The breast triple assessment

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The assessment is divided into three separate parts:

1. The doctors examination in the breast clinic
   
2. The investigations in the x-ray department ( mammogram or ultrasound)
   
3. Removal of tissue (usually with a small needle) for examination under a microscope in the laboratory

What will happen at the breast clinic?

You will be seen by one of the surgical team. The surgeon will ask you about your general health as well as about the breast problem. He will want to know about any operations you may have had or other medical problems. You will also be asked about your menstrual history, details of pregnancies and details of any hormones you have taken. (e.g. contraceptive pills or HRT)

You will then be examined by the doctor. He will examine both breasts. The doctor may also want to take a small sample of either cells or fluid from any breast lumps. (see details below)

What is the needle test (fine needle aspiration)?

This test involves taking a sample of cells from a breast lump, using a fine needle. It is no more painful than a blood test and will not require a local anaesthetic. These cells are looked at in the laboratory

What if a larger sample is needed?

This can also be done in the clinic, but this test is not done on all patients. If it is required, the procedure will be explained to you in the clinic and a nurse will usually be with you in the room. A local anaesthetic will be used, and you will be able to go home straight afterwards. The results of this test take about a week to be processed in the laboratory.

What if the lump is a cyst?

These can be drained in the clinic, using a fine needle. A local anaesthetic will not be required and the procedure is no more painful than a blood test. If the cyst had been causing pain, the drainage will make you more comfortable.

What about investigations in the x-ray department?

These may be carried out on the same day (one stop clinic) or at a later date. They are carried out in the main x-ray department. Two kinds of investigation are used, and the doctors in the x-ray department will decide which is most appropriate for you, or he may decide to use both . These two investigations are mammography and ultrasound.

A mammogram uses low dose x-rays to look at the breast. You should not use talcum powder or deodorants when attending for a mammogram. You will have to strip to the waist and stand with your breast in a specially designed x-ray machine. Whilst the x-ray pictures are taken, the breast will be compressed. This can be slightly uncomfortable, but the pressure is automatically released as soon as the x-ray has been taken. Both breasts will be looked at. A female radiographer will take the mammogram, and the films will be looked at by a specialist radiologist.

If you require an ultrasound examination of the breasts, this will be done by a consultant radiologist. It is a painless procedure. It will be done in a slightly darkened room. (It is the same kind of tests which pregnant mothers have to look at a baby in the womb) The radiologist will put some gel onto the breast and will then move a special sensor over the breast. The radiologist will look at the image on a screen. The results of the mammogram and ultrasound will be given to the surgeon.

When will I get my results?

All patients get their results as soon as possible, sometimes on the same day. However not all tests can be arranged on the same day and some tests take longer for the laboratories to analyse. When you attend the breast clinic, the doctor will tell you how long your test results will take.

Can I bring a friend or partner with me to the hospital?

Yes. You are always welcome to bring a friend with you. However the examination rooms are fairly small and usually there is only space for one accompanying person. For some investigations the friend will have to wait outside, e.g. during a mammogram investigation.

Who should I contact if I have any questions about the investigations?

Most hospitals have  breast care nurses who are happy to answer any queries you may have.