Comprehensive Breast Health

MRI, or magnetic resonance imaging, is a technology that uses magnets and radio waves to produce detailed cross-sectional images of the inside of the body. MRI does not use X-rays, so it does not involve any radiation exposure.

Breast MRI has a number of different uses for breast cancer, including:

• Screening high-risk women (women known to be at a higher risk than average risk for breast cancer, either because of a strong family history or a gene abnormality)
• Gathering more information about an area of suspicion found on a mammogram or ultrasound
• Monitoring for recurrence after treatment

If an abnormal breast mass is detected on the breast ultrasound or a breast lump is found, a radiologist can use ultrasound guidance to pinpoint the mass and take samples for further study. There are two methods of ultrasound-guided breast biopsy. In one method, called a core needle biopsy, samples are collected by way of a spring-loaded biopsy needle. Another method, a vacuum-assisted biopsy, applies vacuum pressure to pull tissue from the breast through the needle into the sampling chamber.

Unlike a screening mammogram that images your entire breast, a diagnostic mammogram focuses on a specific area(s) in your breast that the radiologist wants to look at more closely. The radiologist will view your images while you are here and you will be given the results before you leave.

Much like an MRI or ultrasound-guided biopsy, a stereotactic breast biopsy relies on special imaging to place the biopsy needle at precisely the site of the abnormality. In this case, a specialized mammography machine, similar to the mammography unit used for diagnostic screening, is used. X-rays are taken from different angles to help guide the radiologist's instruments to the site. Using a vacuum-assisted device, samples are obtained and sent to a pathologist for diagnosis.

Most breast biopsies are done with special needles using image guidance as described above. Sometimes a needle biopsy is not possible due to the location of the suspicious area in the breast or other factors. In these cases the biopsy is done by a surgeon in an operating room. Before surgery, a seed-localization procedure is usually done if the abnormal area in the breast was first detected on imaging tests (such as mammogram) and cannot be felt. The surgeon will use local anesthetic to numb the area that will be biopsied and you will also get IV sedation (rather than general anesthesia). These procedures are done in an outpatient setting and you will go home the same day.

Ultrasound is an imaging test that sends high frequency sound waves through your breast and converts them into images on a viewing screen. The ultrasound technologist places a sound-emitting probe on the breast to conduct the test. There is no radiation involved.

Ultrasound is not used on its own as a screening test for breast cancer. Rather, it is used to complement other screening tests. If an abnormality is solid (such as a benign fibroadenoma or cancer) or fluid-filled (such as a benign cyst). It cannot determine whether a solid lump is cancerous, nor can it detect calcifications.