Comprehensive Breast Center

Comprehensive Breast Center
Stoneham Outpatient Campus
41 Montvale Ave.
Stoneham, MA
(781) 224-5806
 

The Comprehensive Breast Center at Hallmark Health System offers patients access to the latest technological advances in prevention, early detection, diagnosis and treatment of breast disease in a comforting and caring environment. 
 

Coordination of care….diagnosis to treatment.

Through our collaborative approach and state-of-the-art diagnostic and therapeutic services, patients at Hallmark Health receive accurate diagnosis and immediate care, with an emphasis on compassion. Care is coordinated by our Nurse Navigator who works with our team of Radiologists, Surgeons, Nurses, Oncologists, Radiation Oncologists and others to provide a full range of services to meet our patients’ breast health needs.

Our Comprehensive Breast Center was designed with input from our patients -- specifically for women receiving breast care.  The Center is conveniently located and is easily accessible from routes 93 and 128.  Most services are now in one location, with plenty of accessible parking.

Read news article 'Hallmark Health System Comprehensive Breast Center offers quality care'


Staff

The Comprehensive Breast Center brings together a team of highly skilled and compassionate specialists that includes:
• Board Certified Radiologists specializing in breast imaging
• Board Certified Surgeons
• Breast Care Nurse Navigator
• Certified/Registered mammographers and ultrasonographers
• Licensed and Lymphedema Certified Physical Therapist


Board Certified Radiologists:
Board-certified radiologists, who specialize in breast imaging, are located on-site.  The experience, training and skills of the physician interpreting your mammogram are even more important than the state of the art technology that we use.  At Hallmark Health System we are able to have the benefit of the best of both physician and technology.

Olga Efimova, MD, Director Breast Imaging Services
Esther Sreter, MD
Joshua Stein, MD

Board Certified Surgeons (on site)
Matthew Brown, MD
Diana Caragacianu, MD
Carl Danielson, MD
Claire Shernoff, MD
• Kristin Smith, MD
Catherine Tucker, MD

Board Certified Plastic Surgeons
Peter Gee, MD
Richard Peinert, MD

Breast Care Nurse Navigator
We offer a full spectrum of breast care support services, including a breast care nurse navigator.  Our nurse navigator plays an integral role in the Breast Center, including one-on-one consultation, as well as providing educational support.  The role of our nurse navigator has many facets including:
 • Coordinating individualized care for each patient
 • Assures timely access of scheduled appointments
 • Provides emotional support to patients and their families
 • Works closely with our inter-disciplinary team
• Educates patients about individual cancer diagnosis and treatment options
 • Helps patients make informed decisions about treatment and care
 • Advocate for patients throughout treatment
• Assist with recovery and rehabilitation plans.
Our nurse navigator offers personalized support and is a unique asset that is only available at a few medical centers.  She is able to bring knowledge and comfort to all of our patients and serves an important role as a facilitator and guide for patients providing support through each phase of diagnosis and treatment.
To contact our nurse navigator, please call (781) 224-5806.

Registered Mammographers and Ultrasonographers
• Our mammographers are licensed by the state of Massachusetts and certified by the American Registry of Radiologic Technologists, and our ultrasonographers are certified by the American Registry of Diagnostic Medical Sonography. All of our technologists attend educational seminars to stay current with the latest in technology and techniques in breast imaging.

Licensed and Certified Lymphedema Physical Therapist
• Our physical therapist is a highly-trained, licensed and certified lymphedema specialist with extensive experience working with oncology patients, cancer-related fatigue and scar tissue adhesions.

 


Services

Services provided at the Comprehensive Breast Center

•    Diagnostic Digital  and Screening Mammography
•    Breast Ultrasound
•    Stereotactic and Ultrasound Guided Biopsies
•    Breast Cyst and Fine Needle Aspirations
•    Galactography
•    Nurse Navigator
•    Surgery Consults
•    Oncology Consults
•    Lymphedema Specialist
•    Social Worker
•    Plastic Surgeon

Other services provided at Hallmark Health System Facilities:

• Screening Digital Mammography

    Melrose
    Reading

    Medford

• Needle Localizations

    Melrose

    Medford

• Sentinel Node Studies

    Melrose

    Medford

• Breast MRI

    Melrose

• Breast MRI Guided Biopsies

    Melrose


Mammography at Hallmark Health System

We are dedicated to providing state-of-the-art technology and quality screening and diagnostic mammography services. As with all Hallmark Health services, we also recognize the importance of providing you convenient, accessible care with compassion and respect.

Hallmark Health System offers a comprehensive Breast Health program, including 5 locations for screening mammography (see below for addresses) and a Comprehensive Breast Center for those women who require additional diagnostics and/or treatment services. In addition, a Breast Care Nurse Navigator is available to assist you.

Hallmark Health System is proud to offer women the latest in digital mammography technology in a personal, compassionate environment. We offer state-of-the-art GE technology for the clearest, most detailed digital images available today.

 

  • Improved outcomes as a result of reduced radiation doses, better visualization of breast tissue and integration with our computer aided technology software that improves early detection by 20%
  • State-of-the-art digital mammography machines
  • Shorter examination times – often 15 minutes or less
  • Convenient locations throughout our local communities
  • Newly renovated, private waiting rooms
  • Easy scheduling with appointments for screenings made within 2-3 days along with early morning, evening and weekend appointments at most locations
  • Caring, compassionate and highly experienced technicians

We offer the most advanced technology available today for breast care and screening. The latest technology coupled with experience and compassion leaves you with peace of mind.

Hallmark Health System mammography facilities possess a valid license and certificate of inspection issued by the Massachusetts Department of Public Health.

Screening Mammogram Locations:
•    Melrose-Wakefield Hospital – 585 Lebanon St., Melrose
•    Lawrence Memorial Hospital – 170 Governors Ave., Medford
•    Health Image – 830 Main St. , Melrose
•    Hallmark Health Medical Center – Reading
•    101 Main St., Suite 116 – Medford


Screening Mammograms are now available on Saturdays at our Comprehensive Breast Center location.


Diagnostic Mammogram Location:
•    Comprehensive Breast Center – 41 Montvale Ave., Stoneham

All Hallmark Health Mammography Centers are licensed by the Department of Public Health and accredited by the American College of Radiology


Frequently Asked Questions

What is a mammogram?
A mammogram is an x-ray of your breast. It can detect breast tumors before they can be felt,  if found early, over 95% of breast cancers can be treated successfully.

When should I begin having a mammogram?
The American Cancer Society recommends that you have a mammogram every year beginning at age 40 or In some cases earlier if you have symptoms or a family history of breast cancer.

What is the difference between a “screening” and a “diagnostic” mammogram? 
A “screening” mammogram typically refers to the routine mammogram for women to have every year beginning at age 40 (in some cases earlier, if a patient has symptoms or a family history of breast cancer).

A “diagnostic” mammogram refers to the follow-up tests a woman will have if the radiologist sees any questionable issues on the screening mammogram or for women who have a history of breast cancer, palpable lumps, or a suspicious mammograms.

What should I wear?
If possible, please wear a two piece outfit. If not, you will be asked to change into a hospital gown for the exam.

Why can’t I use deodorant the morning of my mammogram?
Deodorant can mimic breast calcifications on the mammogram image, resulting in some women being unnecessarily called back for additional exams.

Does a mammogram hurt?
Most women say that mammograms are not painful but many find them uncomfortable, especially due to the need for breast compression.

Why do we compress your breast during a mammogram?
Breast compression allows us to obtain a clearer image.

How long does the exam take?
The exam usually takes 15 minutes.

How long does it take to receive the results?
For screening mammograms, your primary care and/or gynecologist will receive the report within a week.  For most diagnostic mammograms, you will receive the results directly from a radiologist following your exam, typically within 1 hour.

If I am called back for additional views, what does this mean?
A routine screening mammogram consists of several images of each breast. These images are read by a radiologist who may determine he/she needs additional views for a complete interpretation. Sometimes normal breast tissue may image in such a way as to create a questionable shadow. Additional views with a slightly different angle or position can clear up any question the radiologist may have. If it is determined you need to have additional views, we will contact you directly to set up an appointment for you.  Please understand that many women are called back and then confirmed to have no need for additional testing until their next regular screening mammogram.

Advantages of Digital Mammography (vs. traditional film mammography)
•    Better image quality and detail.
•    Better able to detect breast cancer, particularly for women with dense breast tissue.
•    Uses less radiation
•    Faster
•    Allows images to be stored and sent electronically.

If you are unable to keep your appointment please call (781) 338-7111 to reschedule.


Stereotactic-Guided Breast Biopsy


Frequently Asked Questions

What is a stereotactic-guided breast biopsy?
Stereotactic-guided breast biopsy is a minimally invasive procedure that uses a three-dimensional computerized image to view in detail abnormal areas in the breast. The breast tissue samples, withdrawn using a vacuum-assisted device, are examined by a Pathologist to determine whether the breast tissue is benign or not.

What are the benefits of stereotactic-guided breast biopsy?
•    Especially useful when an abnormality can be seen on a mammogram but cannot be felt
•    Simple procedure, performed under local anesthesia
•    Generally takes about one hour
•    Typically not painful
•    Most activities can usually be resumed the next day

What are the risks of stereotactic breast biopsy?
•    Possible discomfort at the biopsy site after the procedure, usually well controlled by non-prescription pain medication.
•    Infection can occur whenever the skin is penetrated, but the chance of infection requiring antibiotic therapy is minimal.
•    Bleeding or bruising, typically controlled by applying pressure and local application of ice. 
•    Depending on biopsy results, about 15% of women will need breast surgery.

How should I prepare for the procedure?
•    Do not take aspirin or Motrin 1 week prior to the procedure.  Tylenol is permitted.
•    Our Nurse Navigator will speak with you regarding any medications you are currently taking such as Coumadin, Plavix or Heparin.
•    You are encouraged to have a relative or friend drive you to the procedure. However, you can drive home on your own.
•    Do not wear deodorant, lotion, powder or perfume under your arms or on your breasts the day of the procedure.
•    Arrive 30 minutes before your scheduled appointment time.
•    Be sure to wear or bring a bra on the day of the procedure.

What will the procedure be like?
•    A board-certified radiologist or surgeon who specializes in breast procedures   will perform the stereotactic-guided breast biopsy.
•    You will be awake during the procedure and should experience little or no discomfort.
•    You will lie on your stomach with your breast gently placed through a round opening on the table.
•    Your breast will be compressed, just as in a mammogram. Multiple images will be taken at different angles, enabling the computer to locate the abnormal area for biopsy.
•    After the area of concern is located, you will receive a local anesthetic.
•    A very small nick (usually less than ¼ of an inch) will be made in the skin where the biopsy needle is to be inserted.
•    Using computer images as a guide, the vacuum-assisted device needle will be gently inserted into the area of concern. It is common to take multiple tissue samples.
•    A tiny marker (clip) is placed at the site where the tissue is removed.  If benign, the clip will remain.  Only 15% of women will require further surgery, this clip would be removed at that time.  This clip cannot be felt. 
•    Generally the entire procedure is completed in about an hour.  Stitches are placed when needed. A small bandage will be applied.

What will happen following the procedure?
•    You may experience a small amount of bruising and mild discomfort. You will be given an ice pack to help minimize swelling and tenderness of the biopsy area. Tylenol is recommended to control any pain.  Most women feel fine after the procedure.
•    Exercise or strenuous activity should be avoided for 24 hours after the procedure. It is recommended to go home after the procedure and relax.
•    You can resume aspirin or Motrin 24 hours after the procedure.

How will I learn the results of my biopsy?
•    You will be notified of your results by the surgeon or radiologist. Results are usually available within 2 - 3 working days.
Remember:
•    Advise your doctor of any prescription or non-prescription medications or herbal products you are taking.
•    Be sure to talk to your doctor before discontinuing any prescribed aspirin therapy or blood thinning medications.
•    Advise your doctor or the radiologist of any allergies or reactions to general or local anesthesia.
•    Inform the technologist if you are sensitive to latex or other substances.

This procedure is done at our Comprehensive Breast Center which is located at 41 Montvale Ave., Stoneham.Please call the Center with any questions (781) 224-5806.

 


Breast Needle Localization

Abnormal tissues may be difficult to find during surgery even when they show up clearly on your x-ray. When abnormal tissue is discovered, the most effective way to reduce your risk of cancer is to remove the tissue entirely.

In order for your surgeon to remove the area of breast tissue that contains the area of concern, he or she will need a guide to show the exact location of the abnormality. Needle localization is most often performed immediately prior to surgery on patients who are having surgical breast biopsies or lumpectomies. The breast localization procedure will result in precise pinpointing of the abnormality thereby increasing your surgeon’s ability to remove all of the abnormal tissue while reducing the removal of healthy tissue. It also reduces the length of time you are in surgery.

 

The needle localization may be performed under ultrasound guidance, mammographic guidance, or MRI guidance depending on which type of imaging best shows the abnormality. The most common way to perform needle localization is to use mammographic guidance.

 

The Breast needle localization takes less than one hour. Most often, you will be asked to arrive at the hospital on the day of your biopsy surgery early enough to have the needle localization done prior to your surgery.

 

• The procedure will be done in the radiology department unless you are instructed otherwise.

• Be sure to follow instructions regarding eating and drinking prior to surgery.

• Before the procedure you will put on a hospital gown.

• During the procedure images of the breast will be obtained and abnormality identified.

• The radiologist will numb the area and then insert the localization needle toward the exact position of the abnormality.

• Another x-ray will be taken to confirm the location of the needle. Since your radiologist will want to pinpoint the exact location of the abnormality for your surgeon, the needle may need to be repositioned.

• When the radiologist has determined that the abnormality has been targeted, a very thin small guide wire will be inserted down through the inside of the needle to mark the position of the abnormality. A small hook at the end of the wire keeps it in place in the breast.

• The wire is taped to your skin.

• Two final films will be taken to show your surgeon the exact location of the wire and the localization procedure is complete.

• When the localization procedure is complete you will be escorted back to the operating room where the surgeon will remove the tissue.

 

Frequently Asked Questions (FAQs)

 

Is the procedure painful?

The radiologist will numb the skin and the deeper tissue within your breast with a small needle. The injection of anesthetic may sting for a few seconds. Once the anesthetic has taken effect, you should not feel any pain during the placement of the needle. You may feel the pressure of the compression paddles but it shouldn’t be any worse than with mammography. Once the localization procedure is complete patients rarely experience discomfort.

 

Who performs the needle localization procedure?

A board certified radiologist who is trained in reviewing mammograms and breast ultrasounds will perform the procedure. The radiologist will be assisted by a technologist who is also trained in this procedure.

 

What should I expect?

On the day of your breast needle localization, please do not wear any lotions, powders or deodorant around your breast or under arms.

• As in the mammogram, your breast will be placed between specially designed compression plates.

• Before the localization procedure, an x-ray will be taken from different views to determine the location of the abnormality.

• A needle will be inserted into your breast to mark the exact position of the abnormality.

• Once properly located, the needle will be removed leaving a thin wire as a guide for your surgeon.

• Once identified, the procedure for marking the area is the same as the procedure using mammographic guidance.

If you have any questions about the procedure, ask your radiologist or the technologist. Your complete understanding of this procedure is important.

Hallmark Health System Needle Localization Facilities:

  • Lawrence Memorial Hospital

170 Governors Avenue, Medford, MA 02155

  • Melrose-Wakefield Hospital

585 Lebanon Street, Melrose, MA 02176


Galactography/Ductography


Galactography (Ductography) is an outpatient examination of the milk ducts to help evaluate certain types of nipple discharge.
During this procedure, a tiny amount of fluid is obtained by applying pressure on the nipple in order to identify the correct duct.
The duct is cannulated, a small amount of contrast medium is injected, and mammography is performed. The contrast medium makes the duct visible on the mammogram to aid in visualization.
This procedure takes approximately 45 minutes. 
For more information, please call our nurse navigator at (781) 224-5806

 


Breast MRI

Breast MRI is available at our Melrose-Wakefield Hospital campus.  To schedule this exam, please call (781) 279-2213.


Breast Care Nurse Navigator

We offer a full spectrum of breast care support services, including a breast care nurse navigator. Our nurse navigator plays an integral role in the Breast Center, including one-on-one consultation as well as providing educational support. The role of our nurse navigator has many facets including:
•    Coordinating individualized care for each patient
•    Assures timely access of scheduled appointments
•    Provides emotional support to patients and their families
•    Works closely with our inter-disciplinary team
•    Educates patients about individual cancer diagnosis and treatment options
•    Helps patients make informed decisions about treatment and care
•    Advocate for patients throughout treatment
•    Assist with recovery and rehabilitation plans.


Our nurse navigator offers personalized support and is a unique asset that is only available at some medical centers. She is able to bring knowledge and comfort to all of our patients and serves an important role as a facilitator and guide for patients providing support through each phase of diagnosis and treatment.


Lymphedema/Physical Therapy

Lymphedema is a chronic, abnormal accumulation of fluid in the arm, leg, breast, head or neck, often related to cancer.  Lymphedema affects about 1% of the population in the United States. 

Women’s health physical therapy can also address issues such as incontinence (involuntary loss of urine), pelvic pain and sexual pain. 

Located at 41 Montvale Ave., Hallmark Health System’s Comprehensive Breast Center is one of the few breast centers that provide an on-site certified lymphedema specialist. Our physical therapist is a highly-trained, licensed and certified lymphedema specialist with extensive experience working with oncology patients, cancer-related fatigue and scar tissue adhesions.  The physical therapist is also trained in pelvic physical therapy and is qualified to treat urinary incontinence, pelvic pain, and muscle/joint pain for prenatal and postnatal women.

For more information about our Lymphedema and Women’s Health program, please call (781) 224-5895.


Social Services

The Hematology and Oncology Center, (also located at 41 Montvale Ave., Stoneham) has on staff social workers (MS/LICSW) who provide psychosocial assessment and clinical intervention to patients and their families regarding their cancer diagnosis. Our on-site social workers are available for individual counselling.


Available at the request of the patient, family or healthcare staff, these clinicians work closely with physicians to develop a plan that would benefit the needs of the individual. Through support and knowledge we hope to give our patients greater confidence for living fuller lives. Our social work staff also provides genetic counselling and testing for breast and colon cancers.

 


Genetic Counseling and Testing


The Social Work staff along with the surgeons and oncologists provides testing for breast, ovarian and colon cancer and cancer risk in genetic mutations .

After a discussion with your family or physician about your family history with cancer, combined with your personal history, the team at the Hallmark Health Hematology Oncology and the Comprehensive Breast Center will work with you to discuss your level of risk and arrange for the testing right at the Center.

Our team is here to support you and work with you through the psychosocial aspects of genetic testing as well as through a thorough risk assessment and plan of appropriate medical surveillance.

For more information please contact the Hallmark Health Hematology Oncology Center at 781-224-5810 or the Comprehensive Breast Center at 781-224-5806, or Kathi Whittier, MSW at 781-224-5872.   


Breast Cancer Support Groups

This monthly group is a supportive program for women facing and living with a breast cancer diagnosis.  They provide supportive and educational sessions to help patients cope with every day issues including questions to ask your doctor, nutrition, symptom management, work related issues, body image issues and coping strategies.
For more information on this free monthly support group, please contact Kathi Whittier, MSW, LICSW (781) 224-5872 or Sara Henry, RD, LDN (781) 224-5872.


Look Good…Feel Better

Several times each year, in conjunction with the American Cancer Society, we offer the Look Good…Feel Better Program.   This program is for women who are currently in treatment for cancer.    It is a group workshop that teaches beauty techniques to female cancer patients to help them combat the appearance related side effects of cancer treatments.  
For more information regarding this program, please call our social worker, Kathi Whittier, at (781) 224-5872.


Men and Breast Health


Most breast health issues are related to women.  Breast disease affects a much smaller percentage of men than women, accounting for only about 1% of all breast cancers.  According to the American Cancer Society, the overall ratio of female to male breast cancers in the United States is 100 to 1.


We recognize that men are also vulnerable to breast disease.  Any man who experiences any breast abnormality, such as, abnormal lumps, discharge or breast sensitivity should contact their physician.  Awareness and early detection, even in men, are the keys to fighting breast disease.


Location

Our Comprehensive Breast Center is conveniently located in Stoneham at 41 Montvale Ave., on the fourth floor.
For more information or to schedule an appointment, please call (781) 224-5806.

Click here for map.

Bill and Joyce Cummings and OneWorld Foundation are generous supporters of the Comprehensive Breast Center

www.CummingsFoundation.org

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