When you’re facing breast surgery, there’s a lot of information to process. In addition to all the physical and emotional prep, there are myriad medical imaging and other tests that you may have to undergo. Here’s a list and explanation of the tests that could be necessary prior to your surgery:
Mammograms are x-rays that are used to detect abnormalities in breast tissue. Mammography can be recorded on traditional film (large plastic sheets that you will sometimes see on the wall of an exam room) or directly uploaded into a computer as a digital image. There are several different types of mammograms that are now available (tomo-synthesis, 3D or digital mammography), but don’t be concerned if you haven’t had the latest or most sophisticated type. Ask your doctor to explain what you’ve had done and why, and keep a record of the information you’re given.
Ultrasound Imaging uses high frequency sound waves to detect masses or abnormalities in the breast, often in conjunction with or as a follow-up to a mammogram. For some women with dense breasts, this is the only way to accurately visualize the breast tissue.
Breast MRI is an imaging technique that uses sophisticated magnets to look at breast tissue. During this test, you will lie on your stomach so that your breasts rest through holes on the table. These scans will be used as a baseline to rule out any worrisome areas before surgery. The technicians will most likely inject you with a contrast dye (to help create clearer images) before or during the procedure. Before administering the dye, however, they will give you some medication to guard against an allergic reaction. The MRI room is usually cold and noisy, and some MRI machines are like long, thin tunnels, while others are more spacious and open. Be open and honest with your doctor if you have a high degree of anxiety in closed spaces. An accurate MRI requires you to stay perfectly still, so you can ask your doctor for a sedative if you feel you need one. You can also bring ear plugs with you–although some facilities even have headphones so that you can listen to music during the test!
EKG stands for electrocardiogram, a test which checks your heart rhythms. Small electrodes are attached in spots on your chest and arms (no punctures or injections), and the machine measures and records your heart activity on a long piece of paper. It’s painless and very fast.
Chest X-Ray–This painless test is done to rule out any pulmonary (lung-related) disease or infection prior to surgery.
Blood tests— a doctor, nurse or phlebotomist (someone specially trained to draw blood) will insert a small needle into a vein in your arm and fill a few tubes with blood. The tubes are sent out to a lab which sends back a report with useful information about your body chemistry. Physicians use this information to determine your general health and check that your blood is clotting properly and blood cell counts are acceptable (i.e. you’re not anemic). Blood work is also important for understanding your risk of infection and ability to heal from surgery. [Note: if you have had a lymph node dissection in the past, offer the other arm for blood drawing purposes.]
Medical Clearance— your surgeons will discuss any issues related to pre-existing conditions with your medical internist, cardiologist or gynecologist prior to surgery. This is part of the pre-op preparation and why we encourage you to keep all of your medical paperwork in one envelope. Doctors may ask questions that either seem confusing or related to facts that you can’t remember, and keeping all of your information together will help you stay organized.
With any medical procedure, information is the key to keeping together and calm. There may be other tests ordered, so don’t be alarmed. These could include bone scans, PET scans and/or genetic tests. Never be reluctant to ask questions directly to your doctor, and don’t just assume you can find accurate information on the internet. You need to know what’s happening to your body in language you can understand.