What is Breast Imaging?
Medical imaging methods are used for the diagnosis of breast diseases. Is the hardness or mass found by you or your doctor really a sign of disease? If it belongs to a disease, is it benign? Is it malignant (cancer)?
At TOMOKAY, you will find definitive answers to these questions.
If you suspect something during a self-examination, you can come directly to TOMOKAY. The most suitable imaging method for you will be selected and carefully applied by our Specialist Doctor. Our result is definitive. You can be sure of this.
Breast Ultrasound
What is breast ultrasound?
Breast ultrasound is frequently used to evaluate breast abnormalities that can be felt by hand. When any hardness in the breast is noticed, it is decided to examine this point. Breast Ultrasound does not replace Mammography. Mammography images are necessary to examine the entire breast. Breast ultrasound sends high-frequency sound waves that the human ear cannot hear into the breast, and the reflections of this sound appear as images on the ultrasound.
What should I expect?
Our radiologist is one of the most skilled doctors in Turkey regarding ultrasound. When you come to our center, your registration will be done, and you will be taken to the Ultrasound room at your appointment time. Here, you will be asked to undress from the waist up. You will be laid on the examination table. You will be covered, and our Doctor will come. The ultrasound will begin after asking some questions about your health history and symptoms.
In women over 40, breast ultrasound is generally performed together with mammography. Below the age of 40, Ultrasound is the primary method for breast examination. During the ultrasound, you will lie on your back on the table, and pillows will be placed specifically to examine the breast. After that, the doctor applies a non-allergenic, water-soluble solution (gel) to your breast. This prevents air from entering between the ultrasound probe and the breast skin. The ultrasound probe is gently pressed against your breast, and the doctor examines your breast tissue. The image of the breast is seen on the ultrasound screen.
Breast ultrasound takes 30 – 45 minutes. Afterward, our Radiologist interprets the ultrasound images and makes a decision regarding the problematic breast tissue.
When will I receive the results?
Information regarding when you will receive your results will be given to you at our center. Under normal conditions, you can receive your results within 15 minutes to 1 hour.
How can I make an appointment?
You can make an appointment by calling our center at (0224) 513 65 29 – 0533 7252216, sending an email, or via our website.
Digital Mammography
What is Digital Mammography? Mammography is an imaging technique that examines the breast using a low dose of X-rays with a device specially designed for the breast. In Digital Mammography, images are obtained in a digital environment using the latest system. In this way, the received radiation dose is reduced, and images can be examined on a special high-resolution monitor. Mammography images examined by our Radiologist allow for the detection of a mass in the breast before it reaches a noticeable size or the detection of micro-calcification foci (which may be the stage before a mass forms). Digital mammography holds a very important place in the diagnosis of breast cancer. TOMOKAY Medical Imaging attaches great importance to early diagnosis with Mammography. According to early cancer diagnosis programs in American and European countries and the Ministry of Health of the Republic of Turkey, it is considered appropriate for women to have a Mammography every year starting from the age of 40.
Mammography is the only method that reduces deaths caused by breast cancer. Since the widespread use of Mammography for early diagnosis in the USA starting from 1990, deaths caused by breast cancer have decreased by 30%.
As TOMOKAY Medical Imaging, we are working to minimize deaths caused by breast cancer in Turkey. Early Stage Breast Cancer diagnosis made thanks to Digital Mammography enables easier treatment methods to be applied to women. Thus, treatment can be applied with smaller surgeries, lower doses of Radiotherapy, and fewer medications.
Since breast cancer seen in women under 50 is more dangerous, having a mammography every year is very important for women.
Screening Mammography (Control Purposes) It is possible to diagnose breast cancer early and get treated if Mammography is performed every year as recommended. Women aged 40 and over do not necessarily need a referral from a doctor. You can make an appointment and have your Mammography done whenever you want. If you notice hardness, swelling in your breast, or color change in the breast skin, or if you have had breast cancer before, a Diagnostic Mammography is required for you.
Diagnostic Mammography Diagnostic Mammography is performed due to a mass found during a doctor’s examination or suspicion of a mass.
If you detect color change in the breast skin, retraction in the breast skin, hardness or protrusion in the breast yourself, or if you feel pain/ache in the breast or if there is nipple discharge, Diagnostic Mammography is required.
If a lesion is seen in Screening Mammography, Diagnostic Mammography may be required.
How should I prepare?
Please bring your previous Mammography films or CDs.
Do not apply any talcum powder, deodorant, oil, or perfume to your underarm and breast on the day you will have the Mammography. These substances create small errors in the mammography film and make it difficult to examine the film.
Wear a two-piece outfit (top and bottom) so that you only remove your top and bra, and your pants or skirt remain on you.
We recommend that menstruating women have their Mammography done the week after their period ends.
Women who do not menstruate can come for Mammography at any time.
Do not forget to mention your entire health history, surgeries you have had, and breast diseases in your family and yourself.
What should I expect?
When you come for Mammography, carefully fill out the form provided by our medical secretary. If there are questions or topics you do not understand, ask our secretary.
In our center, Mammography is performed by a female Technician. The answers you give to the Technician performing your scan will be used by our Specialist Doctor while evaluating the films.
During the scan, the breast will be compressed and fixed between two plastic plates.
The scan will take approximately 15 minutes.
It is very important to bring previous Mammography films because your breast films need to be compared.
When will I receive the results? The Mammography film/CD and report are given within 1-2 hours.
Benefits and risks of Digital Mammography
-Accuracy Mammography is the most common method used for the early diagnosis of breast cancer. However, Mammography may not be useful in diagnosing all types of breast cancer. A suspicious abnormality in the breast should never be ignored even if your Mammography comes out normal; it should be followed up. If you notice any changes in your breast, inform your doctor immediately.
-Additional tests Approximately 10% of women are recalled for diagnostic mammography after screening mammography. This situation is more common in women aged 40-49. In some cases, a biopsy or a new mammography 6 months later may be required for follow-up.
-Radiation dose Strict restrictions and controls ensure that mammography use is safe and uses the lowest possible dose of radiation. Today, many people worry about exposure to radiation. But the radiation used in Digital Mammography is at a very low dose. The radiation received from mammography is equivalent to the radiation received during a two-hour plane flight.
Breast Biopsy
What is a breast biopsy?
The most definitive method to understand whether a mass or abnormal finding in breast tissue is benign or malignant is biopsy. With a needle biopsy, a small sample is taken from the lesion in the breast. The taken piece is examined under a microscope by a Pathology Specialist after special processing and staining. In this way, it is understood whether the disease is malignant (cancer) or benign.
Needle biopsy is performed in several different ways. Ultrasound-guided breast biopsy is the most common method. However, this method can be used if the lesion is visible on Ultrasound.
Stereotactic breast biopsy is applied to breast lesions seen on Mammography. With the guidance of mammography images, the biopsy needle is directed towards the abnormal tissue. Stereotactic biopsies are commonly used for calcifications (microcalcifications) in the breast.
MRI-guided biopsy is performed with simultaneous Magnetic Resonance imaging. This method is the most advanced technology and superior method for diagnosing breast cancer. This method is used if the lesion in the breast is only visible on MRI.
What should I expect? We understand that biopsy is an experience that can cause fear and stress. However, in addition to definitive diagnosis, patient comfort is our first priority. Our radiologist and staff are trained to perform this procedure in the most comfortable and fastest way possible. Needle biopsy is performed with local anesthesia and minimal discomfort. No stitches are used during this procedure, and most women can resume their normal daily lives immediately. Keep in mind that more than 80% of breast abnormalities are benign and not cancer.
If it makes you feel more comfortable, you can bring a relative or friend with you to support you and drive you home. Please do not use Aspirin or Ibuprofen for 6-7 days before the biopsy. If you are using any blood thinners, you must inform our staff when making an appointment. You may need to stop using your blood thinner for a certain period before the biopsy. Other medications (heart, hypertension, diabetes, etc.) are not obstacles to biopsy, and you can continue to use them. Wear a supportive bra after the biopsy.
Wearing a two-piece outfit and having a buttoned top will provide you convenience.
You do not need to make any changes to your diet.
ULTRASOUND-GUIDED BIOPSY: Fast for 3 hours before your appointment and be present at our center at least 30 minutes before your appointment time.
You will lie on your back or slightly on your side. The ultrasound probe is used to locate the lesion. Local anesthesia will ensure you do not feel any pain. After that, the Radiologist makes a small mark on your skin and determines where to insert the needle. After the biopsy needle enters, several samples are taken from the breast lesion. After the biopsy, an ice pack is given to you and placed on the biopsy area. Rules to be followed after the biopsy are explained separately.
STEREOTACTIC BREAST BIOPSY: Fast for 3 hours before your appointment and be present at our center at least 30 minutes before your appointment time.
In this minor operation, you will lie face down on a bed specially prepared for breast biopsy. Your breast is placed into the opening in the bed. After that, your skin is cleaned, and local anesthesia is applied. Then a millimetric incision is made on your breast. This does not cause any bad appearance on your breast. Then the Radiologist enters through the incision and takes several samples from the abnormal tissue inside the breast. If deemed necessary, in some cases, a small titanium piece (clip) is left in the abnormal tissue. In this way, the abnormal tissue can be easily found again for surgery or follow-up purposes.
After the biopsy, an ice pack is given to you and placed on the biopsy area. Rules to be followed after the biopsy are explained separately.
MRI-GUIDED BIOPSY: During MRI-guided biopsy, local anesthesia is applied to the breast, and a contrast agent is given intravenously. You lie face down on the MRI table, and your breasts are placed in the cushioned opening specially designed for breast imaging in the MRI. Using a computer program, the Radiologist measures the location and depth of the breast lesion and takes a piece using a special needle system. When sampling from the breast is finished, a small marker may be left at the biopsy site. This ensures the abnormal tissue in the breast is easily found for follow-up and/or surgery. After the biopsy, an ice pack is given to you and placed on the biopsy area. Rules to be followed after the biopsy are explained separately. If you have claustrophobia or anxiety, you can request your doctor to give you a mild sedative. Fast for 3 hours before your appointment and be present at our center at least 30 minutes before your appointment time. When you come to our center, you will be asked to fill out some documents regarding your health history and symptoms. You will be asked to remove all jewelry on you because these items disrupt MRI signals. Bring all Breast Ultrasound, Mammography, and MRI films you have had before so that our Radiologist can compare your new images with your old images.
If you have:
- Pacemaker
- Artificial heart valve prosthesis
- Aneurysm clip
- Eye implants and metal ear implants or any kind of metal implants activated electronically, magnetically, or mechanically
- Copper 7 IUD
- Shrapnel or unremoved bullet
- Pregnancy
- Weight over 121 kg
- Claustrophobia
- Metal fragments in the eye
You are not suitable to enter the MRI.
What rules should I follow after the biopsy?
- Do not perform any strenuous activity after the biopsy.
- Do not take Aspirin and Ibuprofen for 3 days.
- An ice pack will be placed inside your bra, and you should apply ice treatment for 4 hours.
- It is recommended to sleep with your bra on for 3 nights after the biopsy.
- You can use Paracetamol (such as Vermidon, Minoset) as a painkiller. Do not wet the biopsy site for 3 days after the biopsy.
- You may see slight pain and bruising at the biopsy site.
If excessive bleeding, pain, or fever occurs, contact our Center or the Doctor who requested the biopsy.
When will I receive the results?
The pieces taken by biopsy will be sent to our Pathology Specialist with whom we have been working for many years. Evaluation takes 2-7 days. You will be notified by phone when the result is ready.
Wire Localization of Breast Lesion
What is wire localization of a breast lesion?
Palpable breast masses can be operated on and removed. During breast screening, if a mass, microcalcification, or area suspected of disease is detected and this lesion is not palpable (cannot be felt by hand), it is marked with a wire under imaging guidance.
How is it done?
Local anesthesia is applied to the area where the intervention will be made. This procedure is applied without the patient feeling any pain, ache, or discomfort. Using a special needle, the diseased or suspected area is entered under imaging guidance. The sheath of the needle is withdrawn, and a wire with a hook-shaped tip is attached to the lesion. Thus, the Surgeon removes the breast tissue where the hook of the wire is attached together with a safety margin.
Ideally, the mass, microcalcification, or similar lesion detected by Ultrasound, Mammography, or MRI is marked with a wire using the imaging method where it is seen most clearly. The wire is fixed to the breast, and the patient is sent to surgery.
What should I expect?
The disease in the breast will be safely removed surgically, and the patient will be treated.
Wire localization of breast lesions has been successfully applied at TOMOKAY for years.