At Sydney Breast Clinic, breast cancer can be detected and diagnosed within a single day which can reduce stressful waiting time and the need for multiple return visits to your GP and to medical specialists.

You are considered to have an increased risk of breast cancer if you have:

• a personal history of breast cancer
• a significant family history of breast or ovarian cancer
• Ashkenazi Jewish background
• a previous biopsy indicating high risk for development of breast cancer
• a dense pattern of breast tissue on mammography
• long term use of Hormone Replacement Therapy (HRT)

what does risk assessmenT mean?

The Risk Assessment Screening Clinic at Sydney Breast Clinic is for women with a potentially increased risk of developing breast cancer who need close observation.

The following information provides a brief explanation of the process and the tes ")); ts which may be performed as a part of the Risk Assessment Screening Clinic at the Sydney Breast Clinic.

Average time for a Risk Assessment at Sydney Breast Clinic ranges from one to five hours depending on the results of each assessment and the overall complexity of cases on that day.

Remember, each test you have during your visit is evaluated and reported while you are still at the Clinic. On busy days this may result in some delays but we do this in order to give you as much feedback as possible about your results on the day of your visit. Our doctors are happy to provide you with a medical certificate for work if necessary.

A multidisciplinary team will be involved throughout the process of your risk assessment breast examination. This team may include; a Radiologist, Breast Surgeon, Breast Physician, Radiographers, Sonographers and Clinic Nurse. All members of the team strive to maintain a high standard of excellence.

The triple test approach using:

• Medical history and clinical breast examination
• Imaging (mammography +/- ultrasound) and
• Non-excision biopsy - Fine Needle Biopsy and/or core biopsy

This has been shown to be the most effective means of investigating a breast change or symptom.

Not all women will require all three tests to investigate their breast change. The number and choice of tests required will depend on factors such as the nature of the breast change, the age of the patient and the results of individual tests. The Clinic's doctors will discuss the need for particular tests in your individual case and will be pleased to address any other questions or concerns you may have.

Clinical Breast Examination

A Breast Surgeon or Breast Physician will document in detail your personal medical history and your family history. He/She will then perform a clinical examination of both your breasts, armpits and neck.

Mammogram (breast X-ray)

A Radiographer will perform this test, and check the technical quality of this film. A mammogram is a very low radiation dose x-ray of the breast tissue and involves compression of the breast tissue for a few seconds. This is important as it contributes to the quality of the x-ray and reduces the radiation dose.

The Clinic’s radiographers are highly skilled in performing mammograms and will ensure that every care is taken to reduce discomfort to a minimum.

A Radiologist, with expertise in breast diagnosis will interpret your mammogram. Other members of the multidisciplinary team will also contribute to the evaluation of the film.

The multidisciplinary team consists of: A breast surgeon, breast physician and a radiologist.

Once the doctors have looked at your mammograms and correlated the results with those of your clinical examination, a recommendation will be made about the need for further tests such as ultrasound or needle biopsy.

Breast Ultrasound

A Sonographer or Breast Physician will perform your ultrasound.

An ultrasound compliments a mammogram by using high frequency sound waves to examine the breast tissue. Ultrasound may be the first imaging test performed in younger, pregnant or lactating women. Ultrasound is most useful in providing information about lumps or localised areas of breast change.

A breast physician will discuss the results of the ultrasound with you, and make a recommendation about any further tests required.

Fine Needle Aspiration Biopsy

In this test, a breast physician will insert a fine needle into the area of breast change or breast lump and under ultrasound guidance collect a small sample of cells.

The tissue samples are sent for interpretation to an experienced Pathologist specialised in breast diagnosis.

Results are available in within one working day and will be given to you either by a Breast Physician or by arrangement with your referring doctor.

In a small percentage of cases, it is possible that the result of the fine needle aspiration biopsy may be inconclusive, or at times not enough cells are obtained to make a diagnosis. When this occurs the doctor discussing the results with you will make a recommendation about the need for additional tests.

Core Biopsy

Performed under local anaesthetic

A core biopsy is another test which uses a larger needle to obtain tiny “pieces” of breast tissue. The area is numbed with a local anaesthetic before the biopsy is performed.

The samples are sent for interpretation to an experienced Pathologist specialised in breast diagnosis.

Core biopsy results are available within one to two working days. The Breast Physician performing this test will provide you with your results or alternatively will arrange for you to see your referring doctor.

Your Risk Assessment Results

Correlation of all the findings will be performed by the multidisciplinary team and communicated directly to you.

A written report is sent to your referring doctor approximately one week after your visit or earlier if required urgently. When necessary, your referring doctor will be contacted by the Breast Physician on the day of your visit.