Breast Cancer Screening & Diagnostic Technologies
There are a variety of technologies and tools available to screen for, diagnose, and stage breast cancer and other breast health issues. Talk with your healthcare providers to determine which one is right for you.
Screening mammogram vs. diagnostic mammogram — Routine screening mammograms are designed to catch breast cancer early; these are recommended for women who do not have any breast cancer symptoms or concerns. Diagnostic mammograms are used to investigate breast tissue when symptoms, suspicious breast changes or abnormal screening results indicate the need for follow up evaluation; these often employ additional techniques to focus on a specific area of concern.
Digital 2D Mammogram — A conventional, two-dimensional digital mammogram is an X-ray image of the breasts that shows all the complexities of breast tissue in a single, black and white image; however, breast tissue often overlaps, giving the illusion that normal breast tissue is abnormal in 2D imaging. Women with dense breasts or other risk factors may need more advanced diagnostic imaging, such as 3D digital mammography, ultrasound and breast MRI.
3D Mammogram — Three-dimensional mammogram technology provides more detail than the 2D X-ray, reducing the likelihood further investigative imaging will be required. The imaging machine moves around the breast in an arc, taking multiple X-rays that a computer forms into a 3D image. This allows radiologists to assess several layers of breast tissue at a time and to navigate around tissue that might hide cancer. Women who are getting a baseline screening, who have dense breast tissue or have a history of breast cancer should strongly consider 3D over 2D mammography.
2D / 3D Mammogram with SmartCurve — The Hologic SmartCurve mammography system features a curved compression surface that mirrors the shape of a woman’s breast, rather than the conventional flat paddles of other mammogram machines. The design reduces pinching and offers a more comfortable experience, without compromising image quality, even with dense breasts. SmartCurve is recommended for women who avoid regular mammograms due to fear of pain; however, not all breast types qualify for SmartCurve, so be sure to discuss the option with your imaging team.
Locations — Digital 2D and 3D mammography, Breast Ultrasound and MRI are available at Sarasota Memorial’s Breast Health Center (main campus), University Parkway Health Care Center, Clark Road Health Care Center, Blackburn Point Health Care Center, Heritage Harbour Health Care Center and Venice Health Care Center. The Heritage Harbour location also offers 2D and 3D mammography with SmartCurveTechnology.
A breast ultrasound is often the preferred follow-up to a mammogram for women with dense breasts who are at lower risk for developing breast cancer. Ultrasound imaging uses high-frequency sound waves and a computer to create images that help diagnose breast abnormalities, such as a benign fluid filled cyst or a solid lump. It can be used to supplement mammography, but is not typically used as a screening tool or in place of mammography. It also can give false positive readings, so it’s important to discuss this option with your care team.
Magnetic resonance imaging (MRI) can reveal breast cancers obscured on both mammography and ultrasound screening. MRI uses a combination of a large magnet, radiofrequencies and a computer to produce detailed images of breast tissue. It does not use radiation, but usually requires the use of a contrast dye to help create clearer images and outline abnormalities. Often recommended for women who have had breast cancer, have a family history of breast cancer or those who would benefit from a higher sensitivity, lower radiation screening, breast MRI can also help detect breast cancer in women with breast implants and those with dense breasts.
When diagnostic imaging indicates a suspicious lump or mass, women may be asked to have a breast biopsy to remove tissue samples for further analysis. Keep in mind that most people who undergo a breast biopsy learn they do not have breast cancer. Your doctor will recommend the type of biopsy that is right for you, such as:
• Fine-needle aspiration biopsy – This is a quick method to distinguish between a fluid-filled cyst and a solid mass when a suspicious lump or mass is found.
• Ultrasound-guided core needle biopsy – Using ultrasound guidance, a doctor locates a suspicious mass and uses a probe to remove tissue samples for analysis.
• Stereotactic biopsy – Using X-ray guidance (mammography) to locate a suspicious mass, a radiologist or surgeon inserts a probe into the suspicious area to remove samples for testing.
• MRI-guided biopsy – Guided by MRI, a radiologist uses a special needle to remove samples of breast tissue. This non-surgical, minimally invasive procedure is recommended for high-risk patients, including women with thin breasts, implants, lesions near the medial wall or multiple lesions.
• Surgical biopsy – A portion of the breast mass is removed for examination (excisional biopsy) or the entire breast mass may be removed (lumpectomy). This is usually done in the operating room with general anesthesia.
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Ductography, or galactography, uses dye and mammography to examine milk ducts and evaluate nipple discharge. During the procedure, a small amount of liquid dye is injected through a tiny tube placed in the opening of the duct, and a mammogram is performed. This makes the duct visible on the mammogram so that any abnormality in the duct is easily detected.
Lymphoscintigraphy, or sentinel lymph node mapping, is an imaging test used to check the lymph system for the spread of cancer, and to locate and biopsy the sentinel lymph node. The sentinel node is the first node that filters fluid from the breast and typically the first to be affected by the spread of breast cancer. This cancer-staging test helps doctors determine the best course of treatment.