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Special Procedures

The following procedures all need to be scheduled by a physician. Each is performed by the radiologist except for scintimammagraphy. In this test, the technologist injects the dye and performs the scan but the radiologist does read the films.

The removal of a sample of tissue to see whether cancer cells are present. There are several kinds of biopsies. In a fine needle aspiration, a very thin needle is used to draw fluid and cells from a lump. In a core biopsy, a larger needle is used to remove more tissue.
Ductography or Galactography
The injection of a contrast material into the ducts of the breast to observe the internal structure of the duct. This test is used if there is spontaneous discharge from the nipple. A radiopaque (can be seen on a mammogram) substance is put into the duct using a small plastic tube. The substance fills the duct and outlines the internal structures making them visible on the mammogram. The film can then identify areas of blockage, small growths or other irregularities.
Needle localization
A procedure used to guide a surgical breast biopsy when the lump is hard to locate or when there are suspicious areas on the x-ray but no distinct lump. A thin needle is placed into the breast. X-rays are taken and used to guide the needle to the suspicious area. The surgeon then uses the path of the needle as a guide to locate the abnormal area to be removed.
A test that is used to see if breast cancer has spread to the lymph nodes. After applying numbing medicine, radioactive dye is injected beneath the nipple of the affected breast. Over the next couple of hours, the radioactive dye flows through the lymph system of the breast into the lymph nodes. Once the sentinel node or first node to receive the dye is determined, it can be removed and tested to see if any cancer cells are present.
A supplemental breast exam that may be used in some patients to investigate a breast abnormality. It is not a primary investigative tool for breast cancer, but can be helpful in selected cases after diagnostic mammography has been performed. Scintimammography involves injecting a radioactive tracer (dye) into the patient. Since the dye accumulates differently in cancerous and non-cancerous tissues, this test can help physicians determine whether cancer is present.