Breast Imaging
Breast imaging is essential for detecting, diagnosing, and managing breast diseases, including breast cancer. Various imaging modalities are employed to visualise breast tissue, each offering unique advantages and applications. The primary modalities for breast imaging include mammography, ultrasound, contrast-enhanced mammography (CEM), and magnetic resonance imaging (MRI).
- 1. Mammography: It uses low-dose X-rays to produce images of breast tissue. Digital mammography has replaced film mammography due to its superior image quality and electronic storage capabilities. Tomosynthesis, or 3D mammography, provides three-dimensional images that reduce overlapping structures and improve cancer detection rates. Mammography is particularly effective in detecting microcalcifications and masses associated with early-stage breast cancer.
- 2. Ultrasound: Breast ultrasound employs high-frequency sound waves to generate images of breast tissue. It is often used as a supplementary tool to evaluate abnormalities detected on mammograms or to characterise breast lumps found during clinical examination. Ultrasound is safe, non-invasive, and does not involve exposure to ionising radiation, making it suitable for pregnant or breastfeeding women. It is useful for distinguishing between solid masses and fluid-filled cysts and for guiding breast biopsies.
- 3. Contrast-Enhanced Mammography (CEM): Contrast-enhanced mammography is an advanced imaging technique that combines mammography with the use of contrast agents to enhance the visualisation of blood flow in breast tissue. It is particularly useful for evaluating suspicious lesions detected on mammograms, especially in women with dense breast tissue. CEM provides additional information about tumour vascularity and can improve the detection and characterisation of breast lesions compared to conventional mammography.
- 4. Magnetic Resonance Imaging (MRI): Breast MRI uses powerful magnets and radio waves to create detailed images of breast tissue. It is highly sensitive and can detect small tumours, making it valuable for screening high-risk individuals and evaluating the extent of disease in the breast. Breast MRI is also used for preoperative planning, monitoring response to treatment, and assessing breast implants. However, it is more expensive and time-consuming than other imaging modalities and may produce false-positive results.
Breast imaging modalities such as mammography, ultrasound, contrast-enhanced mammography, and MRI play vital roles in the early detection and management of breast cancer. Each modality has its strengths and limitations, and the choice of imaging technique depends on factors such as the patient’s risk profile, breast density, and specific clinical scenario. A multimodal approach combining different imaging modalities can enhance the accuracy of breast cancer detection and diagnosis, improving patient outcomes.
When choosing where to have your breast imaging it is important to consider if the radiology practice has a special interest in breast radiology. Even if you are not having a mammogram, a practice that does not provide mammography on site is unlikely to a breast interest. Ultrasound of the breast should be of both sides even if you only have symptoms on one side. You should have had a mammogram (if over 35) and an ultrasound prior to being referred to Dr Walker. More specialist imaging such as contrast enhanced mammography or MRI will be organised by Dr Walker after your consultation if required, as will any biopsies.