Take a closer look at all other tests

Most women of screening age know this mantra from the bottom of their hearts, thanks to the annual energetic awareness campaign and the resilient breast cancer survivors of the community sharing stories of early detection. Get a mammogram once a year.

But perhaps you or someone you know is told that you need breast ultrasound or breast MRI.

What is the purpose of these additional studies? Why do I have another breast imaging test when I just took a mammogram?

Simple Answer: Not all breast imaging tests are complete, each breast imaging test provides different information, and all breast imaging tests are free. According to experts, the information obtained from each type of test can help illuminate the big picture, like snapping puzzle pieces. Ackerman Cancer Center..

Understanding the strengths and weaknesses of different types of breast imaging can give you peace of mind with your next exam.

Here’s an overview of the most common breast imaging tests that Ackerman may encounter during your next breast health visit:

Digital mammogram

Digital mammograms are the gold standard for early detection of breast cancer. The test is a very low-dose radiograph of the breast performed using each breast with moderate compression. Compression is important because it prevents the movement of breast tissue during image acquisition and improves the contrast between the tissues in the breast.

A standard screening mammogram usually contains at least four pictures, two for each breast.

Some women may need more than four pictures to properly screen all breast tissue, depending on specific factors such as breast size, breast shape, and the presence of implants.

• advantage: Mammograms are the basis for early detection of breast cancer because they are a fast and cost-effective way to gain a global understanding of how breast tissue is organized and to assess changes associated with early-stage breast cancer. It is a front-line screening tool. Mammograms are particularly good at finding very early breast cancer in the form of advanced calcification. No woman feels that mammograms are a particularly pleasing experience, but the discomfort from the test is usually minimal or mild and usually lasts only a few seconds (the time required for compression).
• Disadvantage: If a woman’s breast tissue is dense, the mammogram is less sensitive to early-stage breast cancer. This is because the cancer may hide within a dense area of ​​glandular breast tissue. This is the so-called “masking effect” of dense breasts. In addition, some types of breast cancer, especially lobular cancer, can be difficult to detect on a mammogram.

“3D” mammogram, also known as digital breast tomosynthesis (DBT)

3D mammograms are an improvement over traditional mammograms and help address the problem of dense breast tissue that obscures the underlying breast cancer. Traditional 2D digital mammogram images represent breast images as tissue slabs, and 3D mammograms analyze traditional slab images into 1 mm thin slices.

Obtaining a 3D mammogram is almost the same experience for a patient as a traditional mammogram. Compression will continue to be used and multiple pictures will be taken, but the mammogram device will move in an arc as it captures the image. 2D mammogram images are still required for annual screening tests and can be performed concurrently with the 3D mammogram or derived from the 3D images. It is a so-called “synthetic” 2D mammogram.

• advantage: 3D mammograms find more cancers than traditional 2D mammograms. Compared to 2D digital mammography, 3D mammography has found about 2.8 breast cancers per 1,000 women. 3D mammograms also help reduce callbacks from screening by resolving asymmetric areas of the 2D mammogram due to breast tissue overlap.
• Disadvantage: Unfortunately, 3D mammograms are still mammograms. Also, the use of ionizing radiation, the challenges of visualizing early stage cancers implanted in high-density breast tissue, mammographic subtle cancer visualizations such as lobular breast cancer and very small non-mineralized invasive or insitu tubes All defects in 2D mammography, including problems, apply to 3D mammography. cancer. Finally, when assessing breast calcification, 3D mammograms are not as good as 2D mammograms.

Breast ultrasound

Breast ultrasound is most often used in a targeted way to evaluate breast tissue using sound waves and to examine specific areas of the breast that have symptoms such as focal pain and palpable lumps. Will be done. Ultrasound is also used when there are mammographic findings that require more characterization.

The breast ultrasound of the subject is performed by a technician or breast radiologist while the patient is lying on the examination table. A warm gel is used between the breast skin and the handheld ultrasound transducer to facilitate the transmission and reception of sound waves, allowing the transducer to slide through the tissue using gentle pressure.

Most women do not feel pain on an ultrasound of the breast, but the breast may become more sensitive or tender during the examination.

• advantage: Ultrasonography does not use ionizing radiation, so it is a very safe test. Breast ultrasonography is reasonably fast and relatively inexpensive. Ultrasonography of the breast can be very helpful in characterizing a breast mass as a solid or cyst, even in women with dense breast tissue. In addition, if ultrasound shows a mass, ultrasound can be used as a tool to assist in breast biopsy. In fact, most breast biopsies are performed using ultrasound to guide the placement of the biopsy needle.
• Disadvantage: Ultrasound approaches the sensitivity of mammography to detect cancer, but it can also detect benign (non-cancerous) breast masses. This is fine if all benign masses appear to be friendly, but ultrasonography may even appear suspicious of non-cancerous masses, and short-term imaging surveillance or breast biopsy is recommended. .. In fact, women undergoing supplemental screening with whole-breast ultrasound are up to three times more likely to undergo false-positive ultrasonography, resulting in additional follow-up breast imaging or breast biopsy found to be benign. A test will be done. Other drawbacks of ultrasonography are the limited ability of ultrasound to visualize calcifications and, like mammography, complex breast tissue, especially containing multiple cystic or solid masses. There is incomplete visualization of lobular and very early invasive cancers in women.

Breast MRI (Magnetic Resonance Imaging)

Breast MRI uses a magnetic field and high-frequency pulses to image both breasts. Tests are always performed with IV gadolinium contrast and take approximately 30 minutes to complete. Breast MRI does not require compression, but the procedure is done with the breast hanging down and lying on the abdomen with the face facing down. Breast MRI scans themselves are not painful, but due to face-down placement, length of the scan, the need for a temporary IV for contrast injection, and a loud MRI environment, the scan can withstand. It takes time and effort. It’s also challenging. It should be very stationary during imaging, as even the slightest movement can ruin the test.

• advantage: Breast MRI is the most sensitive and specific breast imaging test available for the detection of early-stage breast cancer. Breast MRI isn’t perfect, but it’s almost perfect, with a breast cancer detection sensitivity of over 95%. This means that if your breast MRI is negative, you are less likely to get breast cancer. Because of this superior sensitivity, breast MRI is the best study for women at high lifetime risk of breast cancer who require supplemental breast cancer screening in addition to an annual mammogram. Like ultrasound, breast MRI does not use ionizing radiation and is very safe.
• Disadvantage: Not everyone can tolerate a breast MRI scan. Women who have implanted medical devices that are not compatible with MRI (for example, many types of pacemakers), certain types of metals held in the body, or decreased renal function cannot use MRI. Some women may struggle with the downward positioning required for the test or may experience claustrophobia during the test. Many insurance plans cover the cost of breast MRI examinations as a supplemental screening study for women at higher risk of breast cancer, but this does not apply to all insurance plans and of this expensive study It is a self-pay expense. You can do exorbitant things.

Women can be empowered by the knowledge that breast imaging providers can use multiple tools in addition to traditional mammograms to ensure optimal breast health.

By leveraging the strengths of multiple breast imaging methods, breast imaging physicians provide patients with the most accurate assessment possible to rule out the presence of early curable breast cancer.