Services (Breast Health & Mammograms)

The Women’s Center at Cookeville Regional provides a full range of educational, screening, diagnostic and treatment services for women of the Upper Cumberland.

Whether you need to schedule your baseline mammogram, learn more about your diagnosis, receive breast cancer treatments or participate in clinical trials, our JOURNEY™ program offers the services you need in the comfort of a luxury spa. From a free coffee service to the services of a personal nurse navigator, we have what you need to maintain good breast health.

Mammography / Digital Mammography / 3D Mammography

The Women’s Center uses the latest in digital mammography to test for breast abnormalities, including 3-D mammography. Besides providing a more comfortable method of testing, digital screening detects cancer 28 percent more often in women under 50 and in those who have dense breast tissue.

The resulting images can be viewed at different angles, adjusted for contrast and brightness, and magnified. Because a more thorough viewing of test results is possible, digital screening can aid in earlier diagnosis of breast cancer and fewer callback visits. Digital tests also require less exposure to radiation than film-based X-rays.

Another benefit is that your physician is able to view the digital image via the Internet as soon as your test is complete.

Earlier diagnosis, earlier test results and earlier physician viewing of images are some more ways we assist you on your journey to breast health.

3-D Tomosynthesis Mammography

Over the last several years, there has been a move in technology when it comes to mammograms. Now one can choose to receive a 3-D mammogram instead of the traditional 2-D mammogram. But what is 3-D mammography? What makes it different?

3-D mammography produces a three-dimensional view of the breast tissue that helps radiologists identify and characterize individual breast structures by reducing the effect of overlapping tissues.

The benefits of 3-D mammography are:

Lower radiation dose. With the latest software technology, women will receive a slightly less radiation dose than the standard 2-D digital mammogram.
Reduction in the frequency that women are called back for additional imaging.
Detection of 41 percent more invasive breast cancers and reduction of false positives by up to 40 percent, according to Hologic Inc.
Allows doctors to see masses and distortions associated with cancers significantly more clearly than conventional 2-D mammography.

All women who would undergo a standard mammogram are candidates for 3-D mammograms.

The technology of 3-D mammography was approved by the Food and Drug Administration in 2011. Since then, the technology has continued to develop and improve, and more insurance companies are covering this service, as well. Cookeville Regional began providing 3-D mammograms for the Upper Cumberland in 2015.

Stereotactic Biopsy

When you need a biopsy, The Women’s Center offers a less invasive stereotactic procedure that requires a smaller incision than the traditional open surgical method. This outpatient procedure causes minimal scarring and less blood loss than with other methods.

A stereotactic biopsy is sometimes prescribed when an abnormality is identified on a mammogram, ultrasound or other imaging test.

Stereotactic biopsy is performed while you are lying face down on a table that has an opening for each breast. The breast is slightly compressed – less than is required for a mammogram. A tiny nick is made in the numbed skin, and a pencil-sized device is guided to the targeted area. A small sample of the breast tissue is removed and sent to the laboratory for analysis. The entire procedure takes about one hour.

Aspirin products should not be taken for several days prior to the procedure. If you are on prescription blood thinners, such as Coumadin, you need to consult your physician prior to scheduling the biopsy.

The Women’s Center seeks to create a warm and compassionate environment while your test is being performed, and we answer any questions you have concerning your test and its results. Our nurse navigator is also available to answer questions.

Breast MRI

MRI is a supplemental tool for detecting and staging breast cancer and other breast abnormalities.

MRI is often used:

When abnormalities are detected by mammography.
In women with dense breast tissue or those at high risk.
In women who have implants or scar tissue.
To distinguish between scar tissue and recurrent tumors.
To assess multiple tumor locations.
To provide additional information to make treatment decisions.

MRI is noninvasive and usually takes an hour. You may receive an injection into the bloodstream so results are more easily viewed.

If you have allergies or there is a possibility that you are pregnant, you should consult your physician before scheduling an MRI. Some conditions such as kidney disease or sickle-cell anemia may prevent you from having an MRI.

The new fully open MRI at The Women’s Center provides a comfortable environment for women who may feel ill at ease in an enclosed machine. You may also watch television or use an iPod docking station during your procedure.

Ultrasound

Ultrasound is an important diagnostic tool that complements mammography screening. It can be used to determine if a lump or tenderness in your breast is a fluid-filled cyst or solid lesion. Ultrasounds do not use radiation. If you are under 30, pregnant or lactating, this method may be recommended instead of mammography to screen for breast abnormalities.

Ultrasound may also be prescribed to aid your physician in needle biopsies, cyst aspirations and preoperative wire localization procedures.

The procedure is performed while you are lying face up on a table. You will be asked to wear a mammo cape for the test. The ultrasound technologist will apply a warm, clear gel to the area of your breast being studied, then press a transducer firmly against your skin and move the device slowly back and forth over the suspect area. This produces a real-time image on a screen that can be viewed to identify any abnormalities that may be present. The procedure is usually completely painless.

A radiologist, who is specifically trained to supervise and interpret the ultrasound, will analyze the images and send a signed report to your primary care or referring physician, who will share the results with you.

Bone Density Testing

Osteoporosis weakens the bones to the point that they break easily, especially bones in the hip, spine and wrist. It is called the silent disease because symptoms do not occur until the disease is in an advanced stage.

The Women’s Center offers DEXA scan bone density testing that can help identify early stages of bone loss so preventive steps can be taken. Bone density testing may be advised if certain factors are present:

Risk Factors

Overall, women are at greater risk than men for developing osteoporosis. However, several factors can increase a woman’s risk. If you:

Are postmenopausal.
Have a family or personal history of spine or hip fracture after age 45.
Are of Caucasian or Asian race.
Are small-boned and weigh less than 127 pounds.
Have experienced early menopause or cessation of menstruation before menopause.
Have a lifestyle with little or no exercise, especially weight-bearing exercise.
Have a history of alcohol abuse or smoking cigarettes.
Have a history of long-term use of glucocorticoids (oral steroids).
Use medications to treat hyperthyroidism, marrow disorders, collagen disorders, gastrointestinal problems and seizure disorders.

Breast Surgery

Breast surgery may be prescribed if a malignant tumor is identified in your breast. Breast surgeries are performed at the main hospital facility at Cookeville Regional, not in The Women’s Center. One of several types of surgery may be recommended, depending on the stage of the cancer. You may also choose to have breast reconstruction surgery, either at the same time or after you have recovered from cancer.

Talk to your physician or call our nurse navigator for more information about your options or to understand more about the procedure you and your physician have chosen.

Breast-Conserving Surgery - Only the affected area of your breast is removed. Radiation and/or chemotherapy may also be advised after this surgery.

Lumpectomy - Removal of the lump and a marginal area of surrounding tissue.

Partial (Segmental) Mastectomy or Quadrantectomy - Removal of as much as one-quarter of the breast.

Wire Localization - If an identified breast lesion/lump is not palpable by the surgeon, a small wire may be placed inside the breast tissue for easier identification.

Mastectomy - Mastectomies remove breast tissue and sometimes other nearby tissue.

Simple/Total - Removal of the breast but not the lymph nodes or surrounding tissue.

Modified Radical - Removal of the breast, lymph nodes under the arm and the lining over the chest muscles.

Radical - Removal of the breast, lymph nodes, muscles under the breast and some of the surrounding tissue.

Cancer Center Treatment

The Women’s Center works closely with The Cancer Center at Cookeville Regional when a patient receives a diagnosis of breast cancer. At the Cancer Center, you will find personalized care not often offered at larger facilities. The patients at Cookeville Regional will be able to receive the latest in imaging diagnostics, including PET/CT. Additionally, chemotherapy, radiation therapy and follow-up care are available in one location. Patients are also offered an opportunity to participate in clinical trials and have access to the latest medicines and procedures being tested to treat cancer.

The Cancer Center has received approval with commendation from the Commission on Cancer (CoC) of the American College of Surgeons. The Center earned a 1+ rating, the highest overall score, in the rigorous evaluation to ensure quality care and conformance to CoC standards.

The Cancer Center has developed a Tumor Board that meets regularly to confirm patient diagnoses and discuss the best treatment options. The board includes doctors who are experts in different specialties, including a medical oncologist, a surgeon, a radiation oncologist, radiologist, pathologist and your primary care physician.

The caring and professional staff at The Cancer Center at Cookeville Regional is committed to providing the highest quality treatment and service as you journey to breast health.

Lebed Therapy

A condition known as lymphedema is a side effect that can sometimes occur during or after breast cancer surgery. It is not life threatening, but can lead to other complications. Lymphedema is an abnormal buildup of fluid that causes swelling in parts of the body, most often in the arms, legs or trunk. The swelling may be accompanied by numbness, discomfort and sometimes infection.

The Women's Center at Cookeville Regional offers Lebed therapy, a therapeutic exercise program that was developed by physicians and a dance movement specialist. Lebed therapy requires no special physical ability and helps patients to recover physically and emotionally from breast cancer surgery and lymphedema.

Physical Benefits:

Enhances range of motion.
Increases flexibility.
Improves balance.
Stabilizes weight.
Helps reduce swelling from lymphedema.
May help reduce the risk of lympehdema.

Emotional Benefits:

Decreases depression.
Adds to sexuality.
Increases feelings of femininity.
Promotes a positive self-image.

Lymphedema Treatment

The Outpatient Rehabilitation Center at Cookeville Regional – located in The Rehabilitation Center on West Sixth Street just two blocks from the hospital – is staffed with licensed physical therapists who are also credentialed to treat lymphedema. Usually a chronic condition, lymphedema is a swelling of the body’s soft tissue, usually in an extremity, caused by damage to the circulatory or lymph systems.

Some women experience lymphedema following lymph node surgery. While there is no cure for lymphedema, it can be properly managed with proper care and treatment. Symptoms of lymphedema include swelling, feeling of heaviness, hardness, numbness/tingling, and frequent infections in the arms or legs. If left untreated, the patient is at risk for developing an infection and/or lymphoscarcoma — both of which are painful and debilitating.

Please see your doctor if you think you may be experiencing lymphedema.

Stereotactic Biopsy

While mammography is an excellent way to detect breast abnormalities, it is not possible to tell from the imaging studies alone whether a growth is cancerous or not. That’s why we also take advantage of stereotactic, or X-ray guided, biopsy procedures.

An alternative to open surgical biopsy, this outpatient procedure requires just a single, small incision using a local anesthetic. Once the tissue specimen is removed, our pathologists can examine it and determine the nature of the growth. This procedure results in less internal scarring compared to the open surgical method.

Ultrasound

Yes, the very same technology that’s used to produce images of an expectant mother’s womb can also aid in the detection of various types of cancer. Ultrasound can be used to look for suspicious lesions in the pelvic, abdominal and vascular areas. In fact, ultrasound is often used to determine if a suspicious area is a cyst or a solid growth.

Early Detection of Breast Cancer is Key – When Should I Have a Mammogram?

The American Cancer Society (ACS) advises women age 40 and older to have a mammogram every year.

Forms & Information

Osteoporosis

Bone Density Testing

Osteoporosis is known as the “brittle bone disease” because it thins and weakens the bones to the point that they break easily — especially bones in the hip, spine and wrist. It is also called the “silent disease” since you may not notice any changes until a bone breaks.

Risk factors

Gender, age, slender build, race, family history, estrogen deficiency, low testosterone in men, eating disorders, diet low in calcium and/or vitamin D, use of certain medications, inactive lifestyle, tobacco and alcohol use.

DEXA Scan

The Women’s Center offers dual energy X-ray absorptiometry, or DEXA scanning, which is currently the most widely used method to measure bone mineral density. It is a totally painless, noninvasive procedure to measure bone mass and can be completed in less than 15 minutes.

If scanning is done in yearly intervals, DEXA can even determine your rate of bone loss and/or monitor the effects of your osteoporosis treatment. And all of this is performed with minimal radiation exposure.

OTHER SERVICES

Patients

Visitors

Services (Breast Health & Mammograms)

3-D Tomosynthesis Mammography

Risk Factors

Physical Benefits:

Emotional Benefits:

Stereotactic Biopsy

Forms & Information

Bone Density Testing

Risk factors

DEXA Scan