Breast Imaging

Based in the Chancellor’s Wing, St James’ University Hospital (SJUH), this is the place where patients with breast symptoms are referred to by their GP or for their breast follow up mammograms.

Patients are seen in clinic by surgeons or a registrar or nurse practitioner and have a clinical examination. Patients are then referred to breast imaging if suitable.

We work closely with the Breast Clinic, operating 8 one-stop clinics a week. This involves a full triple assessment of:

  1. A clinical examination
  2. Appropriate imaging i.e. +/- mammogram and/ or breast ultrasound examination
  3. Any intervention needed.  This refers to core biopsies or a fine needle aspiration

After all the imaging and interventional procedures have been completed, the Radiologist or Consultant Radiographer will write a report at the time of imaging. At this point the patient will be given the results either by the imaging team or the report is given to the referring clinician back in clinic. In this case the patient will then be seen by the referring surgeon / registrar or nurse practitioner and given their diagnosis before leaving the department or following a biopsy up to 7-10 days later. This could be either by a telephone appointment or a face-to-face appointment.

Mammagram

A Mammogram is an x-ray of the breasts and is usually performed on both breasts and on patients over 40 years of age. It can be performed by either a Mammographer or an Assistant Practitioner.

During the mammogram the breast will be compressed between two perspex plates for a few seconds in order to visualise the breast tissue. This pressure may be uncomfortable however, the test is over quickly with the process only lasting for about 10 minutes. This may be followed by an ultrasound.

Breast Mammogram machine
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Ultrasound

The Ultrasound test is carried out whilst lying down. Gel is spread over the breast and a small hand-held probe is gently pressed against the skin surface and then moved around so that the breast can be viewed from different angles. It is usually the area of concern that is scanned. The scan only lasts 5 to 10 minutes and has no known risks. If under 40 years of age this may be the only breast imaging required.

Breast Ultrasound machine
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After imaging further tests may be required:

Core Biopsy

The procedure uses a needle which is quickly fired into the lump using a biopsy device (which normally makes a loud clicking noise), removing a piece of tissue from the breast. The breast tissue can then sent away to be looked at under a microscope to see if there are any abnormalities.

After the biopsy, the area will be pressed for a few minutes to help stop any bleeding, and a dressing will be applied. Several samples are usually taken.

The procedure is carried out whilst lying down and will normally take 15-20 minutes. A local anaesthetic will be used to numb the area so the amount discomfort during the test should be minimal.

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Fine Needle Aspiration

Some women may have a procedure called fine needle aspiration instead of a biopsy. This involves removing a sample of cells from inside the breast using a very thin needle, similar to a blood test and the cells sent away to be looked at under a microscope and checked for any abnormalities.

The procedure is usually carried out while you are lying down and takes about 10 to 15 minutes.

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Other Biopsies

A vacuum assisted core biopsy may be necessary. This test involved tissue being sucked through a needle after a local anaesthetic. The procedure is carried out whilst lying down or whilst sitting and it normally takes 45-60 minutes. It reduces the need to have surgery to determine what is going on in the breast. This type of biopsy will not be performed on the day, a further appointment will be made for this.

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