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).

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Here’s how radiologists should manage COVID-19 vaccine side effects spotted on breast MRI exams

Doctors have increasingly been seeing breast exams with swollen lymph nodes imitating cancer in patients who have received a vaccine, prompting Penn Medicine providers to offer up guidance.

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New suspicious findings on breast MRI performed during therapy are unlikely to be cancer

University of California, San Francisco, researchers found unusual lesions in 5.5% of cases and none were malignant.

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USA Today: Massive marketing investments—not clinical evidence—buying 3D mammography acceptance

Marketing-related initiatives, rather than proven clinical efficacy, are putting pressure on women to choose 3D mammography, according to an investigation covered in USA Today.

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ASTRO 2019: Patients satisfied with partial breast radiation therapy after lumpectomy

Patients who undergo partial breast radiation therapy after a lumpectomy are as satisfied with the outcome as those who undergo whole breast radiation therapy, according to findings presented at the 2019 annual meeting of the American Society for Radiation Oncology (ASTRO).

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Radiologists ready to speak with patients about breast density, supplemental screening

Many radiologists believe patient-provider discussions about screening mammography and supplemental screening are inadequate, according to findings published in the Journal of Breast Imaging. The specialty appears ready to step up and take a more visible role in patient education.

Women Radiologists Find Their Voice and Make It Heard

The lopsided male-to-female ratio among radiologists and radiology residents—around three men for every one woman—has remained stubbornly constant despite years-long efforts to narrow the gap. This reality is reinforced each time the American College of Radiology conducts its annual workforce survey.

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Breast MRI in cancer survivors results in more unneeded biopsies

Adding MRI to mammography screening for breast cancer detects more cancers, but results in more unnecessary biopsies, according to a June 4 study published in Radiology.

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Short-interval follow-up MRI helps ID early stage breast cancer

The researchers analyzed the frequency and cancer yield of ACR Breast Imaging Reporting and Data System (BI-RADS) 3 lesions in patients who received baseline and non-baseline screening MRIs.

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