Breast cancer is one of the most common types of cancer occurring in women worldwide. The practice of women’s imaging has transitioned through a wide variety of technological advances - from the early days of mammography to breast screening and digital breast tomosynthesis.
Along with these technological advances, the institutes of radiology are constantly working to come up with improved screening methods. Many medical professionals and service providers are constantly working to come up with more advanced screening methods, such as those working in Women’s Imaging departments.
With the development of breast ultrasonography and magnetic resonance imaging, which are both complementary to mammography, high-risk subgroups of women have emerged. A substantial part of breast imaging practice these days also includes breast interventional procedures- both percutaneous biopsy and localization procedures.
For further information on the various perspectives of women’s imaging, keep reading this helpful guide, complete with definitions and the process used for each procedure.
When you talk about breast imaging, mammography has long been the gold standard among breast cancer detection technologies. In mammographic screening, the breast is compressed four times. Advanced developments in the field of mammography enable considerable reductions in the required radiation dose. Diagnostic mammograms are used to check for breast cancer if a lump or any other symptom has been identified.
A breast ultrasound is an imaging technique which is commonly used to screen for tumors and other breast abnormalities. Ultrasound is a key technology to watch in the wake of spreading breast density reporting legislation due to its widespread availability, affordable costs, and ongoing technological advancements in detection accuracy. Your doctor may perform a breast ultrasound if a suspicious lump is discovered in your breast. An ultrasound helps the doctor determine whether the lump is a fluid-filled cyst or a solid tumor, as well as determining the location and size of the cyst.
A breast MRI captures multiple images of your breast and is performed when you have a biopsy that may be positive for cancer and your doctor needs more information about the extent of the disease, or if the disease exists at all. It is recommended when you have a suspected leak or rupture in the breast implant, or you’re at high risk of breast cancer. As a safe procedure, it will not expose you to any radiation. The good news is that nearly 70 percent of women who have a breast biopsy do not have breast cancer.
If diagnostic imaging is not able to resolve a suspicious area of the breast, your doctor recommends a breast biopsy. A biopsy involves removing a small amount of tissue or fluid and examining it under the microscope.
The different types of biopsies are:
1. Stereotactic biopsy
For instances when you need to target calcifications or masses seen only on a mammogram, a stereotactic biopsy will be needed. For this procedure, you’ll be asked to lie down on a special table with an area for your breast. The breast is compressed and a sequence of images are obtained to localize the finding. A local anesthetic is injected into your skin and breast to obtain the additional images.
2. Ultrasound guided biopsy
An ultrasound guided biopsy is used to target masses, cysts or abnormal appearing axillary lymph nodes seen on ultrasound. You will be asked to lie on your and the radiologist will then inject a local anesthetic in your breast and skin. These Ultrasound images are used to guide the biopsy or cyst aspiration. The duration of the procedure is 15-30 minutes.
3. MRI guided biopsy
An MRI guided biopsy is used to target masses seen only on MRI. For this procedure, you will be asked to lie on a table with your face down just like you did for your diagnostic breast MRI Scan and have contrast infused through an IV in your arm. An MRI scan of shorter version will be performed. The radiologist will then inject a local anesthetic into your skin and breast. The MRI images will be repeated to guide the biopsy. The procedure usually takes 30-40 minutes.
4. Fine needle aspiration
For targeting suspected fluid-filled cysts or lymph nodes, a fine need aspiration will be performed. During this procedure, a syringe and a thin needle are used to aspirate fluid from a lump or lymph node. If the lump collapses while the fluid is removed, the lump is likely to be a non-cancerous cyst. If the lump still persists after the fluid is removed, cells from the lump will be removed for examination. Lymph nodes are used to document metastasis.
Your biopsy or the tissue fluid will be sent to the pathology lab, where trained pathologists will examine the sample.
The field of radiology has evolved rapidly in recent times. Examination volumes have increased significantly; it has become more complex leading to an increasing need for specialized diagnostics.
As radiology is becoming an increasingly diverse and challenging disciple, the need for specialist expertise is more essential than ever. Going forward, look for more medical professionals, hospitals, and clinics to work towards more groundbreaking achievements in this field.