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Breast Imaging

Screening Mammography, including digital mammography

For women not experiencing any kind of irregularities or concerns, screening mammography is a safe, low-dose X-ray of the breast designed to identify cancer in the early stages, long before it can be detected by a physical examination.

Screening mammography can detect all types of breast cancer, including invasive ductal and invasive lobular cancer. It is also the only proven method to reliably detect small mineral deposits in the breast, microcalicifications, which may indicate an early form of breast cancer called ductal carcinoma in situ (DCIS). When breast cancers of all kinds are detected early, more treatment options are available.

CAD (Computer-Aided Detection) often times complements a screening mammogram. Through this process, a computer program is used to highlight areas of breast tissue that may be abnormal. This process may identify areas of the breast that could be suspect for calcifications or breast cancer and allow the Radiologist to re-evaluate that portion of the image.

Diagnostic Mammography, including Digital Diagnostic Mammography

Diagnostic mammography may be performed if a screening mammogram demonstrates a possible abnormality, or a patient is having specific breast problems. Symptoms may include a lump, changes in the breast skin, pain, nipple discharge, or a personal history of breast cancer. A diagnostic mammogram may consist of additional views beyond the standard four included in a screening mammogram. The additional views of diagnostic mammography are also commonly used for women who have breast implants because the implant interferes with imaging “through” the entire breast.

Breast MRI

Breast MRI is now proven to be more sensitive than any other modality in detecting invasive breast cancer. MRI is superior at demonstrating the size and extent of a breast tumor prior to surgery. In addition, it is beneficial for screening patients at particularly high risk for breast cancer due to genetic predisposition or strong family history, diagnosing breast implant rupture, staging breast cancer and planning treatment. MRI also plays an important role in post-surgical and post-radiation follow-up. Breast MRI is not a replacement for conventional mammography, but is extremely useful in special circumstances. Early detection improves survival and expands treatment options.

Breast MRI is most accurate in evaluating these features:

  • Size of a tumor
  • Lymph node involvement
  • Metastases
  • Response to treatment (chemo and radiation therapy)
  • Breast ultrasound

When a lump or mass is detected by a mammogram or physical examination, a Breast Ultrasound is used to determine whether it is solid, or a fluid-filled cyst.

Some studies have suggested that ultrasound be considered in screening women with dense breast tissue (which is difficult to evaluate by routine mammography). But, use of screening ultrasound instead of mammography is not recommended because small calcium deposits, which may be the earliest signs of cancer, are not visible by ultrasound. For this reason, when ultrasound screening is performed it should be done in addition to mammography. Breast ultrasound is useful for evaluation of some breast masses and is the only way to tell if a cyst is present without placing a needle into it to aspirate fluid. Cysts cannot be accurately diagnosed on physical examination alone. Breast ultrasound may also be used to help doctors precisely guide a biopsy needle into some breast lesions.