Our warm inviting waiting area reflects our philosophy about women's health.
A private consultation room. Alone or with a support person, you and your doctor discuss your possible treatment options.
The Ellen Shaw de Paredes Institute for Women's Imaging utilizes state of the art technology and we incorporate our research background to offer the newest technologies as they emerge. Our clinical services are oriented to the detection and diagnosis of breast disease, and these included mammography, ultrasound, bone density, breast MRI and breast biopsy. We do see male patients as well for evaluation of breast abnormalities. We also offer gynecologic care and gynecologic surgery.
DIGITAL MAMMOGRAPHY WITH CAD
One of the recent advances in the field of mammography that will have the largest impact on patient care is the development of digital mammography. The technology allows us to obtain high resolution digital images as rapidly as we obtain analog mammograms. The digital acquisition allows the technologist to immediately review the images for quality, and the technique allows for fewer repeats. The radiation dose to the patient is usually less with digital mammography in comparison with film screen mammography. We are utilizing Siemens and Hologic Units that offer very high resolution mammographic images and a larger detector than most units, which allows for imaging breasts of varying sizes. Images may be sent to other sites in order to facilitate patient care. Also, by using the digital format, we are able to utilize computer assisted detection, or CAD. CAD examines each mammogram for suspicious calcifications and masses, adding another interpretive component to each study.
We have added Tomosynthesis or 3D mammography. This is the newest cutting edge technology that allows the radiologist to view the breast tissues in 1 mm thick slices - like turning the pages of a book. With tomosynthesis, significantly more cancers can be found, and there is less of a need for some additional views for benign findings.
BREAST INTERVENTIONAL PROCEDURES
Percutaneous Breast Biopsy
In the age of medicine when mammographic screening has become the standard of care to detect early breast cancer, biopsies are often necessary to diagnose or exclude breast cancer. Percutaneous breast biopsy has revolutionized the management of clinically occult, mammographically detected abnormalities. Many of the techniques for percutaneous breast biopsy were developed by Dr. Paredes nearly two decades ago.
In our facility, needle biopsies are performed with state of the art equipment using ultrasound, MRI stereotactic or tomosynthesis guidance. The techniques we use include fine needle aspiration with cytology, cyst aspiration, core needle biopsy and vacuum assisted needle sampling of breast abnormalities. Highly precise equipment allows for accurate targeting and sampling of the abnormal area. Samples are sent to an experienced breast pathologist and the patient is notified of the results in one to two days.
For lesions that are found on biopsy to be at high risk for malignancy or for patients undergoing lumpectomy to treat a mammographically detected breast cancer, needle localization is performed. Prior to the surgery, a wire or wires are placed into the breast to indicate to the surgeon the area to be removed. This procedure is performed with stereotactic, mammographic, MRI or sonographic guidance to precisely pinpoint the area of concern. The procedure is performed in our office the morning of the planned surgery.
For patients who have a suspicious type of nipple discharge, we perform galactography to identify the possible cause. Contrast is injected into the duct producing the discharge and digital imaging is performed. We are able to perform imaging guided biopsies of abnormalities detected by this method and diagnose the cause of discharge.
Breast ultrasound is an integral component in the evaluation of the breast. Sometimes findings identified on mammography may be better characterized using our state of the art Siemens Antares ultrasound unit. Ultrasound provides information that helps to identify a finding as benign or one that may need further evaluation. Ultrasound has become the standard method of evaluation for most palpable abnormalities. Sonography may be used to evaluate suspected breast implant rupture. More recently, full breast ultrasound has been used in some high risk patients as a screening tool for breast cancer. All results are given to the patient at the time of the study and communicated to the referring physician.
As our clinical understanding of osteoporosis has improved, bone density analysis has become an important part of patient care. The Ellen Shaw de Paredes Institute for Women’s Imaging provides state of the art analysis of bone density with the most advanced Hologic Unit. Results of bone density assessment, including evaluation for fractures in the thoracolumbar spine, are given to the patient immediately. These results are sent to the referring physician promptly to initiate treatment if indicated.