Imaging Tests for Breast Disease Diagnosis

Virginia Mason offers a range of imaging tests for breast cancer.

Mammography Screening

Screening is the key to finding breast cancer early when treatment is most effective.

A mammogram is an x-ray of the breast that can detect tumors too small to feel. Mammograms may detect breast cancer several years before a tumor becomes large enough to be felt as a lump.

The American Cancer Society recommends that mammograms be scheduled accordingly:

Age / Screening Recommendation

40 and over

Breast self exam (optional) and an annual mammogram and clinical breast exam.

20-39

Breast self exam (optional) and a clinical breast exam every 3 years.

Diagnostic Mammography

When an abnormality is questioned on a screening mammogram, you will be referred for an ultrasound, a diagnostic mammogram, or both.

A diagnostic mammogram can provide more information about abnormalities by obtaining supplemental images, including magnification and spot compression views.

Abnormalities on mammogram are classified as benign, probably benign, suspicious, or highly suspicious of malignancy. With a “probably benign” reading, the radiologist may recommend a 6-month follow-up examination. If your initial mammogram reveals a “suspicious” or “highly suspicious” abnormality, a biopsy is always recommended.

Men also may be referred for a diagnostic mammogram or ultrasound.

Women with breast implants can have high quality mammograms. A specific maneuver, called the Ecklund, or “pushback” technique, allows the radiologist to see much more of the breast tissue without the implant obscuring visibility.

Digital Breast Tomosynthesis (3D Mammography)

Our Seattle and University Village locations offer digital breast tomosynthesis (3D mammography). This latest advancement in breast imaging can improve the early detection of otherwise hidden cancer and is recommended for high-risk patients, including those with dense breasts and cancer survivors.

Ultrasound

An ultrasound test.

This test uses high frequency sound waves to form an image of breast tissue that is displayed on a video screen and captured for analysis. The radiologist also can review the images in “real time” while the scan is being performed.

Often, ultrasound reveals whether a lump is solid or a fluid-filled, non-cancerous cyst. If breast cancer is suspected, a core needle biopsy can be performed by the radiologist using ultrasound guidance.

Magnetic Resonance Imaging

A Magnetic Resonance Imaging (MRI) unit.

An MRI combines a magnetic field and radio waves to create an image on a computer screen of the body’s internal organs. It is sometimes used to distinguish between scar tissue and cancer in patients with previous breast cancer surgery, to define the extent of cancer within the breast, or to give additional information in women with cancer whose breasts are difficult to evaluate with mammogram or ultrasound.

MRI also is commonly used to image breast implants if there is a question of rupture. This MRI study is different from the type used to identify cancer.