Tests for Women

Tests for women

Excisional Biopsy of the Breast

Fine-Needle Aspiration (FNA) of the breast

Mammogram

Stereotactic Biopsy of the Breast
                       (Breast Core Biopsy)

Wire Localization Biopsy of the Breast

Colposcopy and Cervical Biopsy

Endometrial Biopsy
Hysteroscopy

Pap smear
Human Papilloma Virus (HPV) Test

Pregnancy

Bone Density test 

Tests for Women

Tests for evaluating breast lumps:

 

Breast Ultrasound

What is the test?

In Ultrasound the sound waves are beamed into the body instead of radiation to produce snapshots or moving images of internal structures of your body. This imaging system works just like radar and sonar which were developed during World War II to detect airplanes, missiles, and submarines that were otherwise invisible. After coating your skin with a lubricant to reduce friction, a radiologist or ultrasound technician positions an ultrasound transducer. This transducer looks like a microphone. Technician places this transducer on your skin and may rub it back and forth to get the right view of your organ under detection. The transducer then supplies sound waves into your body and picks up the echoes of the sound waves that bounce off internal organs and tissue. A computer transforms these echoes into an image and displays on a monitor.

A breast ultrasound detects if a breast lump is due to a fluid-filled cyst or a solid mass, such as cancer.

Frequently asked questions:

What risks are there from the test?

There are no risks related to this test.

How long it is before the result of the test is known?

In case of abdominal ultrasound, the duration depends on whether a radiologist is able to read the image immediately. Generally a technician performs the test and is not able to provide any results instant 

Excisional Biopsy of the Breast

What is the test?

In an excisional biopsy of the breast, the surgeon makes an incision in the skin to remove all or part of the abnormal tissue to examine under a microscope. Unlike needle biopsies, a surgical biopsy leaves a noticeable wound on the breast and sometimes results in a noticeable change in the breast’s shape.

It’s a good idea to discuss the placement and length of the incision with your surgeon before the commencement of the surgical process. Also discuss with your surgeon about scarring and the possible changes to your breast shape and size after the scar heals, as well as the choice between local anesthesia and general anesthesia.

Frequently asked questions:

What risks are there from the test?

After a surgical breast biopsy, you’ll have a small scar in the shape of a line. There may be some changes in the shape of the breast related its size, and the amount of tissue removed and its location. You may feel some soreness and swelling near the surgery site for a few days. There are also some risks linked with anesthesia. But the risk of general anesthesia is lesser for breast surgery than for other forms of surgery as the anesthesia isn’t used for a long time and the surgery is little more than skin deep.

Should I do anything special after the test is over?

No. Medical staff observes you for a few hours after your surgery is over to make sure that you’re improving well without getting any adverse reactions to anesthesia.
Contact your doctor if you have a fever, strong pain at the incision site, or bleeding from the site of incision. You may also be asked for a follow-up visit in order to remove stitches and make sure you are getting better well.

How long it is before the result of the test is known?

You may get hold of a preliminary report from the pathologist when your surgery is over. A final report generally takes 3 to 4 days. 

Fine-Needle Aspiration (FNA) of the breast

What is the test?

A doctor can do fine needle aspiration in the chamber by inserting a thin needle into the area of concern in order to draw out (aspirate) either fluid from a cyst or a little amount of tissue from a solid mass. Cells collected from a mass, and sometimes fluid from a cyst, are then sent for microscopic assessment to make sure whether cancer is present. Fine needle aspiration is generally performed to drain a breast cyst that feels tender or sore. If the cyst is detected to be a simple cyst that looks clear in an ultrasound and isn\’t tender, it needs no aspiration.

Frequently asked questions:

What risks are there from the test?

You might experience little bruising in the area of the breast that was sampled and also some mild soreness later.

Must I do anything special after the test is over?

No.

How long it is before the result of the test is known?

Your doctor should prepare a final report within a few days. If the cells which are removed during aspiration are not cancerous but the lump appears suspicious on a mammogram or ultrasound, the doctor may advise further testing with a large core needle biopsy or surgical biopsy. 

Mammogram

What is the test?

A mammogram is an x-ray of the breast useful to detect breast cancers that are too small to be felt or to help verify if a lump felt in the breast is due to cancer or something else. Mammography successfully detects 85%-90% of breast cancers, including small cancers measuring less than a quarter-inch. Normally, a lump can\’t be felt until grows at least twice that size. Most of the physicians believe that women should have a mammogram every year starting at age 40; and it should be done annually after age 50.

Frequently asked questions:

What risks are there from the test?

Essentially no risk is related to this procedure as mammography is performed by allowing very low levels of radiation. There is actually no harm done to the breast when it is pressed flat to get the images.

Must I do anything special after the test is over?

No.

How long does it take before the result of the test is known?

Some mammogram centers will provide you a preliminary report within 10 or 20 minutes. But most of the centers take a few days to issue you a final report. If the mammogram detects the presence of a mass or cyst, your doctor must recommend additional tests including a breast ultrasound, to become more sure. 

Stereotactic Biopsy of the Breast (Breast Core Biopsy)

What is the test?

This method requires a larger needle than the one used to perform a fine needle aspiration, to increase the amount of tissue that can be removed for microscopic evaluation. Large core needle biopsy is often done using either x-rays or ultrasound to show the location of the tip of the needle. Since the early 1990s, large core needle biopsy has been preferred to evaluate abnormalities detectable on a mammogram but cannot easily be felt by hand. In the more advanced medical centers, this method is regarded the standard one. However, core needle biopsy may not be appropriate for women having an irregularity near the chest wall, the nipple, or the surface of the breast; and those with calcifications that need enlargement; or women with very small breasts. In these cases, accurate results may not be possible unless your doctor recommends a surgical biopsy.

Frequently asked questions:

What risks are there from the test?

After the biopsy, you might experience little bleeding or bruising and sometimes breast soreness. This procedure leaves only a small dot for a scar.

Should I do anything special after the test is over?

No. After the completion of a core needle biopsy, the doctor may place a bag of ice on the site of the biopsy for 15–30 minutes. Most likely; you\’ll be able to restart normal activity almost immediately after it.

How long it is before the result of the test is known?

Examination of the biopsy sample usually takes several days. At centers where physicians are experienced in evaluating these biopsies, 65% of women who undergo this procedure are diagnosed with a benign condition and can resume having annual mammograms. Another 25% is detected to have a malignancy or a premalignant condition and carry on with treatment. For the remaining 10%, results are indecisive; in most of these cases, a surgical biopsy is done. 

Wire Localization Biopsy of the Breast

What is the test?

Sometimes an abnormal area will be visible on the mammogram that needs to be examined for cancer or absolutely removed from the breast, but this area is not easily felt as a lump on examination. The mammography department can guide your surgeon to find the area more easily by a technique known as \”wire localization.\” Wire localization is used to spot the location of a breast abnormality that is considerably small, or that can\’t be easily felt by touch. Wire localization ensures greater accuracy for a breast biopsy or lumpectomy. Your radiologists (who have had the benefit of seeing the abnormal area on your mammograms), will utilize the wire as a guide to the tissue which is to be removed. Before the wire localization process a mammograms will be taken first. So ask your radiologist if you can apply Lidocaine gel to numb your breast before the procedure begins.

Frequently asked questions:

What risks are there from the test?

Although there will be hardly any complications but if they happen at all they can include:

Infection
Bleeding
Occasionally fluid collection in the biopsy area.

If you develop the following call your doctor:

A temperature higher than 101 degrees Fahrenheit
Not stop bleeding
Swelling of the breast

Severe bruising
Unusual or severe pain
Any abnormalities that concern you 

Colposcopy and Cervical Biopsy

In Colposcopy a magnifying lens is used to closely examine a woman\’s cervix, the entrance to the uterus, located at the inner end of the vagina. The colposcope is fundamentally a pair of special binoculars placed on a rolling stand. By looking through the colposcope, a doctor can detect abnormal-appearing areas of the cervix, which can then be biopsied. A pathologist reads the specimen under a microscope to decide the presence of a precancerous condition (or, rarely, cancer). Colposcopy is done to assess an abnormal Pap smear.

Frequently asked questions:

What risks are there from the test?

The colposcopy examination itself (without biopsy) includes no risks. With biopsy, there is a slight risk of bleeding and infection, which might need additional treatment. If a biopsy was performed, you might experience some cramping and discharge or light bleeding from the vagina for some days. The discharge may appear grainy and black (or sometimes gray) if a chemical solution was applied to stop bleeding.

Must I do anything special after the test is over?

You can return to work or normal activities right after the biopsy. If you\’re bleeding you can use sanitary pads but not tampons, for the first day. If you had a biopsy, your doctor might also suggest you to wait a day or two before having intercourse because it can lead to some extra bleeding. Consult your doctor if you experience bleeding with clots, unusual vaginal odor, fever, or pelvic pain.

How long it is before the result of the test is known?

Your doctor can tell you immediately if abnormal areas are visible on the cervix. If a biopsy is performed, it may require 3 days to a week to have the results. When your doctor receives the report, he or she may recommend additional testing including additional Pap smears or treatment depending on the biopsy report. Your doctor will probably have you come back after the cervix has had time to heal from the biopsy, usually in about two weeks or after the next menstrual cycle. Additional treatment might be followed that include removal of any abnormal areas of the cervix. This might also incorporate shaving off the abnormal cells with a special electrical wire loop called LEEP procedure, freezing a part of the surface of the cervix (cryotherapy), or removing a thin layer of the cervix all around the opening (cone biopsy or conization). 

Endometrial Biopsy

What is the test?

Doctors take biopsies of areas that look unusual and use them to detect if they indicate cancer, precancerous cells, infections, and other conditions. In some cases, the doctor inserts a needle into the skin to draw out a sample; in other cases, tissue is removed following a surgical procedure.

This test requires a tissue sample from the lining of your uterus (also called the endometrium) in order to evaluate it for problems, including endometrial cancer that might explain unusual bleeding.

Frequently asked questions:

What risks are there from the test?

You might have pelvic cramps (sometimes intense) during the procedure and it may sometimes lasts for a day or two afterward; you may also experience slight vaginal bleeding. Heavy bleeding or an infection that needs treatment hardly occurs. There is also a small risk of disturbing a very early pregnancy. To have protection against this, your doctor might recommend a pregnancy test before performing the biopsy.

Must I do anything special after the test is over?

Visit your doctor if you have a fever of over 100 ° F or if you have vaginal bleeding longer than two days or is heavier than your normal menstrual period. Your doctor may also advise avoiding sexual intercourse until two or three days after the bleeding has stopped. 

Hysteroscopy

What is the test?

Hysteroscopy makes your physician look inside your uterus. A hysteroscope is a thin instrument just like a telescope. This is inserted into the uterus through the vagina and cervix to help a physician diagnose or treat a uterine problem. Hysteroscopy is a minor surgery generally performed either in your physician\’s office or in a hospital setting following a local, regional, or general anesthesia. Sometimes no anesthesia is required. It should be noted that there lies little risk with this procedure for most women.

Hysteroscopy is of two kinds: diagnostic or operative.

Diagnostic hysteroscopy:

It can be used to diagnose abnormal uterine bleeding, infertility, repeated miscarriages, adhesions, fibroid tumors, polyps, or to trace displaced intrauterine devices (IUDs).

Operative hysteroscopy:

It may be used, instead of open abdominal surgery, to both diagnose and treat uterine adhesions, septums or fibroids. These can often be removed through the hysteroscope.

Another unusual complication is a puncture of the urethra or bladder by one of the instruments. This requires surgery to cure.

Frequently asked questions:

When should hysteroscopy be performed?

The best time to perform hysteroscopy is during the first week or after your period. During this time your physician can view the internal portion of the uterus.

What happens during the hysteroscopy procedure?

The opening of your cervix may be dilated or made wider with the help of special instruments.

First, the hysteroscope is inserted through your vagina and cervix, and into your uterus.

Next a liquid or gas is usually passed through the hysteroscope in order to expand your uterus so that your physician can have a better view of the inside. A light source shinning through the hysteroscope enables your physician to examine the inside of the uterus and the openings of the fallopian tubes into the uterine cavity.

In case of surgery, small instruments are inserted through the hysteroscope. Sometimes a laparoscope is used simultaneously to examine the outside of the uterus and a gas for example carbon dioxide or nitrous oxide is allowed to flow into the abdomen. The gas expands the abdomen to make the physician see the internal organs easily. Most of the gas is removed when the test is done. A laparoscopic procedure is usually done in a hospital setting.

When will I be able to go home?

Patients who received a local anesthetic can go home shortly after the test. Women receiving regional or general anesthesia are kept in longer observation before they are released, but can normally go home on the same day.

How will I feel after a hysteroscopy?

Some patients may have shoulder pain after laparoscopy or when gas is used to expand the uterus. Once the gas is absorbed the pain should reduce quickly. You may also feel faint or sick, or have minor vaginal bleeding and cramps for 1-2 days after a hysteroscopy.
Contact your Doctor if you experience any of the following after your hysteroscopy:

Fever
Severe abdominal pain
Heavy vaginal bleeding or discharge

Is hysteroscopy safe?

Hysteroscopy is a quite safe procedure. Problems can occur in less than 1% of cases including:

Injury to the cervix or uterus
Infection
Heavy bleeding

Side effects from the anesthesia:

Although general anesthesia is occasionally used, in maximum cases it is not required. Hysteroscopy allows your physician to see inside your uterus and helps in the accurate diagnosis of some medical problems. The procedure and time of recovery are generally short 

Pap smear

What is the test?

The Papanicolaou test, or Pap smear, is a verification of a sample of cells collected from your cervix (the entrance to the uterus, situated at the inner end of the vagina) to examine cervical cancer. This cancer is a result of infection with a virus known as Human Papilloma Virus, or HPV. Pap tests study the shape of the cells under the microscope, to detect is there anything that is clearly cancerous or appears precancerous. Modern Pap smear may include testing to find out if you are infected with HPV. Only a few of people infected with that virus get cancer, but yes, the infection does heighten the risk. All women who are 21 or older, and also the younger women who are sexually active, should do a Pap smear every 1 to 3 years, and more often if any abnormalities are detected.

Frequently asked questions:

What risks are there from the test?

There are no risks related to this test. Some women may experience a little vaginal bleeding or spotting after the test.

Must I do anything special after the test is over?

No.

How long it is before the result of the test is known?

It requires one to two weeks to get results. But if your sample is abnormal, your doctor may recommend additional tests or treatment, such as colposcopy. 

Human Papilloma Virus (HPV) Test:

A Human Papilloma Virus (HPV) test is done to trace a high-risk HPV infection which is a sexually transmitted disease (STD). An HPV test examines the genetic material (DNA) of the Human Papilloma Virus. An HPV test is done on a sample of cells collected from the cervix similar to the Pap test.

There are many types of HPV. These include 16, 18, 31, 33, 39, 45, 51, 52, 56, 58, 59, 66, 68, and 73. This test will show whether a high-risk type of HPV is there. In women, high-risk types of HPV including the types 16, 18, 31, and 45, bring changes in the cervical cells that can be found as abnormal changes on a Pap test. Such abnormal cervical cell changes may disappear on their own without any treatment. But some untreated cervical cell changes can lead to serious abnormalities and may also cause cervical cancer over time.

Why It Is Done?

An HPV test is performed to:

Look for a high-risk type of Human Papilloma Virus (HPV) in women who had a Pap test that revealed abnormal cervical cells termed as Atypical Squamous Cells (ASC).

An HPV test can help detect one or more high-risk types of HPV. If an HPV test determines the presence of high-risk types of HPV, further testing, such as colposcopy or cervical biopsy, may be suggested.

Check for HPV in women above age 30 as part of screening for abnormal cervical cells.

To detect abnormal cervical cells after treatment of a high-risk HPV infection.

The HPV test may be carried out at the same time as the Pap test. The results of this test helps doctors come to a decision if further tests or treatments are required.

How It Feels

You may feel some uneasiness when the speculum is inserted into your vagina, particularly if your vagina is irritated or soft or narrow. You may also sense pulling or pressure at the time of the collection of the sample of cervical cells.

Risks

There is minor chance of having a problem from an HPV test. You may worry or feel scared if you are suggested more testing.

Do not have sex until your doctor tells you it is safe to do so.

Results

A Human Papilloma Virus (HPV) test is performed to detect a-high risk HPV infection in women. HPV test resul 

Pregnancy

Tests

Blood or Urine tests and a pelvic exam are essential to confirm pregnancy.

Urine Pregnancy Test

The simplest way to determine pregnancy is to buy a pregnancy testing kit which is available in drug stores and test if you are pregnant two weeks after a missed period or earlier. It detects pregnancy hormone in the urine. The first urine specimen of the day is preferred for testing because it contains more concentration of pregnancy hormone. This test is just a matter of few minutes and only one or two drops of urine is needed. If the urine changes color, the test result is positive. But the test result can produce incorrect results- occasionally false. Negative results mat indicate the sign of ectopic (tubal) pregnancy.

Pelvic Exam

If the urine test report is positive or if you have any symptoms of pregnancy but the urine test is negative, you must see a gynecologist. The doctor generally performs the pelvic exam after 6 weeks from the last menstrual period, to determine if you are pregnant. The physician inserts two fingers into the vagina alongside the cervix and presses the lower abdomen and directs the pelvic organs towards the examining fingers with the other hand. If your abdominal and vaginal muscles are relaxed, the exam will be more comfortable and thorough. The pelvic exam is carried out in early pregnancy with an objective to evaluate the size of the uterus, tubes and ovaries. The doctor determines how many weeks you have been pregnant by examining uterine enlargements, initially detectable about 4 weeks after conception. Besides uterine enlargement he also examines two other symptoms of pregnancy, uterine softening and a slight bluish colorization of the cervix.

Blood Pregnancy test

Blood pregnancy test is the most expensive as well as the most sensitive and dependable of all pregnancy tests. The basic type of such blood test is called the Radio Immuno Assay (RIA) or beta subunit HCG. This test is often suggested during pregnancy complications such as a suspected tubal pregnancy. It is also useful to determine if a woman is pregnant before the missed period. A blood sample is taken and the test result usually requires about an hour. This test can also determine approximately how far your pregnancy has advanced in weeks.

 

Bone Density test

What is Bone Density test?

Bone density or bone mass suggests the amount of bone present in your skeletal structure. In Osteoporosis bone mass reduces and bones become so feeble that they can break easily. Earlier it was tough to detect osteoporosis after you had a fracture. But now days osteoporosis can be determined in its premature stage following a bone density test. Bone density test is also known as densitometry. It is performed to verify whether you have osteoporosis or are at a risk of getting it.

Bone density test is performed on the bones, which may break due to osteoporosis. The bones that are prone to breakage include lower spine, arms, wrists and neck. Bone density tests are easy, fast and painless. There are some simple versions of bone density tests and these can be performed even at a nearer medical store.

Special X-Rays are used to determine the thickness and strength of the bones and also the amount of calcium and other bone minerals (bone mineral content) present in the bone segment. The higher the bone mineral content, the denser and stronger are the bones. And stronger bones are less likely to break. Thus with the help of bone density test (by knowing the bone mineral content and thickness) it can be easily determined whether you have or are at a risk of developing osteoporosis.

The equipments used to measure bone density in bone density test include:

SXA or DEXA Scan (Single or Dual-Energy X-Ray Scan):

SXA or DEXA scans measure bone density of your spine or hip. This is the most favored bone density test to determine osteoporosis as it gives accurate results. During this test a person is asked to lie on a padded platform while an imager (arm-like device) is passed over him without touching him. SXA or DEXA scans release certain amount of radiation. The duration of this bone density test is about 5 to 10 minutes.

QCT Scan (Quantitative Computerized Tomography Scan):

This bone density test requires computer software and a CT scanner to measure bone density of your spine. This bone density test gives detailed, 3-D images of your bones. A person, in this test is required to lie on a movable table and taken into a large tube-like area, where the images are taken. QCT scans emanate more radiation compared to SXA or DEXA scan and the test requires less than 10 minutes for completion.

SXA or DEXA scans are preferable to QCT scans because they are cost effective and emit less radiation than QCT scans which are expensive and emit more radiation.

What do my bone density test results mean?

The results of a bone density measurement (DEXA scan) are reported in two ways:
✓ T-scores
✓ Z-scores

In a T-score your bone density is compared to the optimal peak bone density for your gender. The result is showed as number of standard deviations below the average.

If,

T-score is > -1 = Normal.
T-score rages -1 to -2.5 = Osteopenia (there is a risk for developing osteoporosis).
T-score is < -2.5 = osteoporosis

In a Z-score your results are compared to others of your same age, weight, ethnicity, and gender. This is useful to determine if there is something strange causing your bone loss.

If,

Z-score is < -1.5 = it raises concern of factors other than aging as contributing to osteoporosis.

[These factors may include thyroid abnormalities, malnutrition, medication interactions, tobacco use, and others.]

Who needs Bone Density Test?

Women of the age 65 and above.
All postmenopausal women between the age group 50 to 65 years.
A person having history of fractures.
Family history of osteoporosis.
A person having poor health and low body weight.
People who smoke and drink frequently.
People who have calcium and vitamin D deficiency.