A Clearer Picture of Breast Imaging

Do You Understand and Know About the Various Types of Breast Imaging?

Mammograms

Mammography is widely recognized as the “gold standard” in detecting breast cancer. A mammogram is an X-ray exam of the breast that is used to detect and evaluate breast changes. Today’s mammograms expose the breast to much less radiation compared with those in the past and are more accurate. Breast cancer develops over time and can be present before a tumor can be detected by a physical exam. Establishing a pattern of annual mammography, ongoing physical exams by your physician and being aware of any changes in your breasts are the best ways to take an active role in maintaining good breast health. The standard recommendation is an annual mammography screening for women beginning at age 40.

Screening Mammogram

Screening mammograms are used for women who are at average risk and have no signs or symptoms of the disease. The goal of a screening mammogram is to find breast cancer when it's too small to be felt by a woman or her physician. This type of mammogram usually involves two X-ray pictures, or images, of each breast. The images make it possible to detect tumors that cannot be felt as well as microcalcifications (tiny deposits of calcium) that may indicate the presence of breast cancer. Finding small breast cancers early with a screening mammogram greatly improves a woman's chance for successful treatment.

Diagnostic Mammogram

Diagnostic mammograms are performed if there are noticeable breast problems — like a lump or nipple discharge — or if abnormalities are found in a screening mammogram. Sometimes diagnostic mammograms are done for screening in women without breast problems who were previously treated for breast cancer. It is still an X-ray of the breast, but more images are taken to carefully study the area of concern. In most cases, special pictures are enlarged to make a small area of suspicious breast tissue easier to evaluate.

Digital Mammogram

Digital and conventional mammography both use X-rays to produce an image of the breast. In conventional mammography, the image is stored directly on film, whereas in digital mammography, an electronic image of the breast is stored as a computer file. This digital information can be enhanced, magnified or manipulated for detailed investigation of specific parts of the breast.

3D Mammogram (Tomosynthesis)

Three-dimensional (3D) mammography — also known as tomosynthesis — is a type of digital mammography that produces a 3D image of the breast by using several low dose X-rays obtained at different angles. For tomosynthesis, the breast is positioned and compressed in the same way as for a mammogram but the X-ray tube moves in a circular arc around the breast, and the information is sent to a computer, which produces a focused 3D image of the breast.

The 3D images enable doctors to see inside the breast more clearly than with a standard 2-view mammogram. While 3D mammograms expose the breasts to more radiation than standard mammograms, they remain within FDA-approved safe levels for radiation from mammograms.

Breast Ultrasound

An ultrasound, also known as sonography, uses sound waves to make a picture of the tissues inside the breast, including the area closest to the chest wall. Breast ultrasound is used to find the cause of the breast symptoms, check a breast lump found on breast self-examination or physical examination, and check abnormal mammogram results.

Breast MRI

Used in combination with other tests, such as mammogram or ultrasound, breast magnetic resonance imaging (MRI) is recommended for screening women who are at high risk for breast cancer due to family history and/or a BRCA1 or BRCA2 gene mutation. It is used for patients who have been diagnosed with breast cancer to help measure the size of the cancer and look for any other tumors in the breast. It's also used to examine the opposite breast — to be sure that it doesn't contain any tumors.

Breast MRI Biopsy

An MRI-guided breast biopsy is helpful when MRI imaging shows a breast abnormality such as a suspicious mass not identified by other imaging techniques, and an area of distortion or abnormal tissue change. Using MRI guidance to calculate the position of the abnormal tissue and to verify the placement of the needle, the radiologist inserts the biopsy needle through the skin, advances it into the lesion and removes tissue samples.

Galactogram

A galactogram is a special X-ray exam that evaluates breast fluid. The procedure requires the insertion of a very fine plastic tube into the breast duct. This allows the radiologist to insert a contrast material into the duct so it can be seen on the X-ray of your breast.

Stereotactic Breast Biopsy

Stereotactic breast biopsy is a nonsurgical needle biopsy technique that may be used in place of surgery to decide whether a suspicious mammographic lesion is benign or malignant. This procedure involves an X-ray-guided needle that is controlled by a computer to obtain a tiny sampling of breast tissue.