Mammography plays a critical role in the early detection of breast cancer. The
U.S. Department of Health, the American Cancer Society, The American Medical
Association and the American College of Radiology recommend annual screening
mammography for women beginning at age 40.
As with all radiological procedures patients should inform the technologist
if there is any chance of pregnancy or if you are nursing.
are two basic types of Mammography: 1) a screening mammogram
in which 2 basic views of each breast are taken and 2) a
diagnostic mammogram which utilizes additional views if there
is a symptom, family history or finding on screening mammography.
Following a mammogram the radiologist may recommend additional imaging such
as Ultrasound or MRI.
All women should perform monthly self breast examination and have a clinical
breast exam performed by their Gynecologist or Primary care Physician annually.
Mammography is not a perfect study. Five to 10 percent of all
screening mammography result in a "false positive finding". This
means that results appear abnormal and additional studies are
required (ultrasound, fine needle aspiration and biopsy) with
the subsequent testing proving no cancer. Normal breast tissue
appears different in each woman and the slightest movement or
trace of deodorant, powder, lotion can compromise the image. Prior
breast surgery, the presence of implants (silicone or saline)
can block the view of tissue.
Ultrasound may be used to evaluate palpable findings or as an adjunct to mammography.
These images are recorded and displayed on a monitor. The ability to visualize
a finding on sonography greatly facilitates performing a biopsy, if required.
Breast ultrasound may also be helpful in evaluating breast symptoms in younger
patients, where mammography may be inappropriate.
Ultrasound maybe used to evaluate suspicious masses within the breast detected
via ultrasound. Tissue specimens are acquired using a vacuum assisted device.
Breast Biopsy can be performed as an outpatient procedure, often avoiding the
need for surgery.
Breast MRI has become an important adjunct to mammography and breast ultrasound
in recent years. While mammography detects many breast cancers, its sensitivity
is limited. Breast MRI uses molecular signals to look for cancers that may be
too subtle to identify on mammography or ultrasound.
Park Avenue Radiologists offers MRI guidance for core biopsy of lesions only
visualized on breast MRI. Very few outpatient facilities have this capability.
While breast MRI is very sensitive, it can sometimes detect lesions that mammography
and ultrasound cannot see. As such, the ability to perform breast MRI biopsies
makes breast MRI much more clinically relevant and we are confident that virtually
all lesions identified can be sampled. Park Avenue Radiologists offers the latest
breast MRI technology, including computer aided diagnostic (CAD) software.
Breast MRI may be an appropriate test in addition to mammography
for patients with a strong family history of breast cancer (i.e.,
mother/ sister with breast cancer before age 50).
Breast MRI may also be helpful in patients recently diagnosed
with breast cancer who desire breast conservation therapy or where
there is concern for tumor recurrence versus scar. Non contrast
breast MRI is also the best test to evaluate breast implant integrity.
Following placement in the MRI scanner, images are acquired before
and following the injection of gadolinium. After the patient is
imaged, computer processing of the images performs 'subtraction'
of the pre-contrast images from the post-contrast images. This
allows the radiologist to see cancers that mammography or ultrasound
might not detect.
The procedure takes approximately 20 minutes and is noninvasive,
except for the requirement of an intravenous injection. The newer MRI design
results in a larger, shorter opening to the magnet. This feature
vastly improves patient comfort and mitigates concerns of patients
If you would like additional information on these procedures
we recommend visiting RadiologyInfo.org
and the American