:::: FAQ : DETECTION of BREAST CANCER :.

Triad for Breast Cancer Detection

What other methods are used for breast cancer detection?

Breast cancer detection is not just about breast imaging. Three noble endeavors work in harmony to maximize the opportunity for detecting early and curable breast cancer.

The TRIAD for Early Detection of Breast Cancer

Breast Self-Examination (BSE)	Clinical Breast Examination (CBE)
Screening Mammography

 

Breast Self–Examination

Why is breast self-examination important?

A woman soon learns the appearance and feel of her own breast tissue; thus she is the best qualified to recognize changes that may occur. Changes in the texture of breast tissue occur commonly with changes in the menstrual cycle. Changes that persist or progress should be brought to the attention of the woman’s physician who can perform a clinical breast examination and determine whether a diagnostic breast imaging consultation is appropriate. Women who are menstruating are advised to perform breast self-exam during the time from about 3 to 7 days after the period has ended when the breasts are less likely to be swollen or tender.

The American Cancer Society recommends that women learn and perform BSE each month beginning at age 20.

Pacific Breast Center provides women instructional materials that will help them learn to properly perform this important examination.

Clinical Breast Examination (CBE)

Why is a clinical examination important if mammography is the only reliable method for detecting curable breast cancer?

Clinical breast examination is a physical examination of the breast performed by a trained healthcare professional. CBE is performed for the purpose of discovering changes in the texture or feel of the breast tissue that might represent a lump or thickening requiring further evaluation with a diagnostic breast imaging consultation (mammogram or ultrasound). more >>>

When a clinician finds a subtle abnormality on physical examination and calls attention to it in the request of a diagnostic breast imaging consultation, the radiologist is able to direct special attention to the area and is less likely to disregard a subtle mammographic finding.

Do I need an annual mammogram if I do regular BSE and have an annual physical examination?

High quality screening mammography is the only reliable screening test for detecting early curable breast cancer. more >>>

The earliest detectable breast cancers are those found by mammography before self-examination or clinical examination can feel any abnormality.

Breast cancer mortality is reduced by at least 40% among women who participate in annual mammographic screening beginning at age 40.

 

Screening Mammography
(Screening Mammography Link)

Do I need an annual mammogram if I do regular BSE and have an annual physical examination?

Screening mammography is a highly sensitive method for detecting early signs of breast cancer in women who have no signs or symptoms of breast disease and have no reason to suspect a breast abnormality. The goal of screening mammography is to detect breast cancer when it is in a curable stage. Screening mammography does not detect all breast cancers, but when combined with breast self-examination and a breast physical examination performed by a health care professional, screening mammography provides the best opportunity we have for early detection.

Over 95% of breast cancers, detected by screening mammography when they are no more than half an inch in diameter, are curable. High quality screening mammography is the only reliable screening test for detecting early curable breast cancer. The earliest detectable breast cancers are those found by mammography before self-examination or clinical examination can feel any abnormality. Breast cancer mortality is reduced by at least 40% among women who participate in annual mammographic screening beginning at age 40.

 

Ultrasound of the Breast
(Ultrasound Procedure Link)

What is the role of ultrasound in detecting breast cancer?

Ultrasound (also referred to as breast sonography) employs inaudible sound waves to image the breast. The waves bounce back to the place from which they originate. The energy with which the wave bounces back is dependent on how much energy is lost in encountering and passing through tissue. Sound waves that bounce back are then converted into an image or map of the tissue.

There is no radiation associated with ultrasound and no measurable effect on the tissues being examined. Ultrasound is particularly useful in demonstrating the difference between cysts (water-filled sacs) or solid lumps which may or may not be cancerous. Ultrasound is of great benefit in “seeing through” dense breast tissue which might be difficult to evaluate on the mammographic film.

A solid mass (Fig. C, green arrow) causes echoes, but not as intensely as normal glandular tissue (yellow arrow).

Most patients with lumps will have a breast ultrasound study as part of the imaging workup. Radiologists may request an ultrasound study after observing an area of interest that is not well seen on a screening mammogram.

Ultrasound is often the first (and may be the only) study needed to evaluate lumps in women less than 30 years of age. Radiologists commonly use ultrasound to guide the placement of a needle during a needle biopsy.

Each white spot on the film represents an “echo” of an ultrasound wave that is being reflected back to the transducer. Where there is dense tissue there will be white dots (Yellow arrows). Sound waves pass freely through fluid without bouncing back until they encounter tissue. A fluid filled cyst appears as a black hole with no echoes (Fig. B, white arrow).

 

Breast-Specific Gamma Imaging
(B.S.G.I. Link)

There is NO COMPRESSION involved in a BSGI examination. The platforms simply position and support the breast.

In addition to offering the highest resolution digital mammographic service available Pacific Breast Center is among the first in the Northwest to acquire Breast Specific Gamma Imaging (BSGI) with the Dilon 6800, a technologically advanced tool for breast cancer detection.  This new imaging device means quicker answers and possibly better outcomes for patients.

BSGI has been clinically proven to provide clearer and more concise images for women with questionable mammograms, helping the breast imaging radiologist provide more accurate results and quicker answers than with many other types of diagnostic tests.

X-ray mammography is still the first-line screening tool for breast cancer, but there are those challenging cases where mammography raises as many questions as it provides answers. Mammography primarily measures differences in tissue density, but because dense tissue and cancers often display as the same density and structure on a mammogram, it may be difficult to locate masses. BSGI is not affected by tissue density. When further evaluation is needed, BSGI helps the radiologist determine if an area of concern is cancerous or not.

BSGI is a strong diagnostic tool and is especially helpful for patients who have:

• Dense breast tissue
• Suspicious areas on a mammogram
• Lumps that can be felt but not seen with mammography or ultrasound
• Implants and breast augmentation
• Scarring from previous surgeries

Working on a cellular or molecular level, BSGI provides the needed capability to help differentiate cancer from other structures or benign (non-cancerous) tissue in the breast. BSGI can help detect cancers at very early stages allowing for optimal intervention and treatment. BSGI has the potential to significantly reduce the number of invasive biopsies that result in negative findings (no cancer present) for thousands of women annually.

More good news is that Medicare/Medicaid and most private insurance companies cover BSGI under standard nuclear breast imaging and related pharmaceutical codes.

Also see;

• BSGI Proceedures
• Advanced Breast Cancer Diagnosis News

 

MRI of the Breast
(MRI Procedure Link)

What is the role of MRI in breast cancer detection?

MRI or magnetic resonance imaging is a sophisticated imaging technology that uses radiofrequencies in a magnetic field that results in differing signals sent back from tissue in the field of the radiofrequency. These signals are interpreted by a computer and displayed as a map or picture of the tissue. MRI, using special equipment and techniques designed for imaging the breast, has many specific uses in studying breast tissue. MRI may be better than mammography or ultrasound in determining whether an implant is leaking silicone or is ruptured. Although MRI of the breast is still in its infancy, compared to mammography, it is proving to be superior in its ability to determine the extent of breast cancer or in finding breast cancer in some high risk patients or women with very dense breast tissue.

Pacific Breast Center radiologists are specially trained and PBC is equipped with the specialized breast MRI devices for evaluating patients with specific problems.