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Screening & Diagnosis

Screening for breast cancer before symptoms develop can help detect and effectively treat cancer early. A woman should talk with her health care provider about her personal risk of getting breast cancer and know when to start and how often to be checked for the disease. If a woman has a breast change, her health care provider will determine whether it is due to breast cancer or some other cause. The physician may perform a physical exam and ask about personal and family medical history, and she or he may recommend a breast mammogram or other imaging procedure to evaluate the tissues inside the breast. After testing, the physician will decide if any further tests or treatment are necessary, which may include a biopsy to examine a suspicious area for cancer cells.

Mount Sinai offers the following comprehensive breast cancer screening and diagnostic services:

Mammograms

A mammogram is an X-ray image of the breast that is used to screen for and detect breast cancer and plays a vital role in early breast cancer detection, leading to the well-being and longevity of patients. How often a woman should have a mammogram depends on age and her individual risk of breast cancer. Screening mammograms can help reduce the number of deaths from breast cancer among women ages 40 to 74, especially for those over age 50.

To detect breast cancer early, the American College of Radiology (ACR) recommends:

  • Women should start getting annual mammograms at age 40
  • Women who are at higher than average risk of breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them

Mammograms are the best tool physicians have to detect breast cancer early; however, it is good to keep in mind that:

  • A mammogram may miss some cancers that are present (This is called a “false negative”)
  • A mammogram may show things that turn out not to be cancer (This is called a “false positive”)

Some fast-growing tumors may already have spread to other parts of the body before a mammogram detects them. Mammograms (as well as dental X-rays and other routine X-rays) use very small doses of radiation. Although the benefits nearly always outweigh the risks, repeated exposure to X-rays could be harmful.

We offer:

Digital Screening Mammogram

Screening mammography is used to detect breast changes in women who have no signs or symptoms or observable breast abnormalities. The goal of screening is to detect cancer before clinical signs are noticeable. Screening mammograms can often show a breast lump before it can be felt. They also can show a cluster of very tiny specks of calcium called micro-calcifications. Lumps or specks can be signs of cancer. If the breast imaging physician sees an abnormal area on the mammogram, they may need more pictures taken, or possibly a biopsy, which is the only way to confirm if cancer is present. A screening mammogram consists of two mammogram images of each breast, taken from different angles. Women with implants require four images to be taken of each breast. Screening mammograms are analyzed by computer aided detection (CAD) software, which allows the radiologist to interpret the images efficiently and accurately.

What to Expect

For a screening mammogram, the patient will be asked to remove their clothing from the waist up and change into a gown. To make this easier, it is best to wear a two-piece outfit on the day of the mammogram. The patient stands in front of an X-ray platform. The technologist will raise or lower the platform to match the patient’s height before placing the breast on a plate attached to the platform. The technologist then helps position the patient’s head, arms, and torso to allow an unobstructed view of the breast and the most comfortable position possible. The breast is gradually pressed against the opposite plate and pressure is applied for a few seconds to spread out the breast tissue in between the two plates. The breast must be compressed to even out its thickness, permit the X-rays to penetrate the breast tissue properly, and reduce radiation exposure. The technologist will ask the patient to stand still and hold their breath while they take the image. The pressure may be uncomfortable or slightly painful, but the technologist can assist the patient in feeling more comfortable. The procedure usually takes less than 15 minutes. Afterward, the patient may dress and resume normal activity.

How to Prepare

A mammogram should be scheduled for a time when the breasts are least likely to be tender. During the menstrual cycle, breasts are most likely to be tender the week before and the week during menstruation. Deodorants, antiperspirants, powders, lotions, creams, or perfumes under the arms or on the breasts should be avoided on the day of the mammogram. Metallic particles in these products could be visible on the mammogram and decrease the accuracy of the reading. Additionally, the patient should bring all previous breast images taken at another facility so that they can be compared to the new images.

Results

A specially trained radiologist will interpret the images and look for evidence of cancer or noncancerous (benign) conditions that may require further testing, follow-up, or treatment. If the radiologist notes areas of concern on a mammogram, further testing may be required, such as diagnostic mammograms, ultrasound, or MRI of the breast. A follow-up biopsy procedure, such as an ultrasound guided core biopsy or a stereotactic biopsy, is also sometimes necessary. Your doctor will receive the results immediately after the radiologist finalizes the report, within 24 hours. Results can also be reviewed on MyChart approximately 24 hours after the report is finalized. The patient will also receive a letter explaining the results within seven days.

Digital Diagnostic Mammography

Diagnostic mammograms involve X-ray pictures of the breast to get clearer, more detailed pictures of any area that looks abnormal on a screening mammogram. They also are used to help investigate suspicious breast changes, such as a lump, pain, nipple thickening, nipple discharge, or an unusual skin appearance or change in breast size or shape. A diagnostic mammogram is different from a screening mammogram in that it may focus on a specific area of the breast and may involve special techniques and include additional images of the breast, such as magnification and spot compression views.

What to Expect:

For a diagnostic mammogram, the patient will be asked to remove their clothing from the waist up and change into a gown. To make this easier, it is best to wear a two-piece outfit on the day of the mammogram. The patient stands in front of an X-ray platform. The technologist will raise or lower the platform to match the patient’s height before placing the breast on a plate attached to the platform. The technologist then helps position the patient’s head, arms, and torso to allow an unobstructed view of the breast and the most comfortable position possible. The breast is gradually pressed against the opposite plate and pressure is applied for a few seconds to spread out the breast tissue in between the two plates. The breast must be compressed to even out its thickness, permit the X-rays to penetrate the breast tissue properly and reduce radiation exposure. The technologist will ask the patient to stand still and hold their breath while they take the image. The pressure may be uncomfortable or slightly painful, but the technologist can assist the patient in feeling more comfortable. The procedure usually takes less than 15 minutes. Afterward, the patient will be asked to have a seat in our waiting room while the radiologist views the images and determines if they need further X-rays or ultrasound images to gain more information about the breast tissue. If follow-up images are necessary, the technologist will bring the patient to the proper exam room for the follow-up images. The radiologist will then evaluate the follow-up images and/or a member of our team will speak to the patient about the results before the patient is discharged. This entire process usually takes two to three hours.

How to Prepare

A mammogram should be scheduled for a time when the breasts are least likely to be tender. During the menstrual cycle, breasts are most likely to be tender the week before and the week during menstruation. Deodorants, antiperspirants, powders, lotions, creams, or perfumes under the arms or on the breasts should be avoided on the day of the mammogram. Metallic particles in these products could be visible on the mammogram and decrease the accuracy of the reading. Additionally, the patient should bring all previous breast images taken at another facility so that they can be compared to the new images.

Results

A specially trained radiologist will interpret the images and perform a complete analysis of the breast. If the radiologist notes areas of concern on the mammogram, further testing may be required, such as an ultrasound or MRI of the breast. A follow-up biopsy procedure, such as an ultrasound guided core biopsy or a stereotactic biopsy, is also sometimes necessary. A member of our team will talk with the patient about the results and will send a written report of the findings to the patient’s referring physician or primary care physician within 24 hours. Results can also be reviewed on MyChart approximately 24 hours after the report is finalized. The patient will also receive a letter explaining the results within seven days.

Advanced 3D Mammography (Tomosynthesis)

Tomosynthesis advanced 3D mammography can result in:

  • Better visualization of abnormalities within the breast
  • Early detection of breast cancer
  • Fewer false positives and unnecessary callbacks

Breast Ultrasound

A breast ultrasound is usually done for women with dense breasts or as a follow up to a mammogram that reveals an area of concern and needs to be imaged in further detail. An ultrasound (ultrasonography) uses high-frequency sound waves instead of X-rays, so the breast is not exposed to radiation. The specially trained radiologist views these images, which can often show whether a lump is a benign, fluid-filled cyst or a solid mass, which may or may not be cancer. Ultrasound is safe for women who are pregnant or who have breast implants.

What to Expect

For a breast ultrasound, the patient will be asked to remove their clothing from the waist up and to wear a gown that is open in the front. The patient will lie on their back on an exam table and the ultrasound technologist will use pillows to help make the patient comfortable and properly position them for the exam. The ultrasound room will be dimly lit so the technologist can clearly see images of the breast on the monitor. The technologist may ask the patient to raise either arm above the head and will apply a clear gel on the skin to assist in gliding the transducer smoothly over the skin. While pressing firmly, the technologist will guide the transducer back and forth over the areas of concern and watch the images created on the monitor. Once the proper images have been acquired, the technologist will wipe off the clear gel and the exam will be complete. The exam is virtually painless and may take 10 to 30 minutes to complete, depending on how many views are necessary. The patient may need to wait while a specially trained radiologist looks at the ultrasound to make sure that no additional images are necessary.

How to Prepare

No specific preparation is necessary for a breast ultrasound. However, the patient should bring all previous breast images taken at another facility so that they can be compared to the new images.

Results

A specially trained radiologist will review the ultrasound images and determine what additional diagnostic steps are necessary. A member of our team will speak with the patient about the results and will send a diagnostic report of the findings to the patient’s referring physician or primary care physician within 24 hours. Results can also be reviewed on MyChart approximately 24 hours after the report is finalized. The patient will also receive a letter explaining the results within seven days.

Breast MRI

Magnetic resonance imaging (MRI) is a powerful magnet linked to a computer used to make detailed images of tissue inside the body. Often used along with a mammogram and/or ultrasound, a breast MRI detects breast cancer and other abnormalities in the breast by generating detailed images of breast anatomy. For some women who have a very high risk of breast cancer, a breast MRI may be used as a screening tool for detecting breast cancer. An MRI can also be used to detect ruptures and other defects in breast implants.

What to Expect

For a breast MRI, the patient will be asked to change into a gown and to remove jewelry, hairpins, eyeglasses, watches, wigs, dentures, hearing aids, and underwire bras, as these items are a safety concern while around magnetic equipment. The patient lies face down on a padded table where the breasts will fit into a hollow depression in the table that aids the machine in detecting magnetic signals. The entire table slides into the opening of the machine as images of the breast are acquired. A contrast agent (dye) may be injected through an intravenous (IV) line in the arm to enhance the appearance of tissues or blood vessels on the images. During the MRI scan, the internal part of the magnet produces repetitive tapping and other noises. Earplugs may be provided to help block the noise. The patient will be instructed to breathe normally but lie as still as possible, as movement can blur the resulting images. A technologist monitors the patient closely from another room and is available for immediate assistance, if needed.

How to Prepare

If the patient still has a menstrual cycle, the MRI is ideally scheduled between days seven and 14 of the cycle. The patient must inform the facility when they are in their cycle so that optimal timing for the breast MRI can be arranged. Before an MRI exam, the patient may eat normally and continue to take usual medications, unless otherwise instructed. If the patient is worried about feeling claustrophobic during the scan, they should talk to their referring physician beforehand, as they may be able to prescribe medication to help with anxiety. Additionally, the patient should bring all previous breast images taken at another facility, so that they can be compared to the new images.

Results

Your doctor will receive the results immediately after the radiologist finalizes the report, within 24 hours. Results can also be reviewed on MyChart approximately 24 hours after the report is final. The patient will also receive a letter explaining the results within seven days.

Biopsy

Often, fluid or tissue must be removed from the breast to help the physician learn whether cancer is present. This is called a biopsy. Imaging devices are used to see the area from which tissue samples are obtained. Such procedures include ultrasound-guided aspiration or biopsy, stereotactic biopsy, or MRI-guided biopsy. Physicians can remove tissue from the breast in different ways:

Ultrasound Guided Core Biopsy

A breast biopsy is the best way to evaluate a suspicious area in the breast to determine if it is breast cancer. A breast biopsy is performed to remove a small sample of breast tissue that will be sent to the laboratory for testing. Through laboratory testing, physicians can diagnose and identify abnormalities in the cells that make up breast lumps or other unusual breast changes identified through mammography and other studies. Ultrasound-guided needle core biopsy uses high-frequency sound waves to pinpoint the location of suspicious areas within the breast and to provide guidance to the area to be biopsied.

What to Expect

For this procedure, the patient will be asked to change into a gown. The medical team will thoroughly explain the procedure and answer all questions. During the procedure, the patient lies on their back on an ultrasound table. The radiologist will then numb the breast tissue with a local anesthetic using a very small needle. The patient may feel a slight sting in the breast as the anesthetic is injected. A gel is applied to the skin and a small, handheld instrument called a transducer will be passed back and forth over the area of the breast that is of interest. Using ultrasound guidance, the radiologist will locate the mass within the breast, make a small incision in the breast, and insert either a needle or a vacuum-powered probe to remove several samples of tissue. The radiologist will take special care to make sure the patient is as comfortable as possible during the procedure. The samples collected will then be sent to a laboratory for analysis. The procedure can take approximately 30 minutes to one hour.

How to Prepare

Before the procedure, the patient must inform the physician of any medications they are taking or of any allergies. The patient cannot take any analgesics, vitamin E, or blood thinners for seven days prior to the procedure. Additionally, the patient must provide all previous breast images taken at other facilities at least 72 hours prior to the procedure, so the radiologist can properly prepare for the procedure.

Results

After the biopsy, the breast tissue is sent to a laboratory, where a pathologist will examine the tissue and create a report that includes details about the size, color, and consistency of the tissues sampled, location of the biopsy site, and whether cancer cells were present. The pathology report is then sent to the radiologist within seven days. The radiologist or our patient navigator will share the results with the patient. The results can also be reviewed on MyChart approximately 24 hours after the report is final. Should further care be necessary, the patient’s referring physician will work together with the patient in developing a treatment plan that best suits the patient’s needs.

Stereotactic Guided Core Biopsy

Imaging studies can identify breast abnormalities, but a tissue sample (biopsy) is then needed to determine the nature of the abnormality. Stereotactic biopsy is a minimally invasive alternative to open or surgical biopsy. Because the procedure is minimally invasive, patients feel little discomfort and no stitches are required, resulting in less scarring than from surgical biopsies. During the outpatient procedure, a thin, hollow needle is inserted into the abnormal tissue through a small nick in the skin. X-rays are taken and analyzed by a computer. Computer imaging is then used to guide the radiologist to the precise location where small samples of tissue will be removed.

What to Expect

For this procedure, the patient will be asked to change into a gown. The medical team will thoroughly explain the procedure and answer all questions. During the procedure, the patient will lie face down on an imaging table or be seated upright in a special chair. The radiologist will then numb the breast tissue with a local anesthetic using a very small needle. The patient may feel a slight sting in the breast as the anesthetic is injected. Using X-ray guidance, the radiologist will locate the mass within the breast and make a small incision in the breast, and will insert a vacuum-powered probe to remove several samples of tissue. The physician will take special care to make sure the patient is as comfortable as possible during the procedure. The samples collected will then be sent to a laboratory for analysis. The procedure can take approximately one hour.

How to Prepare

Before the procedure, the patient must inform the physician of any medications they are taking or of any allergies. The patient cannot take any analgesics, vitamin E, or blood thinners for seven days prior to the procedure. Additionally, the patient must provide all previous breast images taken at other facilities at least 72 hours prior to the procedure, so the radiologist can properly prepare for the procedure.

Results

After the biopsy, the breast tissue is sent to a laboratory where a pathologist will examine the tissue and create a report that includes details about the size, color, and consistency of the tissues sampled, location of the biopsy site, and whether cancer cells were present. The pathology report is then sent to the radiologist within seven days. The radiologist or our patient navigator will share the results with the patient. The results can also be reviewed on MyChart approximately 24 hours after the report is final. Should further care be necessary, the patient’s referring physician will work together with the patient in developing a treatment plan that best suits the patient’s needs.

Fine-needle Aspiration Cytology

Fine-needle aspiration is a method of collecting cells from the breast to look for signs of cancer, infection, or other conditions. The radiologist will numb the breast tissue with a local anesthetic using a very small needle. The patient may feel a slight sting in the breast as the anesthetic is injected. The physician then uses a thin needle to remove fluid and/or cells from a breast lump. If the fluid appears to contain cells, it goes to a laboratory where a pathologist uses a microscope to check for cancer cells. If the fluid is clear, it may not need to be checked by a lab. Fine-needle aspiration may be the only test needed to find out whether a lump is cancerous. In some cases, another procedure, such as a core needle biopsy or an open biopsy, may be necessary.

What to Expect

For this procedure, the patient will be asked to change into a gown. The medical team will thoroughly explain the procedure and answer all questions. During the procedure, the radiologist will first sterilize the skin area with rubbing alcohol or iodine and will inject local anesthetic that will numb the area of the breast where the needle is to be inserted for the aspiration. The physician will take special care to make sure the patient is as comfortable as possible during the procedure. They will insert a thin needle into the area of interest and use a syringe to remove the tissue or fluid, which may be sent to a laboratory for further analysis. The process takes between a few seconds and a few minutes. The area of the aspiration may be sore for a couple of days and develop a bruise. The patient should be able to return to work the same day or the next day after the procedure.

How to Prepare

Before the procedure, the patient must inform the physician of any medications they are taking or of any allergies to lidocaine or similar local anesthetics. The patient cannot take any analgesics, vitamin E, or blood thinners for seven days prior to the procedure. Additionally, the patient must provide all previous breast images taken at other facilities at least 72 hours prior to the procedure, so the radiologist can properly prepare for the procedure.

Results

The removed cells are sent to a laboratory where a pathologist will examine them. The cytology report is then sent to the radiologist within seven days. The radiologist or our patient navigator will share the results with the patient. The results can also be reviewed on MyChart approximately 24 hours after the report is final. If the cells removed are not cancerous but the lump feels questionable or appears suspicious on a mammogram or ultrasound, the physician may recommend further testing with a large core needle biopsy or surgical biopsy.

Surgical Biopsy

During a surgical biopsy, the surgeon removes a sample of a lump or abnormal area (incisional biopsy) or the entire lump or abnormal area (excisional biopsy). A pathologist examines the tissue for cancer cells. If cancer cells are found, the pathologist can tell what kind of cancer it is. The most common type of breast cancer is ductal carcinoma, which begins in the lining of the ducts. Another type, called lobular carcinoma, begins in the lobules.

Breast Wire Needle Localization

The purpose of breast needle localization is to help identify the precise location of abnormal breast tissue for surgical excision (lumpectomy). This is done by placing a small wire or a radiofrequency device at the point of the abnormality.  The procedure can be performed using mammographic guidance or ultrasound guidance.

What to Expect

For the localization procedure, the patient will be asked to remove their clothing from the waist up and put on a gown. For mammographic localization, the technologist will help seat the patient upright in a special chair. The breast will be compressed and a mammogram (image of the breast) is taken. If the localization is to be performed under ultrasound guidance, the patient will lie on her back on an ultrasound table. A gel will be applied to the skin and a small, handheld instrument called a transducer will be passed back and forth over the area of the breast that is of interest. This image allows the radiologist to locate the area of interest. The radiologist will then numb the breast tissue with a local anesthetic using a very small needle. The patient may feel a slight sting in the breast as the anesthetic is injected. The radiologists will take special care to make sure the patient is as comfortable as possible during the procedure. The physician will then insert another needle that will be used to mark the exact area of concern. A second mammogram or ultrasound will be taken to check the position of the second needle tip. When the tip is in the correct position, the needle will then be removed and replaced with a wire or radiofrequency device.

How to Prepare

The patient must follow the instructions given by the surgeon’s office. Additionally, the patient must provide all previous breast images taken at other facilities at least 72 hours prior to the procedure, so the radiologist can properly prepare for the procedure.

Results

The surgeon will discuss the results with the patient.

Cyst Aspiration

Breast cysts are fluid-filled sacs within the breast that are often described as round or oval lumps with distinct edges. Breast cysts usually feel like soft grapes or water-filled balloons, but sometimes they feel firm. A woman can have one or many breast cysts. Breast cysts are common in women in their 30s and 40s and don’t require treatment unless they are large, painful, or otherwise uncomfortable, or have what is called a “complicated” appearance, or are related to a finding on a mammogram. In that case, draining the fluid from a breast cyst through cyst aspiration can ease symptoms and/or provide diagnostic information.

What to Expect

For this procedure, the patient will be asked to change into a gown. The medical team will thoroughly explain the procedure and answer all questions. During the procedure, the radiologist will first sterilize the skin area with rubbing alcohol or iodine and will then inject local anesthetic to numb the area of the breast where the needle is to be inserted for the aspiration. The physician will take special care to make sure the patient is as comfortable as possible during the procedure. They will then insert a thin needle into the area of interest and use a syringe to remove the fluid from the cyst. Two mammograms (images of the breast) may be taken to ensure the cyst has been completely drained. The process takes between a few seconds and a few minutes. The area of the aspiration may be sore for a couple of days and may experience slight bruising. The patient should be able to return to work the same day or the next day after the procedure.

How to Prepare

Before the procedure, the patient must inform the physician of any medications they are taking or of any allergies to lidocaine or similar local anesthetics. The patient cannot take any analgesics, vitamin E, or blood thinners for seven days prior to the procedure. Additionally, the patient must provide all previous breast images taken at other facilities at least 72 hours prior to the procedure, so the radiologist can properly prepare for the procedure.

Results

The physician will discuss with the patient any necessary steps to take after the exam. Unless there appears to be blood in the fluid aspirated, there is generally no need for further testing or treatment. If the fluid is bloody, laboratory testing may be necessary. A procedure report of the findings will be sent to the patient’s referring physician or primary care physician within 24 hours.  Results can also be reviewed on MyChart approximately 24 hours after the report is finalized.

Galactogram

Galactogram uses mammography and an injection of contrast material to create pictures of the inside of the breast’s milk ducts. It is most commonly used when a woman has experienced bloody or clear discharge from the nipple but has an otherwise normal mammogram. It’s important not to squeeze the nipple prior to the exam as there may only be a small amount of fluid and it is necessary to see where it is coming from to perform the exam.

What to Expect

For this procedure, the patient will be asked to change into a gown. The medical team will thoroughly explain the procedure and answer all questions. The patient lies down on an exam table. The radiologist will first sterilize the skin area with rubbing alcohol or iodine. The physician applies manual pressure to the breast to elicit the fluid discharge from the duct. Once the discharge duct is identified, the physician inserts a tiny hollow catheter into the duct of interest and injects a contrast dye. Our physician will take special care to make sure the patient is as comfortable as possible during the procedure. The patient will then be taken to a mammography machine for images of the breast with the contrast dye in place. When the exam is complete, the catheter is removed. Gauze is typically placed over the nipple afterwards, as the patient will have a small amount of discharge from the contrast. The procedure usually takes about an hour.

How to Prepare

Before the procedure, the patient must inform the physician of any medications they are taking or of any allergies to lidocaine or similar local anesthetics. The patient cannot take any analgesics, vitamin E, or blood thinners for seven days prior to the procedure. Additionally, the patient must provide all previous breast images taken at other facilities at least 72 hours prior to the procedure, so the radiologist can properly prepare for the procedure.

Results

The physician will then share the results with the patient and discuss further care. A procedure report of the findings will be sent to the patient’s referring physician or primary care physician within 24 hours. Results can also be reviewed on MyChart approximately 24 hours after the report is finalized.

Sentinel Node Injection

Sentinel node biopsy is most commonly used in evaluating the spread of breast cancer and melanoma because these are usually the first lymph nodes into which a tumor drains. Sentinel node biopsy involves injecting a tracer material near the tumor that helps the surgeon locate the sentinel nodes. Once the sentinel nodes are identified, they are usually surgically removed and analyzed in a laboratory.

What to Expect

A weak radioactive solution is injected into both sides of the areola to show how the lymphatic system absorbs the material and how it travels to the sentinel nodes. This injection will then be followed by breast surgery. In most cases, there are two or three sentinel nodes, and all are removed. The sentinel nodes are then sent to a pathologist to examine under a microscope for signs of cancer.

How to Prepare

The patient must follow the instructions given by the surgeon’s office.

Results

If the pathologist’s report does not show any sign of cancer, no further lymph node evaluation is needed, and the physician will use this information to help develop the patient’s cancer treatment plan, if further treatment is needed. If any of the sentinel nodes contain cancer, additional lymph node removal may be necessary to determine the extent of lymph node involvement and prevent the cancer from spreading further.

Breast Cancer Risk Counseling

DNA is the chemical database that carries instructions for functions of the body. Genetic testing can provide important information for diagnosing, treating, and preventing illness by examining DNA to reveal changes or alterations in genes that may cause illness or disease. Talking to a health care provider or a genetic counselor about what the results mean is an important first step in the process of genetic testing. Genetic testing has become more common for some cancers, including breast cancer. Positive and negative results are not always conclusive about whether a person will develop an illness or disease. However, results may help make choices related to family planning, careers, and insurance coverage.

What to Expect

For genetic testing, a blood or other tissue sample is collected and sent to a laboratory for analysis.

How to Prepare

Family medical history is a key component to genetic testing. Before talking to a health care provider or genetic counselor, gathering information on family history may help better understand the risk for certain illnesses or diseases. Results not only affect medical care, but may also affect the family, especially children. If testing for a genetic disorder that runs in the family, discussing this decision with the family is recommended beforehand. Not all health insurance providers pay for genetic testing, so it is important to verify coverage. In the United States, the federal Genetic Information Nondiscrimination Act (GINA) helps prevent health insurers or employers from discriminating based on test results.

Results

The laboratory performing the genetic testing will likely provide the results to the physician in writing so that they can discuss the results with their patient. The amount of time to receive results depends on the tests being completed.

Our Physicians

Kfir Ben-David, MD

Roni Jacobson Endowed Chairman of Surgery

Program Director, General Surgery Residency

  • Cancer
  • General Surgery
  • Surgical Oncology
  • Robotic Surgery
  • Bariatric
  • Gastroenterology

Mike Cusnir, MD

Chief, Division of Hematology & Oncology

Co-Director, Gastrointestinal Malignancies

Assistant Professor at the Columbia University Division of Hematology/Oncology at Mount Sinai Medical Center

  • Cancer
  • Oncology
  • Medical Oncology
  • Hematology/Oncology

Steven N. Hochwald, MD, MBA, FACS

Director of the Comprehensive Cancer Center

Chief of Surgical Oncology

Associate Director of the Mount Sinai-Columbia University affiliation at Mount Sinai Medical Center

  • Surgical Oncology
  • Cancer
  • Esophageal Cancer
  • Gastric Cancer
  • Pancreatic Cancer
  • Liver Cancer
  • Metastatic Cancer to Liver
  • Gastrointestinal and Endocrine Tumors and Associated Malignancy

Stuart S Kaplan, MD

Chief, Section of Breast Imaging, Breast Ultrasound and MRI, and Breast Interventional Procedures

  • Cancer
  • Oncology
  • Radiology
  • Breast Imaging

Nicolas Keith Kuritzky, MD

Chief, Division of Radiation Oncology

  • Cancer
  • Radiation Oncology
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Akshay Bhandari, MD

Co-Chief, Columbia University Division of Urology at Mount Sinai Medical Center

Director, Robotic Surgery

Assistant Professor at the Columbia University Division of Urology at Mount Sinai Medical Center

  • Urology
  • Cancer
  • Oncology
  • Robotic Surgery
  • Urologic Oncology
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