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Screening digital breast tomosynthesis, bilateral (List separately in addition to code for primary procedure)

CPT4 code

Name of the Procedure:

Screening Digital Breast Tomosynthesis, Bilateral (DBT)

Summary

Digital Breast Tomosynthesis (DBT) is an advanced form of mammography that uses low-dose X-rays to create a three-dimensional image of the breast. This procedure is performed bilaterally, meaning both breasts are scanned separately. It is commonly used in conjunction with traditional 2D mammograms for more accurate breast cancer screening.

Purpose

Digital Breast Tomosynthesis addresses the need for detailed imaging of breast tissues to improve the detection of breast cancer. By creating a 3D image, DBT helps to:

  • Identify small tumors not visible on 2D mammograms.
  • Reduce false positives and the need for additional testing.
  • Improve the accuracy of breast cancer diagnosis.

Indications

  • Routine breast cancer screening, especially for women with dense breast tissue.
  • Follow-up on abnormal findings from a traditional mammogram.
  • Women with a family history of breast cancer or other risk factors.

Preparation

  • Wear comfortable clothing; a two-piece outfit is preferable.
  • Avoid applying deodorant, powders, or lotions on the day of the exam to prevent artifacts on the images.
  • Discuss any breast symptoms or issues with the radiologist.
  • Provide a history of prior breast surgeries or mammograms.

Procedure Description

  1. The patient undresses from the waist up and is provided a gown.
  2. Each breast is positioned and compressed on the mammography unit by the technologist.
  3. The DBT machine takes multiple low-dose X-ray images from different angles.
  4. The images are reconstructed into a 3D model of the breast.
  5. The process is repeated for the other breast.
  6. Traditional 2D mammography images may also be taken during the same session.

Duration

The entire procedure typically takes about 30 minutes.

Setting

Digital Breast Tomosynthesis is performed in a radiology department or a specialized breast imaging center.

Personnel

The procedure involves a radiologic technologist who operates the imaging machine and a radiologist who interprets the images.

Risks and Complications

  • Exposure to low-dose radiation (similar to standard mammograms).
  • False positives or false negatives.
  • Mild discomfort or pain from breast compression, which is brief.

Benefits

  • Higher accuracy in detecting breast abnormalities and cancer.
  • Reduced need for additional testing and biopsies.
  • Better imaging for women with dense breast tissue.

Recovery

  • No recovery time is needed; patients can resume normal activities immediately.
  • Follow-up instructions will be provided by the healthcare team if any abnormalities are found.

Alternatives

  • Traditional 2D mammography: Less detailed but also effective for screening.
  • Breast MRI: More detailed but expensive and used for high-risk patients.
  • Breast ultrasound: Used to investigate specific areas of concern.

Patient Experience

  • Temporary discomfort from compression during imaging.
  • Usually, there is no pain following the procedure.
  • The technologist can provide comfort measures like padding or adjusting the compression level.

Screening Digital Breast Tomosynthesis, Bilateral, is a crucial tool for early breast cancer detection, offering substantial benefits in terms of accuracy and early diagnosis, particularly for women with dense breast tissue.

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