Division of Breast Imaging
The Division of Breast Imaging at the University of Southern California is dedicated to providing the highest quality patient care using state-of-the-art technology in a compassionate environment. The division is composed of fellowship-trained faculty who are experts in all areas of breast imaging, including 2D and 3D mammography, contrast-enhanced spectral mammography, breast ultrasound, breast MRI, and interventional procedures, including ultrasound-guided, stereotactic-guided, and MRI-guided breast biopsies. In addition to providing outstanding patient care, our faculty are actively involved in numerous national and local research projects and are dedicated to teaching residents and fellows in breast imaging.
Our institution sees a high volume of patients being referred for evaluation and management of breast cancer. Between the Lee Breast Center at Norris Healthcare Center 3, Verdugo Hills Hospital Breast Healthcare Center, and Los Angeles General Medical Center, we see approximately 24,000 patients for routine screening mammograms and perform approximately 3,550 breast biopsies annually.
Lee Breast Center at Norris Healthcare Center 3 (HC3)
Norris Healthcare Center 3, which opened in March 2018, is a world-class specialty care facility located at Keck Medicine of USC on the USC Health Sciences Campus. The entire third floor of the building is devoted to Women’s specialty care. The Lee Breast Center was relocated to this building in 2018 and occupies over half of the third floor. The Breast Center hosts state of the art equipment including three dedicated digital breast tomosynthesis units, two ultrasound machines, and an upright tomosynthesis/stereotactic biopsy device. The radiology faculty at the Breast Center work closely with the breast surgeons and oncologists to provide comprehensive services across all aspects of breast care from pre-evaluation to post-surgery, emphasizing screening, diagnosis, surgical planning, and treatment.
USC-Verdugo Hills Hospital (VHH) Breast Healthcare Center
Acquired by Keck Medicine of USC in 2013 as a satellite community hospital, USC Verdugo Hills Hospital has served the cities of Glendale and La Canada, Flintridge for over 40 years. Keck physicians, as well as experts from the community, join together and provide exceptional comprehensive care in multiple specialties. The USC-VHH Breast Healthcare Center is part of the VHH facility and is located on the first floor of the outpatient building. The equipment includes a state-of-the-art digital breast tomosynthesis mammography unit, ultrasound machine, and tomosynthesis biopsy unit. Each patient receives comprehensive care and medical expertise with a personal touch.
Los Angeles General Medical Center Breast Imaging
In 2008, the Los Angeles General Medical Center completed modernization and expansion of its 1.5 million sq. feet replacement facility, which boasts state-of-the-art equipment and design features. At the heart of the new hospital is the five story Diagnostic and Treatment (D&T) Building, which contains several departments, including radiology. The breast imaging section is located on the third floor of the D&T building. The breast imaging equipment consists of four dedicated digital mammography units, which are in the process of being upgraded to state-of-the-art digital breast tomosynthesis units, four dedicated breast ultrasound machines, a prone digital stereotactic biopsy table, and multiple needle biopsy devices. Our close working relationship with the departments of surgery, pathology, radiation oncology, and medical oncology markedly increases our knowledge of breast disease from many perspectives. A weekly multidisciplinary conference is held to discuss treatment plans for newly diagnosed breast cancer patients. This comprehensive approach provides the patient with the latest clinical expertise and leads to a treatment plan unique to each patient.
Los Angeles General Medical Center is affiliated with local Comprehensive Health Centers (Royal, Hudson, El Monte) where screening mammograms are performed and interpreted by our breast imagers. Patients that need additional work-up and biopsies are seen at our Los Angeles General Medical Center Breast Center.
In addition to 2D and 3D mammography and breast ultrasound, our division specializes in breast MRI. Breast MRI is a highly sensitive tool in evaluating for breast cancer, with a high specificity. There are many indications for breast MRI, including screening women who have an elevated lifetime risk of breast cancer, assessing the extent of disease in women newly diagnosed with breast cancer, and evaluating response to treatment. Most breast MRIs involve the administration of intravenous contrast called gadolinium in order to asses for breast cancer. A breast MRI can be obtained to evaluate the integrity of breast implants, in which case contrast is not required. The exam typically takes 15-30 minutes to perform, with the patient lying on her stomach and her breasts placed into the breast coils. For suspicious lesions detected on MRI for which there is no mammographic or sonographic correlate, we offer minimally invasive MRI-guided breast core needle biopsies.
An emerging diagnostic tool in our fight against breast cancer is contrast-enhanced spectral mammography (CESM). CESM involves injecting an intravenous iodine-based contrast agent prior to obtaining the mammographic images. Both low-energy and high-energy x-rays are used to visualize enhancing lesions in the breast. Indications for CESM are similar to breast MRI, including evaluating extent of disease in patients newly diagnosed with breast cancer. CESM is particularly useful in patients with contraindications to MRI, such as women with pacemakers or women with claustrophobia who cannot obtain an MRI. CESM has been shown to have a high sensitivity in detecting breast cancer, similar to breast MRI, with a high specificity.
Our division is investigating the use of contrast-enhanced ultrasound (CEUS) in the diagnosis of breast cancer. Unlike standard ultrasound, CEUS involves the intravenous injection of small microspheres while imaging in real time to assess the qualitative and quantitative enhancement characteristics of a breast lesion. CEUS may be a valuable tool in assessing whether a lesion is benign versus malignant based on its enhancement characteristics, with the ultimate goal of reducing the number of biopsies performed for benign lesions.
For women undergoing a lumpectomy or surgical excision, we offer the innovative SAVI SCOUT surgical guidance system. In contrast to preoperative wire localizations, which are typically done on the day of surgery, with the SAVI SCOUT surgical guidance system, a small reflector the size of a grain of rice is placed in the breast lesion at any time prior to surgery. This procedure reduces the patient anxiety and wait time on the day of surgery. The reflector is then detected by the surgeon at the time of surgery using a radar localization probe, allowing the surgeon to better plan the surgical incision and potentially lead to better cosmetic outcomes.