A mammogram is a special type of x-ray used only for the breast. Mammography can be used either to look for very early breast cancer in women without breast symptoms (screening) or to examine women who do have breast symptoms (diagnostic).

What to expect?
You will need to undress from the waist up.  One of your breasts will be positioned between two plastic plates which will flatten the breast slightly. Most women find that this is a bit uncomfortable, but not painful. Generally two x-rays are taken of each breast. It is also useful to compare the results with earlier examinations and you should take any previous mammography results with you.

In ultrasound, a beam of sound at a very high frequency (that cannot be heard) is sent into the body from a small vibrating crystal in a hand-held scanner head.  When the beam meets a surface between tissues of different density, echoes of the sound beam are sent back into the scanner head.  The time between sending the sound and receiving the echo back is fed into a computer, which in turn creates an image that is projected on a television screen.  Ultrasound is a very safe type of imaging; this is why it is so widely used during pregnancy.

What to expect?
After lying down, the area to be examined will be exposed.  Generally a contact gel will be used between the scanner head and skin.  The scanner head is then pressed against your skin and moved around and over the area to be examined.  At the same time the internal images will appear onto a screen.

This procedure involves inserting a needle through your skin into the breast lump and removing a sample of tissue for examination.

Open Excisional: a small incision (cut) is made as close as possible to the lump and the lump, together with a surrounding margin of tissue, is removed for examination. If the lump is large, only a portion of it may be removed.

Core Needle Biopsy: this involves inserting a needle through your skin into the breast lump and removing a sample of tissue for examination.

This may be:

• Simple or Total: all breast tissue, skin and the nipple are surgically removed but the muscles lying under the breast and the lymph nodes are left in place.

• Modified Radical: all breast tissue, skin and the nipple as well as some lymph tissue are surgically removed.

• Partial: the breast lump and a portion of other breast tissue (up to one quarter of the breast) as well as lymph tissue are surgically removed.

• Lumpectomy: the breast lump and surrounding tissue, as well as some lymph tissue, are surgically removed. When combined with radiation treatment, this is known as breast-conserving surgery.

When a breast has been removed (mastectomy) because of cancer or other disease, it is possible in most cases to reconstruct a breast similar to a natural breast. A breast reconstruction can be performed as part of the breast removal operation or can be performed months or years later.

Breast reconstruction is performed by specialist Plastic & Reconstructive surgeons and you would be referred to their service to discuss appropriate options of reconstruction.