26-34 Dr. Rupert Indar Snr. Street, San Fernando. +868 652 4535 / 2064

Quality CT Treatment Centre

Southern Medical Imaging Centre is the most Advanced Imaging Centre in the Caribbean.

Digital Mammography

A mammogram is an X-ray of breast tissue. Mammography is a screening tool that searches for cancer when there are no symptoms of a health problem. A mammogram detects lumps, changes in breast tissue or calcifications when they're too small to be found in a physical exam
Usually two images from different angles are taken of each breast. The procedure uses the X-ray images to find abnormalities within the breast tissue.
American Cancer Society guidelines recommend that all women age 40 and over have annual mammograms. A woman at high risk of breast cancer because her mother or sister was diagnosed with the disease should have her first mammogram at age 40 or 10 years before the age at which the relative was diagnosed, whichever comes first. The first mammogram done is called a baseline mammogram. This baseline becomes the standard for which all future mammograms are compared and the physician can tell if there have been any changes in the breast tissue.
A specially trained radiology technologist performs the mammogram by positioning the breast tissue in the screening equipment. Compressing or flattening the breast obtains a clearer picture of the tissue while using the lowest dose of radiation possible. The compression can be uncomfortable but will only last for a few seconds while the X-ray is taken. Some women may feel sore after a mammogram.
Sometimes, additional images for more precise pictures of the breast tissue are required. Although unsettling, this is not unusual and provides the images needed for more accurate results. A radiologist, a medical doctor trained in radiology, reads the mammogram.

The Role of Mammography in Breast Cancer Management

A mammogram is an x-ray exam of the breast. It is used to detect and evaluate breast changes. Mammograms are most often used to look for breast cancer that is too small to be felt in women who have no breast complaints or symptoms. These are called screening mammograms. The goal of screening exams, such as mammograms, is to find cancers before they start to cause symptoms.
Mammograms are also used in women who have breast symptoms, such as a lump, pain, nipple discharge, or who have a suspicious change seen on a screening mammogram. These are called diagnostic mammograms. Breast cancers that are found because they can be felt tend to be larger and there is a possibility that they are more likely to have already spread beyond the breast. In contrast, breast cancers found during screening exams are more likely to be small and still confined to the breast. The size of a breast cancer and how far it has spread are important factors in predicting the prognosis (survival outlook) for a woman with this disease. 
Early detection tests for breast cancer saves many thousands of lives each year, and that many more lives could be saved if even more women and their health care providers took advantage of screening tests.

The benefits of Cardiac Catheterisation

Cardiac cath is a procedure that allows your doctor to gather information about the coronary arteries. It can also tell the doctor about your heart’s structure and how well the heart is working. It also is used to treat heart problems. Cardiac cath can:
• Provide information about your heart. Cardiac cath can show the condition of coronary arteries and heart valves. It can also show how well the heart pumps and blood flows through the heart. This helps your doctor diagnose your heart problem.
• Help treat blocked arteries. Cardiac cath can be used to perform procedures that treat blocked arteries. This can relieve symptoms such as angina and help prevent serious problems like a heart attack.
• Coronary Artery Disease (CAD)

Who should have a Mammogram?

American Cancer Society recommendations for early breast cancer detection are that women age 40 and older should have a screening mammogram every year and should continue to do so for as long as they are in good health.
In particular, recent evidence has confirmed that mammograms offer substantial benefit for women in their 40s. Women can feel confident about the benefits associated with regular mammograms for finding cancer early. However, mammograms also have limitations. A mammogram will miss some cancers, and it sometimes can lead to findings that are not cancer, including biopsies Women should be told about the benefits and limitations linked with regular screening. Despite their limitations, mammograms remain a very effective and valuable tool for decreasing deaths from breast cancer.
Mammograms for older women should be based on the individual, her health, and other serious illnesses. Age alone should not be the reason to stop having regular mammograms.

What is Advanced Digital Mammography?

With film mammography, images are recorded on film using an X-ray cassette. The film is viewed by the radiologist using a "light box". With digital mammography, the breast image is captured using an electronic X-ray detector, which converts the image into a digital image for review on a computer monitor. The digital mammogram is then saved on the computer, making it much easier to view, examine, store and transmit. While film mammography is good, it is less sensitive for women who have very dense breasts, a common characteristic in younger women. Digital mammography is superior to film mammography in younger women with dense breasts due to its ability to selectively optimize contrast in areas of dense parenchyma.
This advantage is especially important in women with a genetic predisposition for breast cancer, where intensified early detection programs may have to start from 25 to 30 years of age.
In the UK Breast Screening Program, there is an increasing proportion of pre-menopausal women being screened, due to the extension of the program to include women in their late 40s. This makes digital mammography more crucial. Digital mammography also has significant practical benefits for the screening units themselves compared with traditional film-based systems "The advantages of going digital include better workflow and possibly more rapid imaging due to cassette-less operation. Storage, retrieval, copying and transmission of images should be simplified by computer storage."
How does digital mammography compare to film mammography?
As in film mammography, when you have a mammogram, your breast is compressed between 2 plates attached to the mammogram machine. The technologist compresses your breast to keep it from moving. These measures reduce blurring, and make the image sharper. Although the compression can uncomfortable, in digital mammography it only lasts for a few seconds and is needed to produce a good mammogram image. Advanced Digital Mammography (also called High-quality full-field digital mammography) is increasingly used for both diagnostic and screening mammography. Diagnostic accuracy of digital mammography has been shown to be equal or better than film mammography in a screening population.
How is it better for the patient?

Improved Speed And Comfort Like traditional mammography, digital mammography requires breast compression for clear pictures, but capturing images takes about half the time. A shorter exam is a more comfortable exam.

Superior Imaging – Digital mammography captures superior images and transfers them to a computer. They can be electronically enhanced for reporting if required. Radiologists can zoom in, magnify and optimize areas of the breast tissue using just four images.

Digital Format – All images are captured, read and stored digitally. This results in sharper images with no loss of resolution. It also makes scans more accessible to your healthcare provider.
Less Radiation - "In addition to better assisting radiologists, digital technology provides the notable benefit of using less radiation (about 50 percent less) than standard film mammography.

Twice The Resolution In Half The Time - Digital Mammography cuts compression and scan times in half while producing images that are clearer, more detailed and superior in every way to traditional mammography. The result is remarkably short exam times. On average, a digital mammogram takes just 15 minutes. This is a short time for women of age to put aside.

Easy Access For A Prompt Report - The technology also eliminates film. Images are stored digitally and can be accessed virtually by any doctor anywhere, anytime. All mammograms performed are read promptly by local radiologists.

Better Enhancement Of Images - Digital mammography creates digital images that can be enhanced by electronically changing the brightness, size or contrast, making the radiologist's job of reading the image much easier.

A Comfortable Environment - Our dedicated breast unit with it's own waiting area is cool and comfortable with seating, magazines, and a private dressing room.

Most important, the people at Southern Medical are among the best and most experienced in the country. The staff and radiographers are dedicated professionals who put patients at ease and ensure everything, from completing forms to filing insurance claims.

How does Southern Medical Clinic provide a complete breast cancer service?

At Southern Medical Clinic, state-of-the-art magnetic resonance imaging (MRI), advanced digital mammography, and ultrasound equipment are used for screening and for early detection of breast cancer. The most modern techniques of surgery, chemotherapy, and radiation oncology are available, as well as support services, including support groups designed to assist women who have had treatment for primary cancer of the breast. International evidence shows that patients with breast cancer have the best prognosis if they are treated in specialist breast units where teams of medical professionals work together and treat patients. This means that all patients are discussed by many specialists working together on the same site. Weekly conferences attended by all the staff allow the diagnosis and future treatment of the patient to be discussed by all team members, a process that increases expertise. This is called multidisciplinary team working.
Our integrated breast service includes:

Same day services:
When a woman finds a breast lump or is informed that her mammogram is abnormal, her first thought is: "Why me". However, until more definitive information becomes available, she is in a state of high anxiety. We have created a unique program to deal with these patients in a timely manner. A woman with a new breast problem can be seen on the day she calls. The patient will be examined, and mammographic evaluation will be performed, and finally, a treatment plan will be provided. Any woman who is about to have her yearly routine mammogram might also be in a state of high anxiety. If during the mammogram extra views are ordered, the level of stress skyrockets. The mammogram is read immediately, and when indicated, all extra views and ultrasound are done at the same visit. A final report is issued on that visit. The surgeon then does an examination if required and reviews the report with the patient. If all is normal, a routine follow-up examination and mammogram is scheduled for the next year. If a problem is identified, an immediate treatment plan is implemented.

Second opinion:
If you or your loved ones have concerns about the care you have received for a breast problem, consider action should be given for a second opinion. Obtaining a quality second opinion in a timely manner can be crucial. We currently have an organized approach that emphasizes the key elements of an effective second opinion: Quality and Timeliness. Questions are answered and a plan of action is initiated.

High risk program:
Every woman is at risk for breast cancer, and the risk increases as women ages. 75% of women who get breast cancer have no family history. Some women, however, are at an increased risk of breast cancer because of a strong family history, or a previous high-risk biopsy. High risk biopsy is one that contains cells that are abnormal but are not frankly cancer. These cells are associated with a significantly increased risk for development of breast cancer. High risk women should do a yearly mammogram and yearly MRI. MRI should be in addition to mammo gram beginning at age 30 years and continue for as long as a woman is in good health.

Screening:
The concept of screening for breast cancer refers to our attempt to detect breast cancer in women who do not have any symptoms such as pain, a lump, nipple discharge, etc. If a woman does have breast-related symptoms, she is evaluated in more detail in reference to those symptoms. When we are referring to screening, we are talking about screening mammograms.

Mammography:
Our approach is based on international points of view in the literature. Women should have their first mammogram at age 40 years, and will need to repeat it 12-18monthly until age 75. Beyond age 75, mammo gram scheduling should be individualized, but we are inclined to recommend a yearly mammogram for healthy women over 75. Women with actual breast symptoms will require a diagnostic mammogram, not a screening mammogram.

Breast Ultrasound:
Breast ultrasound can image several different types of breast conditions, including both benign and cancer ous lesions. Ultrasound is frequently used to evaluate breast abnormalities that are found with mammogra phy or during a physician performed clinical breast exam. Ultrasound allows significant freedom in obtain ing images of the breast from almost any angle. Ultrasound is most useful when there is an abnormality that can be felt.

Breast MRI:
The MRI is an excellent tool for the early detection of breast cancer in high risk women or young women. When an MRI is negative, the chances are about 98% that there is no cancer in the breasts (compared to a negative mammogram, which reflects about an 80% chance of having no cancer in the breasts). The problem with MRI is the high rate of finding areas of concern that are benign. Women who have MRIs should also have a yearly mammogram since some changes are best detected on the mammogram.

Breast Cancer Treatment - Surgery:
There are multiple surgical approaches that are used in the treatment of breast cancer. Surgery can be either removal of the whole breast (mastectomy) or breast conserving surgery (removal of the entire tumour plus a rim of normal tissue). In each operation, the some of the draining lymph nodes are removed. The outlook in either treatment option is the same when used in appropriate patients.

Breast Cancer Treatment - Radiation Therapy:
Radiation therapy is a treatment that is designed to rid the body of any left-over cancer cells after the removal of the breast cancer. It is used routinely after breast conserving surgery (removal of the entire tumour plus a rim of normal tissue). It is also used after mastectomy for large or aggressive cancers. Radiation therapy is a focused beam of high-energy particles that, which can destroy cancer cells without causing damage to normal cells. Radiation treatment is entirely painless.

Breast Cancer Treatment - Chemotherapy:
As our entire treatment team is located on site, there is ongoing communication between team members, and patient care can be more readily coordinated. In most cases, the patient will see an oncologist after surgery has been performed. However, sometimes the patient sees the oncologist for chemotherapy before surgery to try to shrink the breast tumour first to all breast conservation surgery in an effort to improve the cosmetic result of breast conservation. For those patients who proceed to chemotherapy, the oncologist becomes the team leader. The oncologist supervises the chemotherapy and coordinates arrangements for radiation therapy, if needed. When treatment is completed, the oncologist provides a long-term plan for follow-up.

Plastic and Reconstruction Surgery:
Breast conservation is generally considered the procedure of choice for women with early stage breast cancers. However, for various reasons many women are either not candidates for breast preservation, or choose mastectomy for personal peace of mind. If a woman is considering mastectomy, it is important that she be given the option of immediate or delayed breast reconstruction. One problem facing such women is that it is sometimes difficult to coordinate the reconstructive surgery with the mastectomy in a timely manner.

Frequently Asked Questions

How long will my Mammogram take? 
20 Minutes from the time you walk in to the time that you leave.

How long until I receive the results? 
Usually the same day or within 24-hours, unless we are waiting for your previous mammograms for comparison.

Why do you need to have my prior mammogram? 
It is important to compare to the last exam that you have had to see if anything has changed since the last mammogram.

Does Digital Mammography use radiation? 
Yes, slightly less that with film/screen mammograms.

Is there compression with a Digital Mammogram? 
Yes the compression is the same, but the amount of time the compression is applied is shorter.

What if I have breast implants? 
Breast MRI might be a better screening examination for you.

Why is Digital Mammography better? 
Digital Mammography enables the Radiologists to adjust the images contrast and magnification, to aid them in diagnosis. Digital Mammography is especially superior for women with dense fibrous breasts.

Why do I have to remove my deodorant? 
Deodorant can sometimes appear as an area of calcification on a mammogram.