Breast imaging provides different types of information about breast tissue and can be used for routine cancer screening or to evaluate a new breast concern. You do not need to know which imaging test you need before seeking care. Your care team can determine whether mammography, ultrasound, MRI or a combination of imaging methods is appropriate based on your reason for evaluation, breast cancer risk and previous imaging.
Screening and Diagnostic Breast Imaging
Breast imaging may be performed as routine screening or to investigate a specific concern. The difference is based primarily on why the imaging is being performed rather than the imaging technology itself.
Screening Breast Imaging
Screening breast imaging looks for signs of breast cancer in people who do not have a new breast symptom or concern. Mammography is the primary imaging method used for routine breast cancer screening, while additional imaging may be appropriate for some people based on breast density, breast cancer risk or other individual factors.
Diagnostic Breast Imaging
Diagnostic breast imaging is used to evaluate a specific breast concern or an area that needs a closer look after another examination or screening test. A new lump, nipple or skin change, localized breast symptom or finding on a mammogram may lead to diagnostic mammography, ultrasound or another imaging study depending on the clinical question.
Mammography
Mammography uses low-dose X-rays and breast compression to create detailed images of breast tissue. It can identify changes that may be too small to see or feel and is used both for routine breast cancer screening and to evaluate certain breast findings or symptoms.
Screening generally begins at age 40 for women at average risk, although recommendations about how often to have a mammogram vary among national organizations. Your healthcare provider can help determine a screening schedule based on your age, breast cancer risk, health history and previous breast imaging. If you develop a new breast concern between routine screening appointments, you should contact your healthcare provider rather than waiting for your next scheduled mammogram.
Screening and Diagnostic Mammography
A screening mammogram is performed when you do not have a new breast symptom and is intended to look for signs of breast cancer before they can be felt or otherwise noticed. A diagnostic mammogram takes additional or targeted images when a particular area needs further evaluation, such as after an abnormal screening result or when you have a new breast symptom.
3D Mammography (Digital Breast Tomosynthesis)
Digital breast tomosynthesis, commonly called 3D mammography, creates multiple low-dose images of the breast from different angles that are reconstructed into a series of thin images. This allows the radiologist to examine breast tissue in greater detail and can be particularly helpful when areas of tissue overlap on standard mammographic images.
Breast Density
Breast density describes the relative amount of fibrous and glandular tissue compared with fatty tissue in the breast. Dense breast tissue can make some abnormalities more difficult to see on a mammogram and is also associated with increased breast cancer risk. Your mammogram report will indicate whether your breasts are considered dense, and your care team can determine whether additional imaging may be appropriate based on your overall risk and imaging findings.
Breast Ultrasound
Breast ultrasound uses high-frequency sound waves to create images of structures within the breast. It does not use radiation and is often used to evaluate a lump or another area identified during a clinical examination or mammogram. For younger patients with a new palpable breast finding, ultrasound may also be the first imaging test performed.
Ultrasound can help determine whether a finding is fluid-filled, such as a cyst, or solid and can provide additional information about its appearance. Imaging alone cannot always determine exactly what a solid breast finding represents, so a breast biopsy may be recommended when tissue is needed for diagnosis.
Ultrasound can also provide real-time imaging during certain procedures. When an area can be seen clearly with ultrasound, the radiologist can use the images to guide a biopsy needle or cyst aspiration precisely to the area being evaluated.
Breast MRI
Breast magnetic resonance imaging (MRI) uses a magnetic field and radio waves rather than X-rays to create detailed images of breast tissue. Breast MRI commonly uses an intravenous contrast agent and may be recommended when additional information is needed beyond mammography, ultrasound or clinical examination.
MRI does not replace mammography for routine breast cancer screening. Instead, it can provide complementary information for selected patients based on breast cancer risk, imaging findings, a known cancer diagnosis or another clinical concern.
Supplemental Screening for Higher-Risk Patients
Breast MRI may be used along with mammography for some people who have a higher risk of developing breast cancer. Your healthcare provider can consider your family history, genetic factors, previous breast findings and other risk information when determining whether supplemental MRI screening is appropriate.
Additional Evaluation After a Breast Cancer Diagnosis
In selected cases, MRI can provide additional information about the extent of a known breast cancer or identify other areas that may require evaluation. Whether MRI is useful depends on the characteristics of the cancer, previous imaging and how the information could affect treatment planning.
Evaluating Breast Implants
MRI may also be used to evaluate breast implants in selected circumstances, including when an implant complication or rupture is suspected. The appropriate imaging method depends on the type of implant, symptoms and the specific concern being evaluated.
Talk With Our Breast Clinic Team
The Breast Health Clinic can be reached at (310) 582-7209. If you have questions about a new breast symptom, need an evaluation or would like help determining your next step, call and a member of our team can assist you.
