Breast Imaging

Breast imaging includes imaging modalities used for breast cancer screenings and planning therapy once cancer is detected. Mammography is the primary modality used. Mammogram technology is moving from 2D full-field digital mammography (FFDM) to breast tomosynthesis, or 3D mammography, which helps reduce false positive exams by allowing radiologists to look through the layers of tissue. Overlapping areas of dense breast tissue on 2D mammograms appear similar to cancers and 3D tomo helps determine if suspect areas are cancer or not. About 50% of women have dense breast tissue, which appears white on mammograms, the same as cancers, making diagnosis difficult. Radiologists use the Breast Imaging Reporting and Data System (BI-RADS) scoring system to define the density of breast tissue. Many states now require patients to be notified if they have dense breasts so they understand their mammograms might be suboptimal and they should use supplemental imaging that can see through the dense areas. This includes tomosythesis, breast ultrasound, automated breast ultrasound (ABUS), breast MRI, contrast enhanced mammography and nuclear imaging, including positron emission mammography (PEM).

High resolution DBT exams enhance early cancer detection
Recent advances in imaging technology have built on the momentum DBT utilization has created for early diagnoses.
Symptom-detected breast cancers more likely to require mastectomy, chemotherapy
New research adds to the “strong evidence” supporting screening guidelines and highlights the importance of women adhering to clinical recommendations.
Contrast-enhanced mammography significantly improves early cancer detection
New trial results suggest CEM could enhance breast cancer detection beyond DBT exams when patients are faced with barriers to obtaining an MRI.
AI-directed scan protocols cut back on unnecessary MRI sequences
Artificial intelligence could serve as an effective tool for determining which patients may need additional breast MRI sequences mid-protocol.
Symptom-detected breast cancers nearly 7 times more likely to be diagnosed at advanced stage
Advances in treatment are often credited with improving breast cancer outcomes, but new findings suggest the decrease in mortality may actually be due to improved screening initiatives.

High resolution DBT exams enhance early cancer detection

Recent advances in imaging technology have built on the momentum DBT utilization has created for early diagnoses.

Symptom-detected breast cancers more likely to require mastectomy, chemotherapy

New research adds to the “strong evidence” supporting screening guidelines and highlights the importance of women adhering to clinical recommendations.

Contrast-enhanced mammography significantly improves early cancer detection

New trial results suggest CEM could enhance breast cancer detection beyond DBT exams when patients are faced with barriers to obtaining an MRI.

AI-directed scan protocols cut back on unnecessary MRI sequences

Artificial intelligence could serve as an effective tool for determining which patients may need additional breast MRI sequences mid-protocol.

Symptom-detected breast cancers nearly 7 times more likely to be diagnosed at advanced stage

Advances in treatment are often credited with improving breast cancer outcomes, but new findings suggest the decrease in mortality may actually be due to improved screening initiatives.

Example of the four types of breast tissue density. The density of fibroglandular tissue inside the breast impacts the ability to easily see cancers. Cancers are very easy to spot in fatty breasts, but are almost impossible to find in extremely dense breasts. These examples show craniocaudal mammogram findings characterized as almost entirely fatty (far left), scattered areas of fibroglandular density (second from left), heterogeneously dense (second from right), and extremely dense (far right). RSNA

Which exam is best for supplemental imaging of women with dense breast tissue?

It is widely agreed that women with dense breast tissue should undergo supplemental imaging in addition to their routine mammogram screening, but the jury is still out on which modality is best for cancer detection in this group.

Arlene Sussman, MD, radiologist-medical director, mammography, at vRad, explains a telebreast imaging system that allows patients direct video consults with their remote radiologist just after their exams to increase personalized care and to answer questions immediately to avoid waiting for answers. She spoke on this technology in sessions at RSNA 2024.

Creating real-time telebreast imaging that includes remote patient consults

Arlene Sussman, MD, medical director with vRad, explains a telebreast imaging system that allows patients direct video consults with a remote radiologist just after their exams to increase personalized care and answer questions immediately.

Experts use radiomics features to spot specific tissue patterns related to breast cancer.

Research links tissue patterns on imaging with breast cancer risk

These findings could be beneficial for women with dense breasts, which increase the risk of developing cancer while making it significantly more difficult to detect.