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

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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.

Two New Tools in the Fight Against Breast Cancer

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By: Shannon Brauch, RN, TCHC Breast Navigator

3D Mammography

ret9992-4x6When it comes to breast health, every woman deserves the very best care possible. With the addition of 3D Mammography and Minimally Invasive Breast Biopsies at Tri-County Health Care, that is exactly what they will get.

A revolutionary tool in the early detection of breast cancer, 3D Mammography is the new standard in breast cancer screening today, with Tri-County’s new Genius 3D technology providing a 41% increase in the detection of invasive breast cancers compared to 2D alone, as well as up to a 40% reduction in anxiety producing false-positive recalls. The result is greater accuracy in diagnosis and ideally, reduced stress on the patient.

Who should have a Mammogram?

It’s recommended that all women 40 years of age and older receive an annual mammogram.

With 3D mammography, do I still need an annual screening?

Yes. All women are at risk for breast cancer, regardless of symptoms or family history. Mammograms often can detect potential problems before they can be felt. Early detection greatly increases treatment options and the likelihood of successful recovery.

Is 3D Mammography safe?

3D mammography is quite safe. Radiation exposure to the breast is very low. In fact, the radiation dose for a combined 2D/3D mammography exam is well below the acceptable limits defined by the FDA, and is only a fraction of the level of radiation you receive from natural sources.

Minimally Invasive Breast Biopsiesret9856-4x6

One of the only systems in the immediate region to offer minimally invasive breast biopsies, Tri-County Health Care is committed to providing female patients with care and technology required for the early detection and treatment of breast cancer.

A minimally invasive breast biopsy (or Stereotactic Breast Biopsy) is a procedure that uses mammography to precisely identify and biopsy an abnormality within the breast. It is normally done when the radiologist sees a suspicious abnormality on a mammogram that can’t be felt in a physical exam. This procedure will help determine whether or not you have breast cancer or any other concerning abnormalities in your breast.

Utilizing 3D Mammography as a guide, stereotactic breast biopsies use mammographic images to locate and target the area of concern and to help guide the biopsy needle to a precise location. This technique helps ensure the area that is biopsied is the exact area where the abnormality was seen on the mammogram.

Benefits of Minimally Invasive Breast Biopsies

A stereotactic breast biopsy is less invasive than a surgical biopsy, requires less recovery time and causes minimal scaring. Women who undergo the procedure can be in and out of the hospital the same day and able to sleep in their own bed that night.

Why is a Minimally Invasive Breast Biopsy Performed?

A breast biopsy is typically done if your doctor becomes concerned following a mammogram or breast ultrasound. It is used to investigate irregularities (such as a lump) in the breast.

Shannon Brauch, RN

Shannon Brauch, RN

About the Author: Shannon Brauch, RN, is the TCHC Breast Navigator. In her role she paves the path for women with breast health concerns and helps patients and their families navigate through the health care system. To learn more click here:



*Article was originally printed in Healthy Times Summer 2016.