Breast imaging

[medical citation needed] For the average woman, the U.S. Preventive Services Task Force recommended (as of 2009[update]) mammography every two years in women between the ages of 50 and 74.[15] Presently, Cochrane Collaboration recommends that women should at least be informed of the benefits and harms of mammography screening and have written an evidence-based leaflet in several languages that can be found on www.cochrane.dk.[22] since it is able to overcome the primary limitation of standard 2D mammography which had a masking effect due to the overlapping fibroglandular tissue, whereas DBT is able to distinguish between benign and malignant features, particularly in dense breasts.[23] DBT has also been found to be a reliable tool for intraoperative surgical margin assessment in non-palpable lesions thus reducing the volume of breast excision without increasing the risk of cancer recurrence.[24] No longer in widespread use, xeromammography is a photoelectric method of recording an x-ray image on a coated metal plate, using low-energy photon beams, long exposure time, and dry chemical developers.In a study published by Schulz-Wendtland R et al., investigators made more mistakes when using only ductal sonography compared to when they used contrast-enhanced galactography with tomosynthesis which allowed for generated synthetic digital 2D full-field mammograms to diagnose suspicious lesions.The available literature suggests that the sensitivity of contrast-enhanced breast MRI in detection of cancer is considerably higher than that of either radiographic mammography or ultrasound and is generally reported to be in excess of 94%.[36] Additionally, MRI Is also shown to be more accurate than mammography, ultrasound, or clinical exam in evaluating treatment response to neoadjuvant therapy.[40] Recent studies have shown that shear wave elastography in primary invasive breast carcinoma could be useful for indicating axillary lymphadenopathy.A recent study found 100% ultrasound localization with negative margins obtained in both non-palpable and palpable lesions at initial procedure.Additionally, the combined use of MRI and CEUS in lesions > 20 mm has been shown to optimize the diagnostic specificity and accuracy in breast cancer prediction.[44] Research has also shown that Tc-99 Sestamibi wash out rate is a reliable test for predicting tumor response to neoadjuvant chemotherapy in locally advanced breast cancer.
Schematic image showing a woman undergoing a mammogram imaging examination.
The best mammographic images are produced with compression which reduces radiation needed and spreads tissue to produce clearer images.
A color-enhanced MRI of a breast
Breast ultrasounds may be used with or without a mammogram.
Depictions of nuditycomputed tomography (CT)XeromammographygalactographyscintimammographyMammographyX-raysbreastbreast cancermicrocalcificationsstereotactic biopsiesU.S. Preventive Services Task Forcedense tissuesCochrane CollaborationtomosynthesisFood and Drug Administrationbreast cancer screeningphotoelectricphotonxeroradiographymilk ductsmicrodochectomyHadfield's procedureBreast MRIsensitivityultrasoundspecificityfalse positiveneoadjuvant therapyBreast ultrasoundmedical ultrasonographydiagnosticscreeningelastographyaxillary lymphadenopathycancer cellsmammogramsbreast tissuepost-operativebreast implantsradioactivetechnetiumsestamibiDiffuse optical mammographydiffuse optical imagingAmerican Society of Plastic SurgeonsChoosing WiselyABIM FoundationHubbard, Rebecca A.Medical Subject HeadingsBreast surgeryBreast-conserving surgeryLumpectomySegmental resectionWide local excisionQuadrantectomyMastectomyRadical mastectomyBreast augmentationTrans-umbilical breast augmentationMammaplastyBreast implantBreast reductionMastopexyBreast reconstructionLactiferous ductsDuctal lavageDuctoscopyCentral duct excisionPositron emission mammographyAutomated whole-breast ultrasoundBreast biopsyFine-needle aspirationBreast self-examinationBreast duct endoscopy