According to The National Breast Cancer Foundation, 98 percent of breast cancer patients survive – if detection occurs early. Since the late 1960s, traditional mammography has been used widely for breast cancer detection. The future of breast cancer care, however, lies in even earlier detection and individually tailored diagnosis and treatment, and imaging manufacturers are developing technologies that make these possible.
While mammography is the front-line imaging modality, other breast imaging technologies are emerging that will offer even more dramatic benefits to patients. Breast tomosynthesis (3D mammography), ultrasound, breast magnetic resonance imaging (MRI), positron emission mammography (PEM) and molecular breast imaging (MBI) are improving breast cancer detection and treatment, especially for women at high risk for the disease, such as those with dense breast tissue or genetic predisposition, as well as the newly diagnosed.
Innovation in 3D screening
Breast tomosynthesis provides three-dimensional images that increase accuracy and reduce false positives in breast cancer screening. A study in the Journal of the American Medical Association found that the technology, when used in combination with digital mammography, resulted in a 41 percent increase in the detection of invasive breast cancers, a 49 percent increase in positive predictive value (PPV) for a recall and a 21 percent increase in PPV for biopsy. The technology is FDA-approved, suitable for all women and only takes four seconds. 3D mammography is especially beneficial for women with dense breast tissue, breast implants or who have had prior biopsy or surgery.
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Supplemental screening options
While most people think of pregnancy when it comes to ultrasound, it is also increasingly used for breast cancer detection. Breast ultrasound can distinguish tumors from benign cysts, providing a noninvasive solution to determine whether or not a suspicious area is in fact a cyst – a determination that has historically been made only by performing an invasive biopsy.
Another option is MRI scans, which create detailed pictures of the breast that allow for early detection of tumors. Breast MRI may help detect early stage breast cancer in women who are at high risk. In patients who have already been diagnosed with breast cancer, MRI can be used to determine the actual size of the cancer and inspect the breast for other cancers. Additionally, the FDA recently approved the first contrast agent for use with breast MRI, an approach that has been shown to help physicians more clearly detect and visualize malignant breast tumors.
Locating and staging breast cancer
When breast cancer is detected and treated early, patients have a much higher chance of survival. Yet for some women, including those with dense breast tissue, traditional mammography screening can miss small but potentially deadly tumors. Fortunately, there are more options available to women today. One of the defining features of positron emission mammography (PEM) is that it has very high resolution and can identify the location and metabolic activity of extremely small cancers. For patients unable to undergo an MRI – for example, patients with pacemakers or defibrillators – PEM can also be particularly useful for staging a malignancy. PEM may also be used to monitor a patient’s response to chemotherapy or detect disease recurrences.
The next frontier in breast imaging
At the forefront of the next frontier of breast cancer care is molecular breast imaging (MBI), an emerging technology that can detect very small breast tumors. Though not yet widely available, MBI may serve as another valuable imaging technique for women with dense breast tissue as it consistently detects additional cancers in the breast that are not visible with mammography alone, while maintaining a false-positive rate that is equal to or less than that of mammography.
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Thanks to constant innovation in the breast imaging space, it is no longer necessary to take a one-size-fits-all approach to patient care for breast cancer screening and diagnosis; medical imaging can now be tailored to the individual patient. In light of this, women should speak with their doctors about the best option for their unique needs to ensure they are getting the right scan at the right time.
