Imaging

Breast Cancer

Preliminary Diagnosis: Breast Cancer

I. What imaging technique is first-line for this diagnosis

  • Dedicated mammographic evaluation of the bilateral breasts.

II. Describe the advantages and disadvantages of this technique for diagnosis of Breast Cancer.

Advantages

  • Highly sensitive and specific imaging modality in detecting abnormalities of the breast.

  • Gold standard in detecting breast abnormalities.

  • May help guide percutaneous intervention, i.e. stereotactic breast biopsies.

Disadvantages

  • Exposes patients to ionizing radiation.

  • Limited in evaluation of breast tissue for patients with breast implants.

III. What are the contraindications for the first-line imaging technique?

  • May be limited in evaluation in patients with breast implants.

IV. What alternative imaging techniques are available?

  • Ultrasound of the breasts

  • MR imaging

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of Breast Cancer.

Ultrasound of the breasts

Advantages

  • Offers better evaluation of the breast tissue in patients with breast implants.

  • Does not expose patients to ionizing radaition.

  • Warranted in patients with palpable lesions.

  • May help guide percutaneous intervention.

  • May help evaluate the vascularity of breast abnormalities.

  • Highly portable.

Disadvantages

  • Highly operator dependent.

MR imaging

Advantages

  • Does not expose patients to ionizing radiation.

  • Highly sensitive and specific in detecting the extent of an invasive lobular or ductal carcinoma and can better help evaluate for multifocal and multicentric disease.

  • May help evaluate breast tissue in patients with breast implants.

  • Useful in guiding MR guiding biopsies.

Disadvantages

  • Expensive

  • Time consuming

  • May be subject to motion and susceptibility weighted artifact

VI. What are the contraindications for the alternative imaging techniques?

Ultrasound of the breasts

  • No specific contraindications to sonographic imaging exist.

MR imaging

  • Contraindicated in patients with non MR compatible hardware.

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