Breast Imaging

The Breast Imaging Center (BIC) is a component of the Comprehensive Breast Program at DHMC, which coordinates and oversees interdepartmental breast cancer patient care. The Center provides routine screening, diagnostic, and interventional services. Breast imaging plays a critical role in patient care, and the radiologist typically manages a patient with breast problems from her initial visit through her diagnosis and/or referral. In concert with recently published efficacy data, the Center operates a breast magnetic resonance imaging (MRI) program, in conjunction with the Familial Cancer Program. The breast MRI program, led by Michael Click, MD, offers screening of women at very high risk of developing breast cancer, staging of newly diagnosed breast cancer, and MRI-guided vacuum-assisted breast biopsy. The staff uses computer-aided diagnostic software and new interventional equipment to help interpret breast MRI examinations. The Center has increased services and volumes while expanding its space and facilities. Procedures now include contrast-enhanced breast MRI, image-guided (mammography, ultrasound, and MRI) core needle biopsy, and image-guided catheter placement for accelerated partial breast irradiation, in conjunction with Radiation Oncology.
Procedures Imaging Screening mammography Diagnostic mammography Diagnostic breast ultrasound Diagnostic breast MRI NOTE: MRI of the breast is NOT a routine screening option; see Breast MRI Policy (pdf) for more information. Interventional breast procedures Ultrasound guided Stereotactic guided Needle localizations and biopsies Galactography Sentinel lymphadenectomy Lymphoscintography PET
In 2004, a digital mammography screening center with two full-field digital mammography units opened in the doctors' office clinic at DHMC. The main hospital site now focuses exclusively on diagnostic breast imaging and image-guided breast procedures. The new Interdisciplinary Breast Cancer Clinic in the Norris Cotton Cancer Center brings together all the disciplines related to breast cancer diagnosis and treatment: surgery, radiology, radiation oncology, medical oncology, and plastic surgery.
Equipment In 2005 and 2006, the Center obtained a new dedicated ultrasound machine and two new reading areas for breast imaging. Our state-of-the-art imaging center continued renovations with the addition of two new dedicated ultrasound units in July, 2007. In 2007 we installed a new dedicated breast MRI table/coil with state-of-the art, built-in imaging. The table is designed specifically to accommodate and provide comfort for the patient during breast MRI exams. It also optimizes imaging clarity and access for interventional procedures. Breast MRI services continue to experience high demand and increased volumes. In 2008, the Center added a Selenia digital mammography unit, bringing the total number of digital mammography rooms to five.
Research The Breast Imaging Division remains active in cutting-edge research, both funded and unfunded. In September 2007, Steven Poplack, MD; Tor Tosteson, ScD; Christine Kogel, RN, BSN; and Helen Nagy, MD, published their article "Digital Breast Tomosynthesis: Initial Experience in 98 Women with Abnormal Digital Screening Mammography" in the American Journal of Roentgenology (AJR). This was the first clinical publication on digital breast tomosynthesis in a refereed journal. DHMC Radiology was one of five sites that contributed tomosynthesis exams for Hologics for their FDA submission. Doctors Poplack, Nagy, DiFlorio and Christine Kogel, RN, BSN, of Radiology are continuing this research. Other active research includes alternative breast imaging, in which the team is studying four breast imaging techniques for potential clinical use: MR elastography (MRE), electrical impedance spectral imaging (EIS), microwave imaging spectroscopy (MIS), and near infrared (NIR) spectral imaging. The project is funded by an $11 million grant from the National Cancer Institute (NCI). The team is also researching cryoablation of small, non-invasive breast cancers. Staff at the breast center continues to support the New Hampshire Mammography Network, which gathers and collates mammographic and pathologic data on New Hampshire women and contributes to research using this data.
Breast Imaging Team Helene Nagy, MD and Steven Poplack, MD, Co-Directors Michael E. Click, MD; Harte Crow, MD; David A. Desrochers, MD; Roberta diFlorio, MD; Petra Lewis, MBBS; Joseph Pekala, MD; Judith Austin-Strohbehn, MD; William Trought, MD; Therese Vaccaro, MD