Imaging For Breast Cancer

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Imaging For Breast Cancer

I have heard many excuses for not having a mammogram I don't have time; It's painful; I don't have breast cancer in my family; I only need to go every two years. An astute patient recently told me, “If you don't find the time to do it now, you might be forced to find the time to be sick later.” Those few minutes of discomfort can save your life.

Believe it or not, over 80% of women who develop breast cancer have no family history. The American Cancer Society and the American College of Radiology recommend that all women have yearly mammograms beginning at age 40. For those at high risk, screening even earlier may be needed. High Risk patients include those with a personal history of breast cancer, a pre-cancerous lesion, the BRCA gene and/or a family history of breast cancer, especially if the history includes a mother, sister or daughter.

Mammography is an x-ray image of the breasts. It has been shown through several studies to reduce the mortality rate from breast cancer. The recent controversy over screening women under 50 ignored the data that showed a 23-44% decrease in breast cancer deaths in women ages 40-49.

The digital images used today still utilize breast compression, but allow for a quicker mammogram with fewer repeat exposures. The digital images can also be manipulated electronically and CAD (computer-aided detection) devices can be added to the system as well.

Breast ultrasound (sonography) is a frequently used, important technology that can complement mammography. Ultrasound uses sound waves to better define a lump, area of thickening or mammographic asymmetry. Biopsies are often performed using sonographic guidance.

Breast MRI is a powerful technology using magnetic fields and radio waves. This test is used on select patients and in conjunction with mammography and sonography. A few of the many uses of breast MRI include guiding treatment planning for newly diagnosed patients; screening women at high risk for breast cancer who also have very dense breast tissue; and evaluating breast implants for rupture. MRI can be more sensitive than mammography for demonstrating some breast cancers, but it is also less specific, leading to false positive exams. For this reason, it is used in addition to mammography and sonography as opposed to as the sole imaging tool.