In our previous post, we talked about different images that can be taken when something suspicious has been found in your breast. These are necessary to make a ‘map’ of your breast, so irregularities can be identified and followed up. But who are the people who do this? Through whose hands do your breast tests go after they’ve been taken?
When you go to the hospital to have a breast image taken, you will be guided by a technologist: a person who specializes in the devices that take medical images, such as the mammography machine or the MRI scanner. They make sure that the images are correct and clear. Their experience and the quality of the material they use are important for a correct diagnose. However, they are usually not the people who actually interpret the images and make decisions based on them.
Your breast image will be analyzed by a radiologist who has received specialized training in breast structure and images.
The people who analyze ultrasounds, mammograms or MRI scans are radiologists. Radiologists are doctors who work full-time on the analysis of medical images, forming diagnoses based on them. If you’ve ever broken your arm or leg, you’ll probably have had an image taken which was checked by a radiologist.
Mammography is the subspecialty of radiology that focuses on breast images. So your breast image will be analyzed by a radiologist who has received specialized training in breast structure and images.
The radiologist receives the images along with your patient file, interprets them and writes down their findings. It’s possible that the radiologist suggests more tests, in case the images don’t indicate one exclusive explanation.
We visited dr Francis Devlies, a breast radiologist at AZ Groeninge in Kortrijk, Belgium. He explained how he and his colleagues help their patients:
A biopsy can give a lot of additional information about what could be going on in your breast. In contrast to medical images, a biopsy offers more than visual information alone: it’s a very small piece of tissue, taken from the place that needs to be investigated.
You can compare it to the difference between looking at an image of a t-shirt and actually having it in your hands: the picture will give you lots of information about the t-shirt. But there’s a lot more to learn when you can hold it, for example about its texture.
Biopsies might feel a bit scary and invasive, but there’s a lot of information there that can give your caregivers better insights. Just like radiologists specialize in medical images and the way the structure of your body is represented in them, there are pathologists who specialize in analyzing actual tissue.
If a doctor recommends you have a biopsy, it doesn’t necessarily mean you have breast cancer. But a biopsy makes it possible to look at actual cells of the suspicious area. The biopsy can be taken by your doctor or by a different specialist, possibly guided by an ultrasound to make sure they’re aiming at the right spot. After that, the biopsy is sent to the lab where the pathologist will look at it. Just like a radiologist does, the pathologist will send their findings back to your doctor.
As mentioned, a biopsy is a small piece of tissue. In many pathology labs, these are analyzed on a glass slide through a microscope, a trusted method that has existed for literally centuries. They can zoom in and out to see the whole slide or a detail of it.
Some labs are starting to opt for a digital way of working. That means that they use specialized equipment to create a digital image of your biopsy. These digital images are enormous and enable zooming in and out, just like with a microscope. They are analyzed on a specialized display – just like there are specialized displays for mammography radiologists too. One advantage of this digital way of working is that the digital image can be shared faster and more easily with other medical experts.
Additional tests are not always something to worry about. They’re more like additional detective work to eliminate incorrect diagnoses, until the doctors have enough information to move forward. We just can’t state it enough, but you are at the center of this journey. When your doctor informs you of test results or indicates that an additional test is needed, don’t hesitate to ask any question you might have!
In our next and final blogpost, we’ll summarize the information we’ve given so far, and focus on the diagnosis and prognosis as the gateway to treatment.