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Breast Imaging

Breast Imaging at the Marvelle Koffler Breast Centre at Mount Sinai Hospital is used to help identify and diagnose any abnormalities that can be found in the breast. We provide a wide range of screening and diagnostic examinations of the breast using imaging. This includes: digital radiography, ultrasound and interventional procedures including MRIs.

Our dedicated team of receptionists, technologists, radiologists and volunteers are here to support you throughout your appointment.

  • Our radiologists work across the Joint Department of Medical Imaging at our breast imaging sites, which are all Mammography Accredited by the Canadian Association of Radiologists.
  • Our centre was first in North America to start using digital mammography, a practice that is now commonly used by our partners across different care sites.
  • We are an American College of Radiology (ACR) accredited facility for mammography – one of the first in Canada.
  • During your visit you are likely to meet our receptionists, technologists, radiologists and volunteers.

Hours and Contact

  • Monday - Friday: 8 a.m. - 4:15 p.m.
  • Location: 12th floor of the Murray St. wing at Mount Sinai Hospital
  • Telephone: 416-586-4422
  • Fax: 416-586-4714

Making a first appointment and what to bring

Screening mammogram appointments

If you are eligible for the Ontario Breast Screening Program (OBSP), you do not need a referral from a physician for scheduling a screening mammogram. (See details below.)  Our staff will however need to ask you several OBSP eligibility questions.  You can contact the Marvelle Koffler Breast Centre directly to make your appointment.

A referral for the High Risk OSBP program or screening outside of the OBSP criteria does require a physician referral.

Diagnostic imaging appointments

Any breast imaging studies, such as a diagnostic mammogram or breast ultrasound, require a referral / requisition from your doctor that explains the reason for the request.   You will be contacted once that is received.

Please allow at least one hour for your scheduled appointment.

Day of appointment

Please bring your health card.

If you have had previous mammogram studies performed at other facilities, please bring them with you to your scheduled appointment for comparison purposes.  (Contact the facility where you had your mammogram and ask them to provide you with this information.)

Don't use deodorant before your mammogram. Avoid using deodorants, antiperspirants, powders, lotions, creams or perfumes under your arms or on your breasts. Metallic particles in powders and deodorants could be visible on your mammogram and cause confusion.

For your comfort, it's suggested to wear a two piece outfit so that you only need to remove your top.

Ontario Breast Screening Program (OBSP) Screening Eligibility Criteria

The Ontario Breast Screening Program (OBSP) is a province-wide, organized cancer screening program.  Regular breast cancer screening is important because it can find cancer early when it may be smaller and easier to treat. Screening mammography can find breast cancers when they are small, less likely to have spread and more likely to be treated successfully.

The routine screening program eligibility criteria are:

  • 50 to 70 years of age
  • Previous mammogram must be 11 or more months ago
  • No current breast implants
  • No previous breast cancer
  • No current breast symptoms, e.g. recent discovery of lump, bleeding or new discharge from the nipple area or very and reddened breast

Learn more about screening mammograms.

OBSP High Risk Screening Program

Women ages 30 to 69 can get screened through the High Risk OBSP if they have a referral from their doctor,  a valid Ontario Health Insurance Plan number, no acute breast symptoms, and fall into one of the following risk categories:

  • You are known to have a gene mutation that increases your risk for breast cancer (e.g. BRCA1, BRCA2, TP53, PTEN, CDH1)
  • You are first-degree relatives of someone who has a gene mutation that increases their risk for breast cancer (e.g. BRCA1, BRCA2, TP53, PTEN, CDH1), have already had genetic counselling and have chosen not to have genetic testing
  • You have been assessed at a genetics clinic (using the IBIS or BOADICEA tools) as having a 25% or greater lifetime risk of breast cancer based on personal and family history
  • You have had radiation therapy to the chest to treat another cancer or condition (e.g. Hodgkin Lymphoma) before age 30 and at least 8 years ago

Speak with your physician to be referred to this program. They will need to submit an OBSP high risk program referral form.

 

Types of Breast Imaging Exams

A mammogram is an image of the breast taken by a digital x-ray machine. Diagnostic mammograms may focus on one area of the breast.

Your breast will be gently but firmly compressed during the exam. This can be uncomfortable but it doesn’t last long. The breast needs to be compressed to separate breast tissue and keep the radiation dose to a minimum.

A breast ultrasound uses sound waves to create a picture of the breast. An ultrasound can show whether a lump in the breast is solid or a fluid-filled cyst found on the mammogram or palpated by your doctor.

Our technologist will ask you to lie down on a stretcher and raise your arm above your head to perform the exam.

Mammographic consultation provides appropriate examination in the best interest of the patient, consultation is required if recent imaging is not performed at our Joint Department of Medical Imaging Breast Imaging Sites (Mount Sinai Hospital, Princess Margaret Hospital and Women’s College Hospital).

A biopsy is usually necessary to determine a diagnosis of an area identified by our radiologist. These procedures are scheduled as per our radiologist recommendation after mammogram, breast ultrasound, Breast MRI, or mammographic consultation.

Important precautions:

If you are taking anti-coagulants (blood thinner medication), please talk to your doctor about this before your appointment. Depending on the specific medication, a recent INR may be needed and should be provided by the referring physician in advance of your scheduled appointment.

Your doctor should contact us if there is any concerns or known allergies to local anesthetic before your biopsy.

We strongly suggest you have a friend or family member accompany you home after the biopsy and post procedure care sheet will be given to you to provide information on biopsy care.

We complete breast biopsies in a few different ways:

Fine-needle aspiration biopsy

For a fine-needle biopsy, the doctor uses a thin needle to remove fluid or cells from the tissue in the breast or lymph nodes under ultrasound guidance. You may feel some discomfort when the needle enters your breast. Local anesthetic will be used under the discretion of the radiologist and patient.

Core biopsy

For a core biopsy, the doctor inserts a needle in an area in the breast through a small cut in the skin to obtain tissue samples. Local anesthetic (freezing) will be given to numb the area. The doctor may take several samples. Core biopsy is performed either under mammogram or ultrasound guidance that best demonstrate the area of interest in the breast. You may feel some discomfort or pressure during the biopsy. Please advise radiologist if there is pain during the procedure so radiologist could offer more freezing.

Vacuum-assisted biopsy

A special vacuum-assisted technique is sometimes used to take a biopsy. The procedure is the similar to the core biopsy with additional of vacuum and a larger needle sized use to sample the breast tissue. Vacuum-assisted Core biopsy is performed either under mammogram, ultrasound, or MRI guidance that best demonstrate the area of interest in the breast. You may feel some discomfort or pressure during the biopsy. Please advise radiologist if there is pain during the procedure so radiologist could offer more freezing. Radiologist may place a clip in the biopsy site at the end of the procedure for future reference if deemed necessary.

A galactogram is a picture of the inside of the breast’s milk ducts. It is taken using an x-ray machine and special dye.

Before the galactogram, we may apply a warm towel to your breast. The towel will stimulate the duct to discharge the fluid. When the radiologist has identified the duct expressing the discharge, a thin, flexible tube (called a blunt-tipped cannula) is inserted into the discharging duct. Then, a small amount of contrast dye is injected into the duct through the cannula. Some people experience a sensation of fullness or pressure when the dye is injected. After the dye has been injected, the technologist will take some mammogram pictures of the ducts.

You can return to your normal activities as soon as the galactogram is over.

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