Biopsies and 3-D mammography: more accuracy for better outcomes

3-D Mammography – Dr. Gerald McCullough

The technology used in diagnostic imaging is constantly changing and improving, and TCHC remains at the front of these advancements.

A little over a year ago, we were one of the first in the region to get the capability to perform 3-D mammography. For years, we’ve done 2-D mammography, where the image of a breast is Happy breast cancer survivors supporting each othercompressed into one flat image. With 3-D mammography, we can take a picture of a breast and split it into dozens of 1 mm slices, like a loaf of bread.

This separates each image so you can look at it one slice at a time. If I see a nodule, I can scroll straight to it and see whether or not it has characteristics that are suspicious.

The biggest thing about 3-D mammography is increased accuracy. Sometimes we biopsy areas that are normal because they didn’t look normal, but 3-D allows us a better look at slight changes in the breast so we can reduce the number of false positive biopsies.

When you come in for a mammogram, there are two kinds you might receive. Screening mammograms test a healthy population for disease. It’s been shown that by screening for breast cancer, you increase survival, you increase detection and you promote better health. Diagnostic mammograms are performed if the doctor or the patient feels a lump or if we suspect that something’s not right.A Mammogram image showing left and right breasts.

No matter which type you receive, everyone who gets a mammogram at TCHC gets both a 2-D and 3-D. They are done with the same machine and in the same visit and take five to 10 minutes. The use of this technology, along with regular screening, is very important because you can get a clearer picture of the breast, intervene earlier and have better outcomes.

There may come a day when 3-D mammography becomes standard across the board. The great part is that it is already standard at TCHC so that we can give you more accurate results and peace of mind.

Stereotactic Breast Biopsy – Dr. David Kloss

Sometimes technology comes along and it is a flop (think 3-D TV viewing with those stupid, awkward goggles or think Google glasses).

But once in a while, the engineers get it right, and that new piece of technology REALLY delivers a radically new product or a dramatically better result. Stereotactic breast biopsy is one of those new technologies that REALLY delivered a radically new and improved result!

Nurse with a young woman having a mammogram. Dr. McCullough has described how helpful the 3-D mammography is at picking up very small, subtle changes in the breast. Eight out of 10 times, these little areas are NOT cancerous. But patients and doctors like to know for sure that these mammographic spots are benign (not cancerous).

Fifteen years ago, a small area in the breast that needed a biopsy to prove it was benign required a big, expensive operation; this resulted in a large scar, pain and time away from work.

For the last 18 months, the specialists at TCHC have been using the latest in computer technology combined with the newest mammogram machine to biopsy these tiny little areas. Rather than a trip through same-day surgery with a large scar, these biopsies are completed through a 3 mm (1/5 of an inch) incision under local anesthesia. The ENTIRE biopsy takes 15 minutes. The patients can drive themselves home!

Most often, these biopsies are benign and then the patient has the satisfaction of knowing that everything is OK! In the less common event that the biopsy returns suspicious or cancerous cells, I can sit down and talk to the patient and family members to discuss the current options of surgical management. This usually includes a “lumpectomy” (otherwise known as breast conserving therapy), sentinel lymph node biopsy (another minimally invasive biopsy technique) and then followed by radiation therapy.

With the help of this new, minimally invasive technology, the doctors at TCHC can deliver quicker, more effective care to you. We still deliver good ol’ fashioned hometown care, but with this new technology, the patient is even BETTER cared for!



About Dr. McCullough: Dr. McCullough is a radiologist at Wadena Clinic. He graduated from the University of Minnesota School of Medicine in Minneapolis and completed his residency at the University of Minnesota. In his spare time, he enjoys fishing and deer hunting.

About Dr. Kloss: Dr. Kloss is a board-certified general surgeon at Tri-County Health Care. In his free time, Dr. Kloss is an avid marathon runner. His race résumé includes the Marine Corps Marathon in Washington, D.C., as well as marathons in Dublin, Ireland; Paris, France; and Pittsburgh. He also ran the Twin Cities Marathon for the Leukemia and Lymphoma Society and the New York City marathon for the American Cancer Society. Dr. Kloss also earned Ironman status, having completed the Madison, Wisconsin, Ironman race in 2014.

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