DIAGNOSTIC STUDIES

Abnormal mammograms and palpable breast masses may lead to additional mammographic views (diagnostic mammography), breast ultrasound and occasionally breast MRI. If a suspicious lesion is identified, a breast surgeon should be seen for a comprehensive evaluation and a minimally invasive breast biopsy may be performed.

There are some new molecular breast imaging devices PEM (Positron Emission Mammography) and BSGI (Breast Specific Gamma Imaging) that may play a role in the future work up of suspicious mammograms.

Breast MRI

Magnetic Resonance Imaging (MRI) of the breast uses the energy of very strong magnets combined with an injection of gadolinium, a contrast medium used to enhance the images, to determine the nature of breast lesions. The scan should be performed between days 7 to 14 of the menstrual cycle to eliminate changes in the breast due to hormonal variations. The MRI requires placement of an intravenous line to inject the contrast. The MRI scanners are cylindrical chambers where the table moves into the cylinder order to complete the scan. Individuals who are chlaustrophobic may have difficulty with the scan. Some scanners can perform the scan on both breasts at the same time where other scanners require a return on a different day to adequately evaluate the other breast. There is one breast MRI scanner that only scans breasts, and this scanner evaluates both breasts. To reduce claustrophobia, the scanner allows patients to go feet first which provides a sense of relief for them who suffer from claustrophobia.

Positron Emission Mammography PEM

Breast Specific Gamma Imaging BSGI

Molecular imaging is in it’s infancy as a breast imaging technology. A nuclear tracer (Sestamibi or FDG radio labeled glucose), is injected and after a variable time of waiting, images are taken. Images are obtained similar to mammography, but the time in compression is approximately 10 minutes per breast. The scanners are limited in their availability, but they will most likely become far more common in the next few years.

PEM