So Many Types of Breast Imaging Tests. What’s the Difference Anyway?
Mammogram
What it is: Mammography is one of the most common breast imaging tests. It involves taking X-ray images of the breast tissue.
When it's used: A screening mammogram is typically used for routine breast cancer screening in women aged 40 and older. A diagnostic mammogram is used when there are signs or symptoms of breast cancer, such as a lump or nipple discharge.
Why it's important: Mammography can detect breast cancer at an early stage, often before symptoms develop, making it a powerful tool for early detection.
Digital Breast Tomosynthesis (DBT)
What it is: DBT, also known as 3D mammography, is a newer version of traditional mammography. It takes multiple X-ray images of the breast from different angles and creates a 3D image.
When it's used: DBT is often used in combination with traditional mammography, especially for women with dense breast tissue or those at higher risk of breast cancer. It provides clearer images and reduces the chances of false positives.
Why it's important: DBT improves the accuracy of breast cancer detection, particularly in cases where conventional mammography is less effective.
Breast Ultrasound
What it is: Breast ultrasound uses high-frequency sound waves to create images of the breast tissue.
When it's used: Breast ultrasound is typically used as a follow-up to mammography when additional imaging is needed. It can also be used in younger women or during pregnancy when exposure to X-rays is a concern.
Why it's important: Ultrasound is excellent at distinguishing between solid masses and fluid-filled cysts, helping healthcare providers determine whether a lump is benign or potentially cancerous.
Breast MRI
What it is: Breast magnetic resonance imaging (MRI) uses powerful magnets and radio waves to create detailed images of the breast tissue (radiation is not used).
When it's used: Breast MRIs are often used in increased and high risk individuals when there's a strong family history of breast cancer, or when a woman is diagnosed with dense breast tissue. It can also help to further evaluate abnormalities detected through other tests or to assess the extent of cancer in newly diagnosed cases.
Why it's important: Breast MRI is highly sensitive and can detect small lesions that might be missed by other imaging techniques, making it an invaluable tool for accurate diagnosis and staging.
Abbreviated Breast MRI
What is it: Also called fast MRI, this is a new technique that is currently being studied using a standard breast MRI scanner.
When it’s used: This test has the potential to be used in place of a conventional breast MRI. The abbreviated breast MRI takes fewer images over a shorter period of time, making the exam better tolerated especially for those with claustrophobia.
Why it’s important: Like a standard breast MRI, an abbreviated breast MRI is highly sensitive and can detect certain lesions better than other types of breast imaging. The majority of insurance companies do not yet cover the cost of an abbreviated breast MRI for all women.
Molecular Breast Imaging (MBI)
What it is: MBI is a newer imaging technique that uses a radioactive tracer to create images of breast tissue.
When it's used: MBI is currently considered experimental and is not routinely used for breast cancer screening. It may be used in certain cases where mammography, ultrasound, or MRI results are inconclusive or when additional information is needed. A drawback to these studies is that they expose the whole body to radiation. It is therefore unlikely that these tests would be recommended to be done yearly.
Why it's important: MBI has the potential to be a valuable tool in breast cancer detection, especially in women with dense breast tissue, but further research is needed to establish its role in routine screening.
Contrast-enhanced mammography (CEM)
What it is: CEM is a specialized form of mammography that involves the use of a contrast agent (typically iodine-based) injected into the bloodstream several minutes before images are taken.
When it’s used: CEM can be used when an abnormality is seen on a standard mammogram study. It can also be used to evaluate a newly diagnosed breast tumor.
Why it’s important: CEM enhances the visibility of lesions, especially in cases where conventional mammography might not provide clear results. This improved visualization can assist providers in making more accurate diagnoses and treatment plans.
Each of these imaging techniques serves a specific purpose and can play a critical role in detecting and diagnosing breast abnormalities. Understanding the strengths and weaknesses between various breast imaging tests is important for all women. With the right choice of breast imaging, regular screenings, and early intervention when needed - we can make great strides in preventing a late stage diagnosis. Remember, early detection saves lives! Know your risk, and stay informed and proactive about your breast health.
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Shelly Beckley is a dedicated healthcare professional with a strong background in oncology and over a decade of experience as a nurse practitioner. She holds a Master of Science in Nursing from MGH Institute of Health Professions in Boston, with direct experience in cancer care and patient advocacy. Her broad scope in breast health spans from counseling women who are at high-risk to the diagnosis, treatment, and survivorship in breast cancer. Shelly is passionate about improving healthcare outcomes and plays an active role in quality improvement initiatives for cancer care. She also leads the clinical team at Gabbi, a leading healthcare company working to make late-stage breast cancer obsolete.