Breast Imaging & Intervention

At Rhode Island Medical Imaging (RIMI) we offer a variety of breast imaging services using the latest state-of-the-art equipment. These services include screening and diagnostic mammography (exclusively using 3D tomosynthesis technology), ultrasound, and MRI. All breast imaging is interpreted by our board-certified radiologists with subspecialty training in breast imaging. Our experts are committed to providing the highest levels of care for you and improving women’s health.

Additionally, for your convenience and continuity of care, we also offer breast biopsy services in the comfort of our imaging centers. These include stereotactic biopsies (guided by 3D mammography), ultrasound-guided core biopsies, fine needle aspirations and cyst aspirations.

All RIMI facilities are accredited in mammography by the American College of Radiology (ACR) and are inspected yearly by the Food and Drug Administration (FDA). Our breast imaging centers have also been certified as ACR Designated Comprehensive Breast Imaging Centers. This high honor recognizes excellence in breast imaging and for providing exceptional quality imaging leading to better patient outcomes.

Breast Imaging

Screening mammography is used to detect breast cancer in women who have no specific signs or symptoms of breast abnormalities. The goal is to detect breast cancer as early as possible before a patient or her healthcare provider notices a change in her breast. When breast cancer is identified early, the cure rate is very high. The American Cancer Society, American College of Radiology, and the Society of Breast Imaging recommend that all women have annual screening mammograms beginning at age 40. Women at high risk may benefit from starting earlier.

At RIMI, we perform all of our mammograms on state-of-the-art digital mammography equipment, all of which utilize 3D technology and tomosynthesis imaging. This technology allows for more accurate detection of breast abnormalities, particularly in patients with dense breasts. The more comprehensive and detailed images allow fewer call backs for our patients.

A screening mammogram consists of two standard views of each breast, for a total of four images. The breasts are compressed during the exam to reduce motion, spread out the breast tissue, and limit the number of X-rays necessary to penetrate the breasts. This ensures the best possible images. The radiation dose of a screening mammogram is minimal. Please see the Mammography Safety tab if you would like to read more about radiation dosage.

Screening mammograms take approximately 15 minutes. These mammograms are performed by technologists with advanced training and certification in breast imaging. The images are then reviewed by our team of dedicated breast imaging radiologists.

During a screening mammogram, a patient’s breast will also be assigned a breast density. Read more about Dense Breasts below.

Screening mammograms are usually read within a few business days at which point the final report is sent to the patient’s healthcare provider. Patients can expect to receive a copy of the report in the mail or on their RIMI portal. If a screening mammogram is normal, patients will be asked to come back in one year for their next annual mammogram.

Additional imaging also known as a diagnostic mammogram could be needed. Read more about Diagnostic Mammograms below.

For additional information, go to the American College of Radiology’s mammographysaveslives.org.

Diagnostic mammograms are read by RIMI’s dedicated breast imaging radiologists at the same time the exam is performed. Patients typically receive their results during the same visit. Our radiologists are available to answer questions about the findings.

A diagnostic mammogram is performed when:

  • The radiologist requests additional imaging after a screening mammogram to focus on an area in question using specialized views and techniques.
  • A patient needs to have breast symptoms evaluated. For example, a lump in the breast, breast pain, nipple discharge, or due to changes in your nipple or skin.
  • The last mammogram or ultrasound showed a finding that is being closely followed.

Diagnostic mammograms are performed at our RIMI offices in East Greenwich, Johnston, Providence, and East Providence (Veterans Memorial Parkway).

Some women have dense breast tissue, which can make it more difficult to detect cancer on a mammogram. For these women, RIMI offers whole breast screening ultrasounds to supplement their annual screening mammogram. Read more about Breast Density below.

After a diagnostic mammogram, the radiologist often requests an ultrasound of the area in question for a complete evaluation. As with diagnostic mammograms, diagnostic breast ultrasounds are read by RIMI’s dedicated breast radiologists the same day and patients receive their results during their appointment.

Breast MRI is used for many purposes in breast imaging:

  • To screen women with an elevated lifetime risk of breast cancer (less than 20% of all patients).
  • For women who have been diagnosed with breast cancer to evaluate the extent of the disease and for treatment planning.
  • For further evaluation in the rare situation that neither mammography or ultrasound are able to provide a diagnosis.

Breasts are made up of fibrous and glandular tissue, along with fatty tissue. Patients with more fibrous or glandular tissue than fatty tissue have breasts that may be considered dense. Although density may decrease with age, most women will not demonstrate significant changes in their density over time.

Radiologist rank breasts in one of four categories of mammographic density:

  • Non-Dense
    • Fatty (10% of women)
    • Scattered (40% of women)
  • Dense
    • Heterogeneous (40% of women)
    • Extremely (10% of women)

Having dense breast tissue may increase your risk of getting breast cancer and may also make it more difficult to spot a small cancer on your screening mammogram. Studies have shown that a screening breast ultrasound or a breast MRI can help find breast cancers that may not be seen on mammograms. They may also present more findings that are not cancerous. 

If you have dense breasts, please consult your healthcare provider to determine if additional screening exams are right for you. If your breasts are not dense, but you’re at high risk (for example, you have a family history of breast cancer, prior chest radiation, or a previously biopsied high-risk lesion), you may qualify for additional screening. Even if you are at low risk, you should still have your annual screening mammogram starting at the age of 40. The cost of an ultrasound or MRI may not be covered by your insurance. 

All RIMI breast MRIs are performed at our East Greenwich and Providence locations. 

RIMI’s mammography equipment produces high quality breast images using very low doses of radiation.

The level of radiation in today’s mammograms does not increase the risk of breast cancer for women who receive annual screening mammography. The benefits of early detection and treatment of breast cancer far outweigh the potential harm from a mammogram’s very low dose radiation exposure.

At RIMI, we follow strict guidelines and conduct frequent inspections to ensure our equipment is safe and utilizes the lowest radiation dose possible to produce high quality images. 

Breast Intervention

There may be times when an abnormality is found during diagnostic imaging that could require a biopsy for a final diagnosis. Biopsies are performed by our dedicated breast imaging radiologists. Most breast abnormalities are benign and present no health risk.

Patients may continue to take their medications (with the exception of certain blood thinners) and eat food/drink liquids on the same day of their biopsy. A typical biopsy takes about one to two hours and the results will be available to your healthcare provider in three to five business days.

A stereotactic guided biopsy is a minimally invasive procedure that uses mammography to determine the exact location of the abnormality in a breast in order to accurately sample small fragments of tissue through a specially designed needle. This test is safe and relatively painless, with little recovery time, no stitches, and no significant scarring of the breast.

The biopsy is performed by an experienced breast radiologist and mammography technologist. The technologist will position you for the biopsy. The breast is compressed with a small paddle and images are taken. The radiologist then determines the location for the needle’s placement, and the site is sterilized.

A local anesthetic (similar to the anesthesia used by a dentist) will be injected into the area to ensure the site is numb. The radiologist will make a very small incision for the placement of the biopsy needle. Additional mammographic images will be taken to confirm the needle placement. Once the placement is confirmed, the tissue samples are taken and may be imaged to ensure they contain the abnormality.

A tiny metal clip is then inserted into the breast at the biopsy site and a gentle mammogram will be performed to confirm clip placement. This clip will remain in place unless it’s removed surgically and will be used to identify the area on follow-up exams.

POST BIOPSY CARE:

A bandage and ice are applied to the biopsy site after the procedure. The area may bruise and feel a little sore. This is normal and should resolve over a short period of time. Over the counter pain medications, such as Tylenol, may relieve the discomfort. Additional ice packs at home may be used to ice the area at 15-20 minute intervals (15-20 minutes of ice on the area and 15-20 minutes without ice for up to two hours).

It is recommended that patients avoid showering, bathing, exercise or any strenuous activity for 24 hours after the procedure. Swimming should be avoided until the wound heals. A sports bra may be worn during sleep to help prevent bleeding. Additional instructions for post-biopsy care may also be given. 

COMPLICATIONS:

Although RIMI performs all procedures using sterile techniques that minimize bleeding, complications can occur. If bleeding occurs, it will normally develop within the first 24 hours. Should the site bleed through the dressing, apply pressure for 20 minutes. If the bleeding persists, contact your healthcare provider or the RIMI office where the biopsy was performed.

If infection occurs, it typically develops in two to three days. Signs to watch for are redness or heat around the incision, excessive swelling, tenderness or drainage. Please contact your healthcare provider or the RIMI office where the biopsy was performed if symptoms occur.

An ultrasound guided biopsy is a minimally invasive procedure that uses ultrasound to determine the exact location of an abnormality in the breast to accurately sample small fragments of tissue through a specially designed needle. This test is safe and relatively painless, with little recovery time, no stitches, and no significant scarring of the breast.

The biopsy is performed by an experienced breast radiologist and sonographer. The sonographer helps the patient lie down in a similar manner to an ordinary breast ultrasound. When the breast is scanned the team will mark the area of the abnormality on the skin. The site is then cleaned with an antiseptic.

Using the ultrasound image as a guide, a local anesthetic (similar to the anesthesia used by a dentist) will be injected into the area to ensure the site is numb. The radiologist will make a very small incision for the placement of the biopsy needle. Once the position is confirmed by ultrasound, the tissue samples will be obtained.

A tiny metal clip is then inserted into the breast at the biopsy site and a gentle mammogram is performed to confirm clip placement. This clip will remain in place unless it’s removed surgically and will be used to identify the area on follow-up exams.

POST BIOPSY CARE:

A bandage and ice are applied to the biopsy site after the procedure. The area may bruise and feel a little sore. This is normal and should resolve over a short period of time. Over the counter pain medications, such as Tylenol, may relieve the discomfort. Additional ice packs at home may be used to ice the area at 15-20 minute intervals (15-20 minutes of ice on the area and 15-20 minutes without ice for up to two hours).

It is recommended that patients avoid showering, bathing, exercise or any strenuous activity for 24 hours after the procedure. Swimming should be avoided until the wound heals. A sports bra may be worn during sleep to help prevent bleeding. Additional instructions for post-biopsy care may also be given.

COMPLICATIONS:

Although RIMI performs all procedures using sterile techniques and that minimize bleeding, complications can occur. If bleeding occurs, it will normally develop within the first 24 hours. Should the site bleed through the dressing, apply pressure for 20 minutes. If the bleeding persists, contact your healthcare provider or the RIMI office where the biopsy was performed.

If infection occurs, it typically develops in two to three days. Signs to watch for are redness or heat around the incision, excessive swelling, tenderness, or drainage. Please contact your healthcare provider or the RIMI office where the biopsy was performed if symptoms occur.