Patients who are diagnosed with breast cancer must not only deal with the difficult diagnosis, but also with deciding which treatment path to take.

Assuta's Center for Breast Health provides medical expertise and compassionate care – from the moment a lump is detected through all treatment and follow-up stages. Assuta offers the following services:

Mammogram

 A mammogram (mammography) is a special X-ray of the breast in which the diagnostic radiologist looks for abnormal lumps or asymmetries in the breast, areas where the tissues appear very dense or have irregular margins. These may be indicators of breast cancer.

Ultrasound imaging for breast health

Ultrasounds are non-invasive medical imaging scans that enable clinicians to analyze the breasts and surrounding tissues. The scans use high-frequency sound waves to generate images of the breasts and project them onto a computer screen. The tests are fast and effective.

Breast ultrasounds are performed as complementary exams to mammograms, giving more accurate results than a mammography, in some instances, an ultrasound is more accurate than an MRI.

Complementary breast ultrasounds are highly recommended for two populations:

• Young women, whose breast tissue can be dense, which can make it difficult to locate tumors via mammogram
• Women in high-risk groups

Breast biopsy

A breast biopsy is a sampling of tissue taken from the body for close examination to check for signs of disease. A biopsy is required to know with certainty whether a finding discovered during the mammogram or ultrasound (or a lump found upon touch) is benign or malignant (cancerous).

If the lump is malignant, the biopsy gives the treating physician the medical data to determine the patient’s prognosis and set a course for treatment.

In most cases, breast biopsies can be performed in the doctor's clinic. The tissue sample is sent to the laboratory to be evaluated carefully under a microscope.

Common biopsies

The common types of biopsies to diagnose breast cancer include:

• Fine needle aspiration: During the procedure, the doctor inserts a thin needle into the breast to draw out a small sample of the affected tissue. This test is simple, but it gives only partial information on whether the tissue is benign or malignant.
• Large-core needle biopsy: This procedure provides extensive information on the cells taken from the patient’s body. For accuracy, clinicians often perform this biopsy under the guidance of an ultrasound or mammography.
• Vacuum-assisted biopsy (Mammotome biopsy): The vacuum-assisted procedure is used mainly to sample small calcium deposits in the breast, with diameters of up to about ⅝ of an inch (1.5 cm).

In the process of choosing the appropriate biopsy method, the Assuta physician evaluates the size and location of the suspicious tissue and the patient’s breast structure and general health.

Next steps after the biopsy

If the biopsy reveals cancer, further tissue analysis is performed to determine the severity of the disease. This analysis covers questions such as:

• What type of growth is it? For example, is it a growth that develops in the milk ducts, which is the most common type of cancer (about 85% of breast cancers)
• Is this an invasive or non-invasive cancer?
• How big is the tumor?
• What is the cancer grade? The grade defines the degree of similarity to or difference from normal cells.
• Do the cells have receptors for estrogen, progesterone or the HER-2/neu protein?
• How aggressive is the tumor? (This is measured via the rate of growth of the Ki 67 antigen.)

Using data to make treatment decisions

This biopsy data enables the clinical team to plan the best treatment for the patient. For example, often, breast cancer that has receptors for estrogen and progesterone can be successfully treated with biological medications that block the influence of hormones on the tumor. This treatment method is sometimes considered more effective than chemotherapy.

Preoperative tumor marking:

 This process is designed to optimize surgery accuracy. It is performed several days or several hours before the surgery, under local anesthesia. The physician delineates the tumor for surgery by placing special markers or coloring agents inside the tumor using image guidance.