Surgery Transcript

Samaritan Health System presented a live mammogram and breast biopsy on July 28th. Here is the transcript of those procedures.

Performing and narrating the biopsy from the Good Samaritan Breast Center is general surgeon Dr. Richard Perry.	Live commentary for the mammogram is provided by Dr. Marina Giurescu, a radiologist at Good Samaritan Regional Medical Center and the Director of Women's Services at Clinical Diagnostic Radiology in Phoenix.

Jul 28 - 18:27:15 MST - Hello, I'm Dr. Marina Giurescu, with Clinical Diagnostic Radiology. In partnership with the Good Samaritan Breast Center, I'd like to welcome you to our Webcast featuring mammogram and biopsy procedures.

Jul 28 - 18:33:07 MST - The technologist is positioning the patient's breast for the top to bottom view also known as craniolcaudad.

Jul 28 - 18:34:08 MST - The technologist is lifting the patient's breast and positioning the x-ray film holder under the breast applying the compression paddle from above.

Jul 28 - 18:34:50 MST - The patient is asked to hold her breath while the film exposure is being taken, after which the compression paddle automatically releases.

Jul 28 - 18:35:52 MST - The technologist will now position the patient for the side to side view (the oblique view).

Jul 28 - 18:36:25 MST - The patient has already filled out a preliminary questionaire detailing her prior breast history such as surgeries, implants, radiation and/or chemotherapy and use of hormonal replacement therapy.

Jul 28 - 18:37:29 MST - The x-ray film holder will be leaning against the patient's armpit (axilla) and the compression paddle will be applied from the inner side.

Jul 28 - 18:38:06 MST - The breast is being pulled forward and inward and the surface of the skin is being smoothed to avoid any possible folds.

Jul 28 - 18:39:40 MST - Mammograms are the best available way to detect breast cancer early. Early detection is the key to protection. Women over 40 should have annual mammograms according to the latest recommendations.

Jul 28 - 18:40:12 MST - Call Samaritan's (602) 230-CARE (2273) to schedule a screening mammogram at the Good Samaritan BreastCenter or any Samaritan facility.

Jul 28 - 18:42:43 MST - Mammograms only take about 10-15 minutes - it is not a long procedure. That includes the time it takes to have the x-rays checked for any technical problems.

Jul 28 - 18:44:14 MST - Michelle Griffiths of the Phoenix Mercury WNBA team welcomes you to the Webcast of a breast biopsy. The WNBA has adopted breast cancer as its official cause. Michelle is currently on maternity leave from the team and is expecting her baby at the end of September.

Jul 28 - 18:45:12 MST - The patient is already positioned on the table lying flat on her stomach with the breast falling through the opening. The breast is then impressed in the area of interest for biopsy and the first x-ray picture is taken.

Jul 28 - 18:46:06 MST - Dr. Perry is pointing at the area that we will be biopsying on the x-ray.

Jul 28 - 18:46:50 MST - We then take 2 views 15 degrees to the left and right of the original view, which is what stereotactic means. This allows us to determine the coordinates of the lesion for an accurate biopsy.

Jul 28 - 18:48:40 MST - Dr. Perry will put a computer target on the lesion in each view. The computer will then create an XYZ coordinate which allows the doctor to deliver the needle accurately to the biopsy site.

Jul 28 - 18:50:11 MST - The computer then transmits this information to the x-ray table. The biopsy needle, which sits on a holder, then moves to the exact site on the breast.

Jul 28 - 18:51:31 MST - Michelle Griffiths of the Phoenix Mercury WNBA team here. It is important for women to understand that 80 percent of women who undergo these procedures are found to be cancer free.

Jul 28 - 18:53:25 MST - Before the incision, the skin is cleansed with betadine and numbed. Then the doctor makes a tiny incision, about the size of a small pinky nail, and places the needle inside the breast to the proper coordinates.

Jul 28 - 18:55:04 MST - Dr. Perry is now at the computer reverifying the coordinates with the x-ray view.

Jul 28 - 18:55:47 MST - If not satisfied, the doctor can reposition the needle as you have just witnessed.

Jul 28 - 18:57:07 MST - The needle is now repositioned. The doctor will advance a needle quickly by pressing a button. He has just deployed the needle is verifying accurate position of the needle tip.

Jul 28 - 18:58:47 MST - Dr Perry has just given the patient additional numbing to ensure her comfort throughout the procedure.

Jul 28 - 18:59:37 MST - Michelle Griffiths of the Phoenix Mercury here. The risk of breast cancer increases after age 40. Women younger than 40 are at relatively low risk of breast cancer. However, if a member of your immediate family, such as your mother or a sister, had breast cancer before menopause, you may want to perform breast self-exams and other screenings on a more regular basis before age 40.

Jul 28 - 19:00:19 MST - Dr. Perry has just retrieved the first biopsy sample and will continue to get several more.

Jul 28 - 19:01:22 MST - The Mammotome biopsy needle is a vacuum assisted needle, which means the breast tissue is pulled into the needle chamber with vacuum (air suction).

Jul 28 - 19:02:09 MST - Dr. Perry is removing several pieces of tissue which he's labeling and sending to the lab for analysis.

Jul 28 - 19:04:04 MST - Dr. Perry will place a metal clip marker now at the biopsy site to mark the area for future identification. The marker will be removed if the patient requires further surgery, but will remain in place otherwise.

Jul 28 - 19:04:47 MST - The average time for a biopsy procedure is 20-25 minutes.

Jul 28 - 19:05:24 MST - Call Samaritan's (602) 230-CARE (2273) to schedule a screening mammogram at the Good Samaritan Breast Center or any Samaritan facility.

Jul 28 - 19:06:43 MST - Throughout the procedure x-ray is used to verify the accuracy of the biopsy. However, this is a very low dose of x-ray used off and on.

Jul 28 - 19:07:55 MST - The biopsy is now complete and the breast is being cleaned and compressed with an ice pack and a bandaid is placed over the incision. The results will be available within 48-72 hours.

Jul 28 - 19:08:45 MST - Stay tuned for another mammogram involving a patient with implants and right after that, our chat with Dr. Giurescu and Michelle Griffiths of the Phoenix Mercury.

Jul 28 - 19:09:38 MST - The technologist is positioning the breast for the top to bottom view of the mammogram, displacing the implant as far up and to the back as possible.

Jul 28 - 19:10:22 MST - The technologist is applying the pressure paddle from above first making sure the skin surface is smooth, without any folds.

Jul 28 - 19:11:42 MST - A patient with implants needs to have a total of 8 views taken, 4 for each breast. Two are taken to look at the breast tissue and 2 are taken to look at the implant.

Jul 28 - 19:12:23 MST - You comfort level is the same during the mammogram with or without implants.

Jul 28 - 19:13:52 MST - The pressure paddle is now released. The technologist will take the oblique view (side to side) now.

Jul 28 - 19:14:02 MST - Call Samaritan's (602) 230-CARE (2273) to schedule a screening mammogram at the Good Samaritan Breast Center or any Samaritan facility.

Jul 28 - 19:15:29 MST - The technologist is applying the compression paddle from the inner side of the breast; the implant is again pushed as far up and back as possible, to show the most tissue.

Jul 28 - 19:19:18 MST - This concludes the mammogram and biopsy Webcast. We thank our patients for their participation in this educational Webcast. We also want to thank Dr. Marina Giurescu of Clinical Diagnostic Radiology, Dr. Richard Perry, the clinical staff at the Good Samaritan Breast Center, Michelle Griffiths of the Phoenix Mercury and Ethicon Endo-Surgery.

Jul 28 - 19:20:08 MST - Please join Dr. Marina Giurescu and Michelle Griffiths of the Phoenix Mercury in the chat room linked on the right side of this page.

Call Samaritan's (602) 230-CARE (2273) to schedule a screening mammogram at the Good Samaritan Breast Center or any Samaritan facility.