Running Head: BREAST CANCER IMAGING

The Different Types of Breast Cancer Imaging for Early Detection and Prevention
Kortney Richardson
Schoolcraft College

BREAST CANCER IMAGING

The Different Types of Breast Cancer Imaging for Early Detection and Prevention
Breast Cancer is one of the most common cancers, especially among the female
population. Although it affects mostly women it can still affect men as well. Even though the
affects of breast cancer can lead to death, with early detection it can be treated with great success
(McPeak, 2104). The breasts are made of several layers of adipose or fat tissue as well as
connective tissue layers called stroma and lymphatic tissue. The stroma is an important part of
the anatomy of the breast as it functions to provide the breasts with structural support. Other
features of the breast are lobules, which are glands that produce milk and ducts that connect the
lobules to the nipples (Johnson, 2012). Breast cancer can occur in any part of the breast tissue.
Infiltrating lobular carcinoma is one of the most common forms of breast cancer. This type of
cancer begins in the lobules and will eventually spread to the surrounding breast tissue and into
the lymph nodes (McPeak, 2014). Two other forms of breast cancer are ductal carcinoma in situ
and lobular carcinoma in situ. Both of these forms of breast cancer are almost always cured and
have a 99.5% survival rate when treated. Ductal carcinoma in situ occurs inside the milk ducts
but does not spread beyond them. Lobular carcinoma in situ is similar to ductal carcinoma in that
it does not spread beyond the lobules (Johnson, 2012).
There are many risk factors than can increase ones chance of getting breast cancer, and
knowing these factors can help with early detection of the cancer. Heredity plays a major role in
increasing ones chance of developing breast cancer. If the mutated BRCA 1 gene is inherited, it
increases an individuals chances by 80%, and if the mutated BRCA 2 gene is inherited, it
increases an individuals risk by 45%. Also having a close relative who has breast cancer can
almost double the chance of developing breast cancer. Another risk factor for breast cancer is
having dense breasts because it can make imaging difficult to do. It is important to know what

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risk factors apply because this will help determine the appropriate imaging and treatment to use
that best fit each patient (McPeak, 2014).
One of the most common breast cancer screening techniques is mammography. Although
other forms of breast cancer screening are used, this method still remains most popular.
Mammography helps to reduce the risk of mortality by allowing early detection of the cancer.
(Johnson, 2012). A mammogram works by compressing the breast to obtain bilateral images.
Women who have more adipose tissue in their breast have a sensitivity rate of about 87%-97%.
On the other hand, women who have denser breast seem to have a lower sensitivity rate of about
30%-48% (McPeak, 2014). A mammogram is very useful in detecting some cancers, but it is not
completely accurate and does have some limitations. Two main limitations are dense breasts and
silicone breast implants. Both implants and dense breast can disguise any lesions that may be
present on the breasts (Johnson, 2012).
Another method of screening is digital breast tomosynthesis. This type of screening is
very similar in mature to a mammography. Instead, however, it uses x-rays to create a 3D image
of the breast. Images of about 25 different sections of the breast are taken and then pieced
together to achieve the 3D image. This screening technique allows the physician or radiologist to
determine the size and shape, as well as the location of any lesions (McPeak, 2014).
A third type of screening is called ultrasonography. This type of imaging does not use
radiation; instead it uses sound waves to produce the image. This imaging technique is useful in
distinguishing solid from cystic lesions. However, one downside to this form of imaging is that it
is not as sensitive as a mammography (McPeak, 2014).
Nuclear medicine breast imaging techniques are also common in screening for breast
cancer. Nuclear medicine uses radioactive tracers to show areas that have high metabolic and

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vascular activity. A few different nuclear medicine breast imaging techniques are
scintimammography, positron emission mammography, breast-specific gamma imaging, and
molecular breast imaging. The purpose of all these nuclear medicine imaging techniques was to
develop a high- resolution camera that could detect lesions that were too small to otherwise
detect (McPeak, 2014).
Molecular breast imaging is one example of a nuclear medicine procedure. This is
sometimes preferred over a mammography. This type of imaging uses a radiopharmaceutical and
an imaging device. This allows the physician or radiologist to also examine the metabolic
activity in the breasts. The radiopharmaceutical that is injected into the patient is technetium
Tc99m sestamibi. This radiopharmaceutical will then cling to tumors because of their high
metabolic activity. Areas of high metabolic activity are then highlighted indicating where tumors
may be present. Molecular breast imaging is especially useful in detecting lesion in dense breasts
(McPeak, 2014).
Magnetic Resonance imaging is other technique for breast cancer screening. This type of
screening shows the vascular activity of the breasts by using a high-energy magnetic field plus an
enhancing contrast medium. The sensitivity of magnetic resonance imaging is about 88%-99%
making it a very useful screening technique (McPeak, 2014). This is especially useful with
patients who have breast implants or dense breasts because it does not interfere with this type of
imaging (Johnson, 2012). It can also be used in patients who have had lumpectomy. It can
evaluate any scar tissue, check to see if any cancer has returned, or check the progress of a tumor
during chemotherapy (McPeak, 2014).
A special type of magnetic resonance imaging that is sometimes used in breast cancer
screening is contrast-enhanced MR. The contrast used in this procedure is a gadolinium-based

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agent. One important quality of this screening technique is its ability to distinguish between a
malignant tumor and a benign tumor. The high vascular activity in malignant tumors shows up
with a higher contrast than normal tissue or benign tumors making it easy to determine if a
cancerous tumor is actually present. Also, contrast-enhanced MR imaging is more effective in
recognizing abnormalities than most other tests (Johnson, 2012).
Theses are just a few of the common imaging techniques that are used in breast cancer
screenings. Some imaging techniques work better than others at detecting breast cancer in its
earliest stages. But, knowing which risk factors apply to the patient can help narrow down the
different choices and find the best treatment and screening option. The purpose of these different
techniques is to detect the cancer early in an effort to make treatment more effective as well as
reduce the risk of breast cancer mortality.

BREAST CANCER IMAGING

References
Johnson, M. M. (2012). Breast Magnetic Resonance Imaging[corrected][published
erratum appears in RADIOL TECHNOL 2012; 8(4):364]. Radiologic Technology,
83(3), 261M-288
McPeak, P.R. (2014). Advancements in Molecular Breast Imaging. Radiologic Technology,
85(5), 523M-541.