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Screening Automated Whole

Screening Automated Whole Stanford now offers screening automated whole breast ultrasound (SAWBU) at our Stanford Cancer Center Palo Alto location. This is an optional test that can be used as a supplement to screening in women with mammographically dense . It can find cancers that cannot be seen on mammograms due to overlap with dense breast tissue. Stanford uses automated whole breast technique, a new method developed for accuracy and efficiency.

Who is a candidate for SAWBU What will happen during the How is SAWBU exam is examination? SAWBU examination? different? This is an optional test to supplement You will lie on your back, and gel will Screening automated screening mammography in women be applied to your breast. whole breast ultrasound

who: uses sound waves (no radi- A large ultrasound handpiece will be • Undergo routine screening with ation) to create 3D pictures placed on the breast, and the system mammography. of the breast tissue, using will automatically take a “sweep” • Have no current signs or a new automated method that obtains ultrasound images of symptoms of . developed for accuracy and the tissue from top to bottom. The • Have mammographically dense efficiency. handpiece will be repositioned to take (heterogeneously or extremely other “sweeps” to include all of the It can find cancers that dense) breasts. breast tissue. cannot be seen on mam- • Are not at “high risk" undergoing mograms alone due to supplemental screening with An exam of both breasts takes less overlap with dense breast breast MRI. Screening ultra- than 20 minutes to obtain. tissue. sound does not provide benefit in women having breast MRI. After you depart, the radiologist will • Do not have a pacemaker or review and interpret the exam. defibrillator.

Radiology Screening Wellness Program · Insurance Coverage: Some payers may not cover SAWBU and coverage may be subject to co-pays and deductibles. If exam is denied, please contact Patient Financial Services to request the self-pay pricing.

· Self-Pay Pricing: Self-Pay Pricing for eligible patients after discount $550 for bilateral breasts (technical & professional fees). Pricing is subject to change without notice. (Internal Use Only CPT 76641 /IMGBI0104) Breast Density Stanford

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A mammogram is the only medical imaging screening test Your doctor should be able to tell you whether you have proven to reduce breast cancer deaths. Many cancers are seen Diagnostic Radiology Digital Mammography dense breasts based on where you fall on the density scale. Areproven there to reduce any breast tests cancer that deaths. are Manybetter cancers than are aseen denseto tellbreasts you based whether on where you you have fall on dense the density breasts scale. on mammograms even if you have dense breast tissue. Sunita Pal, MD Digital mammography, also called full-field digital (See scale below.) mammogramon mammograms even for ifdense you have breasts? dense breast tissue. (Seebased scale below.)on where you fall on the density scale. mammography (FFDM), uses a low dose x-ray sys- In dense breasts, cancer can be hard to see on Clinical Assistant Professor of Radiology (See scale below.) Are there any tests that are better than tem to take pictures of the breasts electronically rather Radiologists classify breast density using a 4-level density scale: a mammogram.a mammogram Magnetic for dense resonance breasts? imaging What is breast density? Radiologists classify breast density using a 4-level density scale: a mammogram for dense breasts? than with film. Radiologists read the mammograms (MRI)In breasts and that to are a lesserdense, cancerextent, can ultrasound be hard to see can on a Diagnostic Radiology Breasts are made up of a mixture of fibrous and glandular and fatty tissue. In breasts that are dense, cancer can be hard to see on a for early detection and diagnosis of breast diseases in findmammogram. breast cancers Studies have that shown can’t that be ultrasoundseen on aand Jafi Lipson, MD mammogram. Studies have shown that ultrasound and women. Stanford also uses computer-aided detection Your breasts are considered dense if you have more fibrous or glandular tissue mammogram.magnetic resonance However, imaging MRI (MRI) and can ultrasoundhelp fi nd breast Assistant Professor of Radiology magnetic resonance imaging (MRI) can help fi nd breast (CAD) on the mammograms, which uses a computer but not much fat. cancers that can’t be seen on a mammogram. However, both MRI showcancers findings that can’t thatbe seen are on nota mammogram. cancer, which However, can both MRI program and neural networks to find cancer. and ultrasound, show more fi ndings that are not cancer, which resultand ultrasound, in added show testing more andfi ndings unnecessary that are not cancer, biopsies. which can result in added testing and unnecessary biopsies. Also, the Diagnostic Radiology Also,can result the costin added of testingultrasound and unnecessary and MRI biopsies. may Also,not thebe Breast Ultrasound How do I know if I have dense breasts? cost of ultrasound and MRI may not be covered by insurance. Linda Nayeli Morimoto, MD Almost entirely Scattered areas Heterogeneously Extremely dense coveredcost of ultrasound by insurance. and MRI may not be covered by insurance. Ultrasonography, which is sometimes called Breast density is determined by the radiologist who interprets your mammo- Almostfatty entirely ofScattered fi broglandular areas Heterogeneouslydense Extremely dense Clinical Instructor of Radiology fatty of fi broglandulardensity dense sonography, uses high-frequency sound waves and density gram and assigns one of four defined categories of mammographic density What should I do if I have dense breasts? a computer to create images. The primary use of WhatWhat should shouldif I don’t? I Ido do if if I Ihave have dense dense breasts? breasts? (see scale to the right.) Your mammogram report will include your assigned Breast density in the U.S. (See pie chart) What if I don’t? ■ State-of-the-Art Technology breast ultrasound today is to help diagnose breast BreastBreast density density in the in U.S. the (See U.S. pie (See chart) pie chart) What if I don’t? • 10% of women have almost entirely fatty breasts If you have dense breasts, please talk to your doctor. Together, The Stanford Outpatient Imaging Centers have the abnormalities detected during a physical exam (such mammographic density. 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Mammography and Ultrasound, offering referring If your breasts are not dense, other factors may still place you at WhetherIf your breasts your are breasts not dense, are other dense factors or may not, still other place you at physicians and patients easy access to the latest Breast MRI Why is breast density important? increased risk for breast cancer — including a family history of factorsincreased may risk stillfor breast place cancer you — at including increased a family risk history for of imaging advances. Magnetic resonance imaging (MRI) is a noninvasive Almost entirely the disease, previous chest radiation treatment for cancer and Dense breast tissue is common and not abnormal. However, dense breasts Extremely Almostfatty entirelybreasts • fatty breasts breastthe disease, cancer previous — including chest radiation a family treatment history for cancer of and medical examination that does not use ionizing Extremelydense breasts 10% previous breast biopsies that show you are high risk. Talk to your make it more difficult for radiologists to spot cancer on mammograms. Dense dense breasts • • previous breast biopsies that show you are high risk. Talk to your ■ Comprehensive Breast Imaging Services: 10% • 10% thedoctor disease, and discuss previous your history. chest radiation treatment radiation (X-rays). The MRI machine uses a large 10% doctor and discuss your history. tissue appears white on a mammogram. Lumps, both benign and cancerous, for cancer and previous breast biopsies that Tomosynthesis (3D Mammography) magnet and a computer to take pictures of the inside also appear white. 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However, family history and other risk factors may have a • density in breasts • 40% get an annual mammogram starting at age 40. studies show higher cancer detection and lower unless the request is urgent. greater influence on your breast cancer risk. 40%

What should I do if I have dense breasts? Even if your breasts are dense, it is important to have screening with mam- mography. It is the only imaging screening test proven to reduce breast can- cer deaths. Many cancers are seen on mammograms even if you have dense breast tissue.

Please talk to your doctor about your dense breasts. Together, you can decide if any screening exams to supplement mammography are right for you.

Supplemental screening ultrasound is an option in women with dense breasts. It can find cancers that cannot be seen on mammograms alone due to overlap with dense breast tissue. In women at “high risk” such as those with a gene mutation or lifetime risk of breast cancer greater than 20-25%, supplemental screening with MRI is recommended.

NATIONALLY RECOGNIZED Stanford Radiology The Breast Imaging service is a Center of Excellence designated by the ACR Scheduling Center Mammography Accreditation Program. Phone: 650-723-6855 Fax: 650-723-6036

For a listing of imaging centers nearest you, go to: stanfordhealthcare.org/imaging Stanford Health Care • Send messages to your care team • Schedule appointments • Check lab results • Review medical history • View prescriptions • Pay bills myhealth.stanfordhealthcare.org

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