Advances in Breast Cancer Detection: What’s New?
Also called a digital tomosynthesis, this test is a lot like a 2-D digital mammo. The breast is compressed for X-ray imaging. But it doesn’t just take pictures from top-to-bottom and side-to-side. It sweeps across the breast, taking multiple low-dose images from many different angles to create a 3-D picture.
“On a 2-D detector, overlapping tissue can give the appearance that there’s something there when there really isn’t, or, more ominously, hide a cancer that’s present,” says Mary Newell, MD, an associate professor of radiology at Emory University. “With a 3-D image, we can go through the tissue millimeter by millimeter.”
One study found that, when used along with a digital mammogram, a 3-D mammogram can increase the number of cancers found and decrease the number of false positives. The downside: It delivers a higher dose of radiation than a standard mammogram.
If your doctor says you have a high risk for breast cancer, she may suggest adding yearly MRI screening tests to your mammograms. Or, if your annual test shows something suspicious, this procedure can provide more information before you have a biopsy.
MRI uses radio waves to make detailed images of the breast. Typically, your doctor will inject a dye into your veins beforehand.
“MRIs offer a substantially higher amount of detail. However, that means you also have more of a chance to observe a false-positive finding. That’s why we don’t want to use them all the time, across the board,” says Keerthi Gogineni, MD, an assistant professor of medical oncology at Emory.
If a mammogram shows a mass that doesn’t look normal, this test can give your doctor a better picture of what’s happening. And if you feel a lump in your breast, but the X-ray doesn’t find anything, an ultrasound can help him know for sure whether you need a biopsy. If you do, this test can even help guide the biopsy needle with pinpoint precision.
“Ultrasound is like sonar of the breast,” Newell says. “If the sound waves pass through the mass, that indicates that it’s cystic, or benign, while if the waves bounce back, that indicates a solid tumor.”