MedifocusHealth

Laboratory Evaluation

• Complete blood count (CBC) helps to determine the presence of infection (usually reflected in an elevated white blood cell count) or anemia (low red blood cell count)

• Ductal Lavage - This is an experimental test developed for women who have no symptoms of breast cancer but are at very high risk for breast cancer. Gentle suction is applied to the nipple to draw fluid from the milk ducts up to the nipple surface. The fluid droplets that appear help locate the milk ducts' natural openings on the surface of the nipple. A small catheter is then inserted into a milk duct and saline solution is slowly delivered through the catheter to gently "rinse" the duct and collect cells. This fluid is withdrawn through the catheter and sent to a lab, where the cells are viewed under a microscope. More studies are needed to better define the usefulness of this test.

Radiological Evaluation of Breast Cancer

Mammography

Mammography is a low-dose X-ray of the breasts that produce an image of the breasts known as a mammogram. Both screen-film mammography and full-field mammography use x-rays to obtain images. With screen-film mammography the image is captured on film; with full-field digital mammography the image is captured digitally. Approximately 95% of women with abnormalities on screening mammograms do not have breast cancer.

The American College of Radiology (ACR) has developed a standard way of describing mammogram findings. In this system, the results are given a code (numbered 0 through 6). This system is called the Breast Imaging Reporting and Data System (BIRADS). Having a standard way of reporting mammogram results lets doctors use a consistent language and ensures better follow up of suspicious findings.

The BIRADS system for describing mammogram findings includes:

• Category 0: "Additional Imaging Evaluation and/or Comparison to Prior Mammograms Is Needed" - A possible abnormality may not be completely seen or defined and will need more tests, such as the use of spot compression, magnification views, special mammogram views, or ultrasound.

• Category 1: "Negative" - In this case, there is no significant abnormality to report. The breasts appear the same (symmetrical) with no masses, architectural distortion, or suspicious calcifications.

• Category 2: "Benign (Non-cancerous) Finding" - This is also a negative mammogram, but the reporting doctor chooses to describe a finding known to be benign, such as benign calcifications, intramammary lymph nodes, or calcified fibroadenomas. This ensures that others viewing the mammogram will not misinterpret this benign finding as suspicious. This finding is recorded in the mammogram report for use in future mammogram assessments.

• Category 3: "Probably Benign Finding - Follow-up in a Short Time Frame Is Suggested" - The findings placed in this category have a very high probability (greater than 98%) of being benign. Follow-up with repeat imaging is usually done in 6 months and regularly thereafter until the finding is known to be stable (usually at least 2 years). This approach helps avoid unnecessary biopsies but allows for early diagnosis of a cancer should the suspicious area change over time.