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At Indiana University Health North Hospital, our board certified breast care physicians work together to provide comprehensive care using the latest technologies and methods to diagnose and treat all breast conditions, including breast cancer.
The Breast Care team at IU Health North Hospital provides all the specialists you need to treat a breast condition in one location. The team includes medical oncologists, breast surgeons, radiation oncologists, a geneticist and a genetic counselor, breast cancer prevention specialists, plastic surgeons, a physiatrist specializing in cancer rehabilitation, specially trained therapists, a gynecologist specializing in menopause, an oncology social worker and dedicated nurse navigators who guide you through the diagnostic and treatment process. These providers see patients in the Breast Care at IU Health North office in the IU Health North Medical Office Building.
Breast Care at IU Health North Hospital is fully accredited by the National Accreditation Program for Breast Centers (NAPBC)—a program administered by the American College of Surgeons. IU Health North Hospital was the first hospital in Indiana to receive this accreditation. Accreditation by the NAPBC is only given to centers that have voluntarily committed to provide the highest level of quality breast care.
Our partnership with the Indiana University School of Medicine allows IU Health North Hospital physicians to stay on the forefront of medicine. Through research, our physicians are working to improve how breast conditions are treated and how side effects can be managed.
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IU Health North Hospital provides the following breast cancer screening and prevention services:
- Women’s Diagnostics Imaging Center
- High-risk screening assessments as part of the Breast Cancer Risk Screening Program
Every woman who comes for her regular screening mammogram at IU Health North Hospital will be offered a chance to participate in the High Risk Screening Program.
The High Risk Screening Program evaluates a woman's risk for:
To learn your cancer risk, women take a short computer survey in the Women’s Diagnostic Center. The computer delivers the risk results to a specialized nurse. If a participant's score shows them to be at a higher risk, the nurse will contact you in person or by phone.
Women who are identified as having increased risk will then be offered an appointment as part of one of our Cancer Risk Prevention Programs. With these prevention programs, a specialized physician helps the patient choose from the options that best reduce your risk. These women will continue to benefit from risk appropriate screening tests, clinical trials and new innovations in prevention as they develop.
Comprehensive services for high-risk patients in Breast Care at IU Health North Hospital are part of the Catherine Peachey Breast Cancer Prevention Program (includes risk education, genetic counseling and regular screenings).
All specialists needed for breast cancer treatment are all in one location. The highly skilled breast care team at IU Health North Hospital provides the following treatments and services for patients with breast cancer:
- Breast reconstruction surgery
- Axillary dissection
- Skin-sparing mastectomy
- Nipple sparing mastectomy
- Oncoplastic reduction surgery
- Radiation therapy
- Insertion of radiotherapy balloon catheters
- Sentinel lymph node biopsy
- Clinical trials
- Rehabilitation services
- Lymphedema therapy
- Survivorship care
- Menopause medicine
- Spiritual care
- Financial counseling
- Social work support and counseling services
- Expressions: A Store for Women
- Free Wellness Series sessions for breast cancer patients, survivors and caregivers offering free yoga, energy therapies, cooking classes and educational sessions on Tuesday evenings
IU Health North Hospital Women’s Diagnostics Program offers a broad range of breast-related imaging services. Our program has been designated as a Breast Imaging Center of Excellence by the American College of Radiology (ACR). Our radiologists and staff are dedicated to helping patients maintain good breast health and specialize in the diagnosis of breast disease.
The program is designed to provide the best possible care by using the latest technology and making the diagnostic process as efficient as possible. Our goal is to deliver patient-centered care that is both supportive and educational.
For women who have no breast problems, Indiana Radiology Partners (IRP) at IU Health North Hospital offers the following services:
- Screening mammography. For a screening mammogram, the patient receives two X-rays of each breast. Upon review of the film by the radiologist, a letter indicating the results is mailed to the patient and the ordering physician. A small percentage of patients are asked to return for additional assessment. Computer-aided detection (CAD) is used for screening mammography.
- Comprehensive screening mammography. A comprehensive screening mammogram includes two X-rays of each breast. The radiologist immediately reviews the X-rays and if necessary, additional studies will be performed during the same visit. The radiologist will also perform a thorough physical examination of the breasts. Results and recommendations will be discussed with the patient at the end of the appointment.
We use the following techniques to screen for and diagnose conditions of the breast:
- Diagnostic mammography. A diagnostic mammogram is for women who are experiencing a breast problem such as a lump, nipple discharge, skin changes or localized breast pain. A diagnostic mammogram is also performed on a patient with abnormal or questionable findings from a screening mammogram or a history of breast cancer.
- Digital mammography. Digital (computerized) mammography is similar to standard mammography in that X-rays are used to produce detailed images of the breast. Digital mammography uses essentially the same mammography system as conventional mammography, but the system is equipped with a digital receptor and a computer instead of a film cassette. The images are viewed on a high-resolution computer monitor. Breast tumors can appear in a number of forms and are often hard to detect among the normal dark and light areas of a mammogram. A radiologist, who is a physician experienced in mammography and other X-ray examinations, will analyze the images, describe any abnormalities and make a diagnosis. A report will be dictated by IRP’s board certified radiologist and then sent to the patient’s referring physician. The patient will also be notified of the results by the mammography facility.
- 3D mammography (tomosynthesis). Three-dimensional mammography more effectively screens for invasive tumors when used in combination with traditional, 2D mammography, especially for women with dense breast tissue.
- Breast magnetic resonance imaging (MRI) with computer-aided diagnosis (CAD). Breast MRI exams are used as an aid to mammography and ultrasound imaging. Breast MRI is appropriate for patients who are at a high risk of developing breast cancer. In addition, this imaging technique can evaluate the extent of known diseases, measure the effectiveness of chemotherapy and assess for breast implant rupture. Intravenous contrast is administered during breast MRI exams, except when evaluating implants. Breast MRI is an evolving technology and should not take the place of standard screening and diagnostic mammography procedures.
- R2 ImageChecker® System. Screening and digital mammography is further enhanced by the use of the R2 ImageChecker® System, which is similar to a "spell checker" for medical images. The R2 ImageChecker® System is the first U.S. Food and Drug Administration (FDA) approved CAD mammography system for use in breast cancer screening. Images are reviewed by the radiologist and the CAD system. If CAD marks an area on the image, the radiologist goes back to the original mammogram to review the area in detail to determine if further evaluation is necessary.
- Breast ultrasound. A breast ultrasound is not a screening tool, but may be performed to further evaluate an abnormality felt during a physical breast exam or seen on a mammogram. Ultrasounds use sound waves to produce images. These images allow the radiologist to determine if a breast mass is solid or a fluid-filled cyst.
- Clinical breast examination. Mammography is currently the most accurate screening method for detecting breast cancer. However, 10 to 15 percent of breast cancers may not be detected by mammography alone. A breast examination by the radiologist includes a complete physical exam of both breasts and the surrounding areas containing lymph nodes.
- Cyst aspiration. If determined necessary, this procedure is used to drain fluid from breast cysts. With minimal discomfort to the patient, the radiologist inserts a very small needle into the cyst, removing the fluid. This procedure is frequently performed under ultrasound guidance.
- Ductogram. A ductogram is used to evaluate abnormal nipple discharge. The discharge comes from the duct that connects the milk-producing gland to the nipple. A small amount of dye is injected into the affected duct, which allows the radiologist to visualize any abnormalities.
- Image guided breast biopsy. A biopsy is performed to obtain a sample of tissue from the area of concern within the breast. There are three procedures that are highly accurate and alternatives to surgical biopsies. For all three procedures, the patient is under local anesthesia while multiple small samples of tissue are obtained through a needle for analysis. The radiologist will determine which method is most appropriate.
- Stereotactic core needle biopsy. For this procedure, the patient lies face down on a table while the radiologist places a special needle into the area of concern using a computer program with X-ray guidance.
- Ultrasound core needle breast biopsy. For this procedure, the patient lies on their back or side on the exam table. The radiologist uses ultrasound to direct the needle into the area of concern.
- Magnetic resonance imaging (MRI) guided core needle biopsy. For this procedure, the patient lies face down on a table while the radiologist guides a special needle into the area of concern with MRI guidance.
- Pre-operative needle localization. Prior to surgery, the radiologist places a small wire in the abnormal area of the breast. This is performed under local anesthesia using either an X-ray or ultrasound for guidance. The placement of the wire provides a guide for the surgeon to facilitate the removal of the area of concern.
- Second opinion and consultation. At the request of the patient or physician, IRP radiologists, who specialize in breast healthcare, will review mammograms performed elsewhere and provide a consultation with recommendations.
Breast Cancer Screening and Prevention
Kandice Ludwig, MD, Medical Director
Lisa Korff, MD
Cindy Hunter, MS, CGC
Gail Vance, MD
Leslie Clarke, RN, OCN
Sarah Dutkevich, RN, BSN, OCNr
Charlotte Howard, RN, MSN, CBCN
Yvonne Kieffer, NP
Shanese Beaman, Patient Coordinator
Ann Bredensteiner, Office Coordinator
Ivory Jeter, Patient Coordinator
Gwen Ryder, Medical Assistant Dina Risser, Medical Assistant
Juan Socas, MD
Raj Sood, MD
Richard Zellars, MD
Jill Dodson, LSW, LMHC, LMFT
Breast Care Appointment Forms
Women's Diagnostics Appointment Forms
Women's Diagnostics: 11700 N. Meridian St., Carmel, IN 46032
Located on the first floor of IU Health North Hospital. Enter via Entrance C (south). Women's Diagnostics will be on your immediate left, once in the Atrium.
Breast Care at IU Health North Physician’s Offices: 11725 Illinois St., Suite 355, Carmel, IN 46032
Located in the Medical Office Building at IU Health North Hospital. Enter through the Medical Office Building's West entrance and take the elevators to the third floor.