Introduction
Breast imaging refers to the different medical tests used to screen for and diagnose breast diseases or conditions. With advances in technology, various breast imaging modalities are now available that can help detect any abnormalities early.
Mammography
Mammography is considered the gold standard for breast cancer screening. A mammogram uses low-dose x-rays of the breast to detect tumors that cannot be felt. Mammograms are the best way to find small breast cancers early, sometimes up to three years before they can be felt. Early detection significantly increases treatment options and chances of survival.
Digital Mammography
Digital mammography is the most widely used type of mammogram today. In digital mammography, the x-ray image is acquired digitally which has some advantages over the traditional film mammogram. Digital images can be enhanced for better viewing of abnormalities. Images can also be electronically stored and shared more easily between radiologists and healthcare providers. Studies have found that digital mammography is at least as effective as the traditional film mammogram at detecting breast cancer.
3D Mammography
3D mammography, also known as breast tomosynthesis, takes multiple low-dose x-ray images of the breast from different angles and uses computer algorithms to generate cross-sectional views of the breast tissue. This allows radiologists to better distinguish between overlapping tissues and detect cancers that may be hidden on a standard mammogram. Some studies have found 3D mammography results in increased cancer detection rates, especially for women with dense breasts. It also reduces unnecessary breast biopsies.
Ultrasound
Breast Imaging ultrasound uses high frequency sound waves to produce images of the breast tissue. It is used as an adjunct to mammography when further evaluation of an abnormality is needed. Ultrasound is also used in women with dense breasts as the sound waves can penetrate dense breast tissue better than x-rays. It is a valuable tool for differentiating solid masses from fluid-filled cysts which often do not require biopsy. Ultrasound is also useful in evaluating palpable breast lumps that are unclear on mammograms and can help guide the positioning of biopsy needles.
MRI
Breast MRI (magnetic resonance imaging) produces detailed three-dimensional images of breast tissue using magnetic fields and radiofrequency pulses instead of x-rays. breast MRI has a very high sensitivity in detecting cancers, especially in women at high risk. Some indications for breast MRI include assessing the extent of disease before breast conserving surgery in women newly diagnosed with breast cancer, screening women at very high genetic risk, or evaluating the opposite breast when one breast has already been diagnosed with breast cancer. While an excellent test, breast MRI is more expensive and not routinely recommended for average risk screening due to lower specificity.
Biopsy
When imaging finds an abnormal area, further evaluation with biopsy may be needed to determine if it is cancerous. During a biopsy, a small amount of the abnormal breast tissue is removed for examination under a microscope by a pathologist. There are different types of breast biopsies depending on the size, location and other features of the area of concern. The most common types are core needle biopsy and vacuum-assisted biopsy. Stereotactic or ultrasound guided biopsies may be used when the area is small or difficult to feel by hand. A biopsy remains the only sure way to know if an abnormal area is cancerous or benign.
Choosing Your Imaging Tests
The type of breast imaging recommended for a woman depends on her individual risk factors and clinical situation. Women aged 40-75 without symptoms should get an annual screening mammogram. Those at high risk due to family history or genetic mutations may benefit from earlier screening and supplemental tests like breast MRI. Ultrasound may help evaluate specific concerns found on a mammogram. After a cancer diagnosis, additional imaging is used to stage the disease. It is best to speak to your doctor about the option that is most suitable in your case. Together you can make informed decisions about screening and management.
Advances in technology have significantly improved our ability to screen for and diagnose breast cancer. No single test is perfect and using a combination of mammogram, ultrasound and sometimes MRI provides the best overall breast cancer detection rates. Early detection through regular screening remains critical for successfully treating breast cancer. Following screening guidelines tailored to your individual risk can help ensure any developing problems are caught in their earliest and most treatable stages.
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A reliable way for early detection is to get yourself regularly screened with mammogram if eligible.
Mammography has been declared as the best screening technique for early detection of breast cancer.
