The American Cancer Society says that women age 40 and older should undergo screening mammography every year, despite the limitations of the screening. They also recommend that women discuss benefits and limitations of yearly mammograms with their doctors.
Women at high risk for breast cancer may benefit from having magnetic resonance imaging (MRI) of the breast in addition to a mammogram, according to the American Cancer Society. “High risk” women include those who have a lifetime risk of 20% or greater based on family history, those with a known BRCA1 or BRCA2 genetic mutation, or those with a first-degree relative with known BRCA1 or BRCA2 mutation.
Risk Profiles and Mammography
Two risks that go along with mammography are that a cancer exists and isn’t detected by mammography (false negative), or that the mammogram shows something suspicious that turns out not to be cancer (false positive). Dr. Mehmet Ayvaci of the University of Texas, Dallas, presented a paper at a conference in June 2014 concerning the value of using patient risk profile information along with mammography.
The study compared accuracy of diagnosis, false negatives, and false positives when mammograms were interpreted in the absence of patient risk profile information, when risk profile information was used by physicians as they read the mammograms, and when risk profile information was provided after physicians read the mammograms.
When doctors examined mammograms along with profile risk information, the number of false negatives was reduced by 3.7%, which would result in earlier diagnosis of breast cancer. Moreover, it cut false positives by 3.23%, reducing unnecessary patient stress and healthcare spending. Risk profile information included factors like family history, reproductive history, ethnicity, and age.
Screening mammography is only one type of medical imaging used in diagnosis of breast cancer. Diagnostic mammography may be performed if the screening mammogram indicates a possible abnormality, or if a patient experiences certain symptoms such as change in breast skin, pain, or the presence of a lump. With diagnostic mammography, additional medical imaging views are made beyond those included in a screening mammogram. Diagnostic mammography may also be used in women with breast implants due to implants’ interference with the standard views used in screening mammography.
Breast MRI is a form of medical imaging that is much more sensitive than other medical imaging used in detecting invasive breast cancer. Though not used routinely for screening, it may be used for screening patients at high risk for breast cancer because of genetic predisposition or family history. For those undergoing surgery to remove a breast tumor, MRI is superior at determining tumor size prior to surgery. It is also useful in staging breast cancer and planning for treatment, as well as for post-surgical and post-radiation follow-up. Additionally, breast MRI is useful in evaluating involvement of lymph nodes and metastases.
Though not used widely because of its limitations, breast ultrasound can be useful in specific situations, such as in determining whether a lump is solid or fluid-filled. Though breast ultrasound can be helpful in screening women with dense breast tissue, which is harder to evaluate by screening mammography, ultrasound alone is insufficient, because it misses small calcium deposits, which can indicate the earliest stages of cancer. Therefore, breast ultrasound as a screening tool is done in addition to screening mammography, rather than as a replacement for it. Ultrasound can also be useful in guiding biopsy needles used to evaluate some breast lesions.
Get Screening Mammography Services from the Experts at SteleRAD
Screening mammography is a routine medical imaging procedure that helps doctors diagnose breast cancer in its earliest stages, when the most treatment options are available. A recent study indicates that when radiologists use patient risk profile information while evaluating screening mammograms, both false negative and false positive results are reduced.
Screening mammography is just one form of medical imaging used in the diagnosis of breast cancer. Diagnostic mammography, MRI, and ultrasound may be used as well. Radiologists with experience in breast imaging who remain knowledgeable about the state of the art in breast medical imaging can help ensure mammography has the most value in terms of catching breast cancer early while avoiding false positive results and the stress that goes along with them.
SteleRAD, a south Florida radiology group owned and operated by Board-certified radiologists, has four breast imaging radiology specialists on staff. SteleRAD‘s breast imaging radiologists have the qualifications and experience necessary to competently perform breast imaging procedures. To learn more about how SteleRAD‘s radiologists can help with your breast imaging needs, contact us online or call 954-358-5250.