providing this service in a professional, warm, patient-centered, and comforting environment that recognizes the need of the patient for direct physician to patient communication, knowledge, and recognition of the patient's emotional needs. We understand that the diagnosis of breast cancer can be a life-altering event that can evoke extreme anxiety and fear. Our team in the breast imaging section and Women's Center for Breast Health is devoted to helping our patients through this process with compassion, to obtain the best treatment possible and to assure that our patients are among the survivors.
The attending radiology breast images are highly motivated and skilled to provide the best imaging services available. Dr Paul Levesque, the section director since 1994, has 28 years of experience in breast imaging as well as 20 years of background experience in interventional procedures. Dr. Levesque introduced and developed the stereotactic core biopsy services at HSR. He also introduced and developed breast ultrasound, breast ultrasound biopsy, breast MRI, as well as, breast MRI guided biopsy and localization procedures services at the HSR. Dr Amy Sherman is also highly skilled and experienced with fellowship training in Cross Sectional Body imaging and many years experience in all aspects of breast imaging. The technologist staff is excellent, many with over 20 years experience. They are known for their competence as well as their compassion, warmth and patient-centered treatment of patients who receive imaging services at our center.
Early detection of breast cancer is critical in the effort to decrease mortality from breast cancer. We provide screening mammograms in asymptomatic women in accordance with ACS/ACR guidelines with the latest all digital Siemens Novation DR (FFDM) mammography equipment. The majority of the screening mammograms are interpreted by a highly experience breast imager who was former director of breast imaging at the Yale School of Medicine for many years.
In those patients who have screening detected abnormalities, present with symptoms or findings on physical exam, are being followed for previous mammogram detected findings, who are being followed for previous breast biopsy or previous surgery for breast cancer (lumpectomy, mastectomy) or who are high risk patients, the mammograms are reviewed at the time of service by one of the breast imaging physicians. The breast-imaging radiologist will determine if the exam is conclusive, or if additional imaging is required which may involve specialized images, physical exam correlation, breast ultrasound, or further evaluation with breast MRI. If short interval follow-up or biopsy is required, the findings and recommendations will be explained to the patient. All patient questions are always welcomed and answered.
Breast Interventional Procedures
The breast imaging section is fully equipped to provide a full range of interventional procedures in support of the diagnosis and management of breast cancer including galactography, and mammographic or ultrasound guided needle localization for excisional biopsy. The most advanced large gauge vacuum-assisted core biopsy devices are utilized for stereotactic and U/S guided core biopsy to achieve minimally invasive, confident, and accurate pathologic diagnosis.
Breast MRI has become a powerful imaging tool for detecting breast cancer in high risk patients, for more accurately staging patients for newly diagnosed breast cancer, for tumor extent to aid in surgical planning, for assessing response to adjuvant chemotherapy, for detecting occult breast cancer for patients presenting with axillary disease, and for evaluating patients with complex mammographic and ultrasound imaging findings. As an important part of the breast imaging resources, the St Raphael Magnetic Resonance Imaging Center utilizes the most advanced MRI technology and dedicated breast coils for the diagnosis of breast cancer. The center also employs the aid of the most advanced, sophisticated 3D imaging workstations and DynaCAD computer aided diagnosis (CAD) workstations for diagnostic interpretation, as well as, for planning of MRI guided core biopsy and localization procedures when necessary.
Breast Cancer Staging and Evaluation
The radiology department at the Hospital of St Raphael also provides a full range of the most advanced imaging modalities such as 64-slice CT, PET/CT and Nuclear Medicine imaging for those breast cancer patients who require comprehensive tumor staging and post treatment follow-up.
The Women's Center for Breast Health
Methods for effective diagnosis and treatment options for management of breast cancer have become much more complex over the last few decades. This success of this effort requires a comprehensive patient-centered collaborative team effort among multiple specialties such as surgery, radiology, medical oncology, radiation oncology, as well as, social services, genetic counselors, and patient support services. To achieve this end the Hospital of St Raphael has created the virtual Women's Center for Breast Health, which strives to bring these multiple specialties together with the common purpose of providing the most advanced diagnostic services, treatment, and follow-up for our patients. A patient “Navigator” is available to provide personal guidance to patients and to facilitate the patients' movement through the complex system from diagnosis to treatment as well as follow-up care and helping in setting up support services. The WCBH has recently been accredited by the National Accreditation Program for Breast Centers (NAPBC) which is administered by the American College of Surgeons. This voluntary program requires the breast center to satisfy a set of quality standards for all aspects of breast cancer diagnosis and management, encompassing all the subspecialties to assure excellent patient care and outcomes. The breast imaging section at the HSR completely supports this effort and emphasizes the critical importance of adherence to the most stringent imaging and breast interventional procedure standards as set forth by the American College of Radiology, Breast Imaging Center of Excellence accreditation program.
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