: M. P. McNamara, Jr., M.D.
The Breast Imaging and Intervention Section utilizes screening and diagnostic imaging and CAD (Computer Aided Detection) to identify and characterize breast abnormalities. Diagnostic and therapeutic breast interventional procedures are also offered. Both stereotactic and ultrasound guided procedures are performed. We offer minimally invasive tissue sampling of masses and lymph nodes with FNA (fine needle aspiration), Tru-Cut® Core Biopsy and Large Core Vacuum Assisted Biopsy (Mammotome®). Therapeutic interventions include breast abscess drainage, minimally invasive percutaneous excision of fibroadenomas and treatment of symptomatic fat necrosis. Patients rarely, if ever go to open surgical biopsy for diagnosis at this institution; patients are evaluated with imaging and minimally invasive procedures.
We are accredited by the American College of Radiology (ACR) and the American Institute of Ultrasound in Medicine (AIUM) and are in full compliance with the Mammography Quality Standards Act (MQSA). We currently have two mammography sites on the main campus- the Ambulatory Plaza Suite, primarily used for screening mammography, and the Hospital Suite where diagnostic mammography, diagnostic breast ultrasound and interventional breast procedures are done. Additionally, we have three outlying facilities where screening mammography is performed. Addition of Breast MRI is anticipated in 2006.
Breast Imaging and Intervention Services:
- Screening Mammography: Evaluation of each breast with two standardized projections: mediolateral oblique (MLO) and craniocaudad (CC), as part of our routine surveillance for breast cancer
- Diagnostic Mammography: An examination tailored to patients who have subjective or objective findings of breast disease, prior history of breast cancer and further evaluation of patients with findings on screening mammography requiring clarification. Standard as well as specialized mammographic views are tailored to the individual patient at the discretion of the radiologist.
- Breast Ultrasound: Two Acuson Sequoia® Ultrasound units are used for focused, real-time evaluation of mammographic findings, palpable breast masses and breast implant and implant-related abnormalities. Additionally, the lymphatic drainage pathways of the breast are studied in patients with suspected or documented neoplasm, as a part of the staging process.
- Breast MR: The Section has access to two (1.5 and 3T) new Philips magnets and an InVivo DynaCAD Breast "workstation."
- Wire Localization: Wire localization procedures are done under ultrasound and mammographic guidance to guide surgical excision of masses/calcifications and selected mammotome procedures.
- Prone Table Stereotactic Breast Biopsy: Minimally invasive Mammotome® sampling of microcalcifications done with mammographic, computer-assisted targeting.
- Ultrasound Guided Breast Diagnostic and Therapeutic Procedures: Real-time sonographic guidance is done for Core biopsy, FNA and Mammotome® procedures. All breast masses requiring tissue evaluation and some cases of microcalcifications are sampled under ultrasound guidance. We offer minimally invasive excision of symptomatic fibroadenomas and fat necrosis with the Mammotome®
The Breast Imaging and Intervention Service, Surgery and Medical Oncology work as a team in the fight against breast cancer. We host a weekly breast conference for breast surgeons, radiation oncologists, pathologists, nurses and social workers and have monthly didactic and weekly Rad/Path conferences for the residents.
We are dedicated to providing outstanding patient care and resident education. Residents benefit from the fact that we are a tertiary care referral center serving a diverse population with a broad range of pathology. Our Section provides cutting edge diagnostic and therapeutic services and is especially strong in breast ultrasound and ultrasound guided procedures. Radiology Residents are proved with "hands-on" and didactic education, are guided and mentored as they develop diagnostic and interventional skills and encouraged to participate in research. We routinely present/teach at Radiologic Society of North America (RSNA), American Roentgen Ray Society (ARRS) and American Institute of Ultrasound in Medicine (AIUM).