Early detection is the key to success in treating breast cancer, osteoporosis, and other diseases common to women. With that in mind, our dedicated comprehensive women's center was designed to provide state-of-the-art services in a pleasant, comfortable environment. From screening mammography and stereotactic breast biopsy, to bone densitometry, ultrasound, and educational facilities, the Center for Women's Health meets the needs of women of all ages.

The center's quality is assured by our accreditations in mammography, stereotactic biopsy, and ultrasound. The entire staff is female, including our mammographers who have advanced certification in mammography, and our ultrasonographers who are registered in multiple specialties. All studies are interpreted by our experienced radiologists, and a report is sent to your physician the next business day. Screening mammograms are 'double read', meaning they are read independently by two radiologists (at no additional cost).  Additionally, a Computer Aided Detection (CAD) system is utilized.  The only system of its kind in Greeneville, CAD assists radiologists in the early detection of breast cancer by digitizing the mammogram picture.  The digital image is analyzed by sophisticated computer algorithms and alerts the radiologists to 'suspicious' areas on the mammogram.  Studies have shown that the detection of early breast cancer can be increased by up to 23% by utilizing this system.  A letter explaining the results of the exam is mailed to all patients who receive screening mammograms.

The Center staff provides various programs to the community throughout the year on related topics such as breast health, mammography, osteoporosis, and others.  Numerous women's groups and individuals participate in our 'Yes, Mam!' program, which is a three-step program designed to promote healthy breast care and aid in the early detection of breast cancer.  'Yes, Mam!' is a no-cost community benefit program sponsored by the Center for Women's Health and the Laughlin Health Care Foundation.

The Center for Women's Health houses the Laughlin Health Information Library, which provides health and wellness materials for males and females of all ages.  The Library includes a large collection of books, videos, magazines, newsletters, brochures, and references, as well as internet access.  Materials may be viewed in the library's quiet sitting area or checked out after completing a complimentary membership.

Registration
The Center for Women's Health has designated registration and parking areas. Patients with appointments at the women's center will go directly there to register. The Center for Women's Health is located on the left end of the hospital, behind the Emergency Room. After turning into the Main Hospital Entrance, turn left at the first intersection and continue around the curve past the Emergency Room to the women's center parking lot (on the left). The main entrance to the women's center is located on the right, across from the parking lot.

The following links provide an explanation of procedures performed at the women's center:

· Mammography
· Bone Densitometry
· Ultrasound
· Cyst Aspiration
· Stereotactic Core Biopsy
· Ultrasound Core Biopsy
· Ductogram (Galactogram)
· Needle Localization

Mammography      top

Preparation Prior to Procedure
If your mammograms have been uncomfortable in the past, you may want to schedule for the week after your period when the breasts are least sensitive. If your previous mammogram was performed at another facility, it is very important that you bring those films with you or have them sent to us for comparison. On the morning of your exam, your breasts and underarms should be cleansed in order for us to perform a beneficial exam. Do not use deodorant, powder, or perfume, as this may cause artifacts on your mammogram films. Wear a comfortable, two-piece outfit. If you think you may be pregnant, or if you have breast implants, scars or moles, are breastfeeding, and/or have a history of surgery or biopsy on your breasts, please inform the technologist before your exam.

*Note: If your previous films are not available for comparison, it may take up to 30 days to retrieve the results and compare them to your current mammogram.

Length of Procedure
The actual procedure lasts approximately 15 minutes. Total time including registration, preparing for the exam, etc., is approximately 30 minutes.

Post-exam Instructions
After the exam, you may return to normal daily activities.

Results of Exam
A typed report of your mammogram results should arrive at your physician's office within three working days. (If your physician's office is not located near Laughlin Memorial Hospital, the report should arrive within seven days.) If you had a screening mammogram performed, you will receive a letter from us explaining the results of your mammogram within one week. If you have not received a letter within ten days, please call the women's center at (423) 787-5123.

Bone Densitometry      top
This is a fast, easy exam that detects osteoporosis by measuring the density of the patient's bones. The lower spine and one hip are scanned while the patient lies on his/her back. A computer analyzes the scan and generates pictures and calculations for interpretation by a radiologist.

Preparation Prior to Procedure
There is no preparation required. However, you may want to wear pants with an elastic waist in order to avoid changing or adjusting your clothes.

Length of Procedure
The actual procedure lasts approximately 10 minutes. Total time including registration, preparing for the exam, etc., is approximately 30 minutes.

Post-Exam Instructions
Resume normal activity.

Results
A typed report will be sent to your physician within the next 1-2 business days.

Ultrasound
Our ACR-accredited ultrasound department performs pelvic, obstetric, and breast ultrasound examinations in the Center for Women's Health. Please refer to the Ultrasound page on this web site for further information on these studies.

NOTE: Women scheduled for an ultrasound in the women's center will register in the women's center and not in Admissions.

Cyst Aspiration      top
Cysts are fluid collections in the breast that are very common and are almost always completely benign. A cyst is identified with ultrasound. Occasionally, when cysts look unusual on ultrasound or when they are painful, a doctor will recommend aspiration. The breast is numbed with local anesthetic, and a small needle (about the same diameter as that used to draw blood) is used to drain the fluid.

Preparation Prior to Procedure
Before your procedure, you will be asked to change into a gown and remove any metal you may be wearing near the chest area.

Length of Procedure
The actual procedure takes approximately one hour and is usually painless. Total time including registration, pre-assessment, and post-exam care is approximately one hour to one and one-half hours.

Post-exam Instructions
You may leave immediately following the procedure and may resume all normal activities.

Results
A typed report should arrive at your physician's office within three working days. (If your physician's office is not located near Laughlin Memorial Hospital, the report should arrive within seven days.)

Stereotactic Core Biopsy      top
This type of needle biopsy is used to sample an abnormality seen on a mammogram. Almost all abnormalities seen on mammography can be sampled this way. This procedure is a less invasive alternative to surgical biopsy. Studies have shown it to be equally accurate to surgery, with both being approximately ninety-eight percent accurate. Stereotactic biopsy is performed on an outpatient basis in the women's center. During the procedure the patient lies on her stomach on a special table with the affected breast placed through a hole in the center of the table. The doctor (radiologist) works from below the table to perform the biopsy. During the procedure, the breast is compressed in a way similar to that used to perform a mammogram. The area in question is identified with preliminary x-ray images and the breast is cleaned with antiseptic and numbed with local anesthetic. The entire procedure is performed through a very small nick in the skin. A needle is inserted and multiple samples of the abnormality are sent to the laboratory for analysis. During some stereotactic biopsies the radiologist is able to completely remove the suspicious area. The procedure is usually painless aside from slight discomfort as the anesthetic is given.

Preparation Prior to Exam
Patients should avoid aspirin, Advil, Motrin, Aleve, Ibuprofen and similar medications for five days prior to the procedure as these medications can cause bleeding.
Tylenol does not increase the risk of bleeding and is the preferred medication for pain during the five days preceding the procedure. Patients who are taking Coumadin or Heparin should speak with their physician prior to scheduling the procedure.

On the day of the procedure, the patient should wear a comfortable, two-piece outfit and a bra that will provide support for a cold pack after she leaves our facility (see Post-exam Instructions).

Length of Procedure
The biopsy takes about twenty to thirty minutes. Total time spent in the women's center is approximately one hour, including registration, pre-assessment and post-biopsy care.

Post-exam Instructions
Following the procedure, pressure and a cold pack are applied to the biopsy site to reduce bruising. A small dressing is applied to hold the cold pack in place, and the patient is released with written follow-up instructions. Patients may drive themselves home and may return to work if they desire. However, for twenty-four hours following the procedure the patient must avoid lifting objects more than ten pounds and avoid vigorous physical activity such as aerobics. The patient should keep the biopsy site clean and dry for twenty-four hours following the procedure, and avoid swimming or showering. A sponge bath or tub bath without wetting the biopsy site is acceptable.

Results
Tissue removed during the biopsy is sent to the laboratory for analysis. Results are usually available in two days. If the results are benign, we routinely check the area again in six months with mammography or ultrasound. If the results are positive or suspicious, surgery may be recommended to remove more tissue from the area.

Ultrasound Core Biopsy      top
This type of needle biopsy is used to evaluate solid abnormalities seen on ultrasound. It is a less invasive alternative to surgical biopsy for applicable patients whose abnormality has been found with ultrasound. Ultrasound core biopsy is performed on an outpatient basis in the women's center. The patient lies on her back, and the area is identified with ultrasound. The skin is cleansed to avoid infection and the breast is numbed with local anesthetic. The doctor (radiologist) places a needle into the breast and removes several samples of the abnormality. The procedure is usually painless aside from slight discomfort as the anesthetic is given.

Preparation Prior to Procedure
Patients should avoid aspirin, Advil, Motrin, Aleve, Ibuprofen and similar medications for five days prior to the procedure, as these medications can cause bleeding. Tylenol does not increase the chance of bleeding and is the preferred pain medication for the five days preceding the procedure. Any patient taking Coumadin or Heparin should speak with their physician prior to scheduling the procedure.

On the day of the procedure, the patient should wear a comfortable, two-piece outfit, and a bra that can provide support for a cold pack after leaving our facility.

Length of Procedure
The biopsy usually takes one hour, but we usually allow one and one-half hours total time for the patient to spend in the women's center to allow time for registration, pre-assessment and post-biopsy care.

Post-exam Instructions
After the procedure, pressure and a cold pack are applied to the biopsy site to reduce bruising. A small bandage is applied and the patient is released with a secured cold pack and written follow-up instructions. The patient may drive home and may return to work if she desires. For twenty-four hours following the procedure patients must avoid lifting objects that weigh over ten pounds and avoid vigorous physical activity such as aerobics. The patient should keep the biopsy site clean and dry for twenty-four hours, and avoid swimming or showering. A tub bath or sponge bath is fine as long as the biopsy site is kept dry.

Results
The biopsy samples are sent to the laboratory for analysis. Results are usually available in two days. If results are benign, we routinely check the area again in six months with a mammogram or ultrasound. If results are positive or suspicious, surgery may be required to remove more tissue from the area.

Ductogram (Galactogram)      top
This procedure is used to evaluate certain types of nipple discharge. The breast is cleaned to avoid infection, and the duct producing the discharge is identified. A very tiny tube (not a needle) is placed into the duct and a small amount of contrast is injected into the duct. Mammogram images are then taken. This allows abnormalities inside the duct to be viewed.

Preparations Prior to Procedure
On the day of the procedure, the patient should wear a comfortable, two-piece outfit.

Length of Procedure
The procedure usually takes from one-half hour to one hour. Allow one hour to one and one-half hours total time for registration, pre-assessment and post-exam care.

Post-exam Instructions
The patient may drive herself home following the procedure and may resume all normal activities. Some bloody discharge may occur for a couple of days and may warrant wearing gauze inside your bra.

Results
A typed report should arrive at your physician's office on the next business day following your procedure.

Needle Localization      top
This procedure is performed prior to some breast surgeries. If a surgeon cannot feel the abnormality which is to be removed, the abnormality must be identified prior to surgery. The patient reports to the Same Day Surgery Department where she changes into a gown and has an I.V. started. The patient is then taken to the women's center for the localization. The needle localization may be performed either under ultrasound guidance or mammographic guidance, depending on which type of imaging best shows the abnormality. The breast is cleaned with antiseptic and is anesthetized with local anesthetic. A small needle is placed into the breast in the area of abnormality. After the radiologist is certain that the needle is in exactly the right position, a thin wire is placed through the needle and the needle is removed. All that is left in the breast is a thin wire marking the area of abnormality. Mammographic pictures are taken and sent with the patient to the Same Day Surgery Department. There is usually only slight discomfort, if any, during this procedure.

Preparation Prior to Procedure
Your surgeon will provide you with all necessary instructions.

Length of Procedure
Averages 30 minutes.

Post-exam Instructions
Your surgeon will provide you with all necessary instructions.

If you think you may be pregnant, please inform your physician or the technologist before any of the above procedures.

If you have a known contrast allergy, please contact your physician or the imaging location where you are having your exam as soon as possible.

If anytime after your exam you need to borrow your films, please call the radiology department at (423) 787-5100 or e-mail radiology@lmhcare.org at least 24 hours in advance, and your films will be ready for you to pick up.