Commonwealth Radiology Associates

Breast Imaging

Breast cancer affects one in every eight women in the United States

85-90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general. Screening tests, such as yearly mammograms, are given routinely to people who appear to be healthy and are not suspected of having breast cancer. Their purpose is to find breast cancer early, before any symptoms can develop and the cancer is usually easier to treat.

Tomosynthesis

Digital Breast Tomosynthesis (also known as 3D mammography) was approved by the FDA in February 2011.

Tomosynthesis creates multiple images or “slices” that step through the breast tissue. This allows the radiologist to see greater detail and helps reduce the impact of overlapping breast tissue. The process is performed at the same time as a normal mammogram, on the same scanner, with no noticeable differences in the experience or time expended for the patient. This improvement in visualization can result in fewer patient callbacks and therefore less anxiety during the process. The radiation dose is below the FDA-regulated limit for 2D mammography and has been found by the FDA to be safe and effective for patient use.

If you are age 40 or older with no new breast concerns, you can schedule a 3D screening mammogram on your own, anytime. While a referral is not required, please talk to your physician or breast imaging provider if you’d like to add it to your mammogram.

Diagnostic Mammography

Diagnostic mammograms is an x-ray of the breast. They are taken because of abnormal results from a screening mammogram or after new clinical signs of a breast issue alerted by the patient or her/his doctor to investigate further.

Such clinical signs may include:

  • A lump
  • Breast pain
  • Nipple discharge
  • Thickening of skin on the breast
  • Changes in the size or shape of the breast

A diagnostic mammogram can help determine the cause of these symptoms and to evaluate the presence of breast cancer. Diagnostic mammograms can utilize the new techniques of 3D mammography to help aide in diagnosis.

Commonwealth Radiology Associates

Imaging Experts

Noninvasive Diagnostics   /   Patient Satisfaction

Breast Ultrasound

Breast ultrasound imaging is a non-invasive medical test that is used to evaluate and further diagnose areas of concern involving the breast. Ultrasound uses inaudible, high-frequency sound waves to produce pictures of the inside of the body and does not utilize ionized radiation. It is safe and painless.

Breast ultrasound does not replace the need for mammography. Mammogram images are still needed to evaluate the entire breast.

Breast MRI

Breast Magnetic Resonance Imaging (MRI) uses a magnetic field, radiowaves and a computer to produce detailed pictures of the structures within the breast. It is used as a supplemental tool to mammography and/or ultrasound. Breast MRI does not use ionizing radiation (that is, x-rays), and when used in conjunction with screening and diagnostic mammography, can provide valuable information for the detection and characterization of breast disease.
MRI 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.

MRI screening guidelines for women in the following groups:

  • have a known BRCA1 or BRCA2 gene mutation
  • have a first-degree relative (mother, father, brother, sister, or child) with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
  • have a lifetime risk of breast cancer of 20% or greater, according to risk assessment tools that are based on a family history that includes both her mother’s and father’s side
  • have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)
  • had radiation therapy to the chest when they were between the ages of 10 and 30 years
  • have a genetic disease such as Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have one of these syndromes in first-degree relatives

Women at moderately increased risk (15% to 20% lifetime risk) should talk with their physicians about the benefits and limitations of adding MRI screening in conjunction to their yearly mammogram. These patient groups include:

  • have a lifetime risk of breast cancer of 15% to 20%, according to risk assessment tools that are based on family history
  • have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)
  • have extremely dense breasts or unevenly dense breasts when viewed by mammograms

Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.

Several risk assessment tools are available to help health professionals estimate a woman’s risk. The results should be discussed between a woman and her physicians when they are used to recommend Breast MRI screening.

Needle Biopsy of the Breast

A breast biopsy is a test that removes tissue or fluid from a lump or abnormality detected by a physical breast examination and/or breast imaging. The removed tissue is examined under a microscope by a pathologist and is tested to check for the presence or absence of breast cancer. A biopsy is a diagnostic procedure that can determine if the suspicious area is benign or cancerous.

This procedure is performed by a radiologist using a small needle and image-guidance with ultrasound, MRI or mammography.

Needle biopsy is safe outpatient procedure and is minimally invasive.

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