Finding a lump in her breast is one of the scariest discoveries a woman can make. Immediately, her mind races as she considers the possibilities: cancer, chemotherapy, surgery, radiation, and more.

While finding a lump is alarming, it’s important to realize that not every lump is cancerous; in fact, about 75 percent of all breast lumps are non-cancerous. Injury, menopause, and even a woman’s menstrual cycle can cause harmless lumps called cysts and fibroadenomas. Still, it’s better to know exactly what you’re up against, and at Crozer-Keystone Health System, physicians utilize a variety of advanced diagnostic procedures to determine whether or not a lump is cancerous.

“The use of specialized techniques, such as core biopsy, fine-needle biopsy and further refinement or definition of breast abnormalities makes Crozer-Keystone hospitals the choice for women in need of advanced diagnostic procedure,” says Raymond J. Vivacqua, M.D., chief of the Section of Hematology/Oncology at Crozer-Chester Medical Center and medical director of the Crozer Regional Cancer Center.

At CKHS, patients benefit from state-of-the-art breast diagnostic procedures as well as a team approach that ensures women get the procedure they need in a timely, caring fashion.

“At CKHS, physicians, nurses, clinicians and other specialists work closely in the diagnosis and treatment of breast cancer,” says John D. Sprandio, M.D., chief of the Section of Hematology/Oncology at Delaware County Memorial Hospital and medical director of the Delaware County Regional Cancer Center. “Once a breast abnormality is found – whether it’s through breast self-examination, a clinical examination or a screening mammogram – our team will quickly work to diagnose every woman’s condition to ensure the delivery of quality, compassionate care.”

If you find a lump through breast self-examination or a clinical examination, or one is located during a screening mammogram, you will be directed to have a diagnostic mammogram performed. Unlike screening mammograms, which are done on a yearly basis for women over age 40, diagnostic mammograms focus on the area of the abnormality to more precisely locate and evaluate the lesion.

“Once your mammography films are received by the Crozer radiology team, they are mounted on a device called an automatic multi-viewer and independently studied by two different radiologists, something unique among hospitals in the Delaware Valley,” says Joseph Stock, M.D., chairman of the Department of Radiology at Crozer-Chester Medical Center. “Studies show that the second reader catches 7 to 9 percent of cancers that were not detected during the first reading. Although it is manpower-intensive, double-reading is worth it for those 7 to 9 percent of cancers. It’s a very compelling reason to choose Crozer for your diagnosis.”

At Crozer-Keystone hospitals, your mammography results will be interpreted by teams of certified mammography technologists and board-certified radiologists who specialize in breast imaging.

“Our radiology teams are experienced, compassionate and approved by the Food and Drug Administration (FDA), which sets strict guidelines for radiology protocols,” says Thomas DiLiberto, D.O., chairman of the Department of Radiology at Delaware County Memorial Hospital. “All of our mammograms and diagnostic procedures are performed in a warm, caring environment using state-of-the-art technology to accurately diagnose your condition.”

Should your mammogram confirm the presence of a breast abnormality, your physician may ask you to have a biopsy, a procedure in which a sample of tissue is removed from the breast to be examined under a microscope for signs of cancer.

The options available at CKHS hospitals range from minimally invasive procedures to procedures guided by the latest technological advances. Among the techniques available are:  

• An open (or surgical) biopsy, which is done by making an incision in the skin and removing a sample of the suspicious lump, or the entire lump. If the lump contains cancer cells, all or part of the breast can be removed immediately (although this is not commonly done). 
• A core needle biopsy, which is done by using a needle fitted with a special cutting tip. As the needle is inserted through the skin toward the abnormality, it collects a “core” of tissue about the size of a pencil lead. Core needle biopsies are performed on abnormalities that can be felt during a breast self examination or clinical exam. 
• A stereotactic biopsy, which is done to evaluate a lump that cannot be felt on breast examination, but is seen on mammogram. The procedure is performed using a special type of X-ray instrument that can precisely locate the area of the breast from which the tissue sample will be taken. A small incision is made in the skin of the breast and a needle is guided by the instrument to the exact biopsy site to collect a core tissue sample. 
• An ultrasound-guided breast biopsy, which is done when the abnormality cannot be felt on breast examination or seen via mammogram. The radiologist or surgeon performing the procedure will use ultrasound waves (high-frequency waves that provide a picture of internal structures, including tissues deep within the body) to locate the lesion, then guide the biopsy needle to the site of the abnormality. Again, the needle will collect a core tissue sample to be examined under a microscope.

Beginning in 2006, Crozer-Chester Medical Center will introduce MRI-guided breast biopsy, which is useful for women with very dense breast tissue whose lesions cannot be seen or felt. Magnetic resonance (MR) imaging waves do not pass through the body as easily as ultrasound waves, allowing them to send back more detailed pictures of lesions or abnormalities of the breast. MRI-guided breast biopsy uses MR waves to guide the biopsy needle to the site of the abnormality to collect a core tissue sample.

“The variety of procedures offered at Crozer-Keystone means that we have a procedure that can diagnose your condition, no matter how it was discovered,” says Mary Lou Patton, M.D., Crozer general surgeon and breast cancer specialist. “Our team approach to cancer diagnosis means that the surgical and radiology teams work hand-in-hand to decide which diagnostic procedure is right for each individual patient.”

If cancer is diagnosed, patients will benefit from quality care at all of Crozer-Keystone’s hospitals. Not only does CKHS deliver the latest in high-tech cancer care with advanced medical oncology, radiation oncology and surgical procedures, but its partnership with the Fox Chase Cancer Center puts it at the forefront of the latest in cancer research.

“At Crozer-Keystone hospitals, our physicians work closely together with our patients to discuss their treatment options and develop the best possible plan, based on each patient’s personal needs,” says Joel Noumoff, M.D., chief of the Division of Gynecologic Oncology and chairman of the Department of Obstetrics and Gynecology at Crozer-Chester Medical Center and Crozer-Keystone liaison to Fox Chase Cancer Center. “Likewise, Crozer-Keystone Health System and Fox Chase Cancer Center have formed a partnership that allows professionals from both institutions to collaborate to develop new programs and options for our patients.”

Patients can also benefit from the range of programs and services specifically tailored for men and women undergoing treatment for breast cancer.

“One of our most unique features is our breast panel, which allows the entire cancer treatment team to review each patient’s condition – imaging, pathology slides and features of care – to help make the best treatment decisions for them ,” says Linda Callans, M.D., Delaware County Memorial Hospital general surgeon and medical director of the DCMH Breast Health Program. “We also have many other amenities for those with cancer or at risk of developing it, like genetic counseling through the PARCA program, which evaluates women with a family history of the breast cancer gene. It’s our commitment to providing the latest in advanced cancer treatment, while caring for each patient in the warm, friendly environment of a community hospital.”

To learn more about the advanced diagnostic procedures and treatment options available at Crozer-Keystone hospitals, call 1-800-CK-HEALTH (1-800-254-3258).