Understanding Mammograms and Other Breast Imaging Options

The American College of Radiology recommends annual breast imaging screening for all women over 40. Not only women with symptoms. Not only women with a family history of breast cancer. All women. 

Breast cancer screening promotes early detection, which can prevent more aggressive treatments and improve your survival rate. As new technologies emerge for breast cancer screening, it’s essential to know your options, why the technology is used, and whether or not it’s right for you. 

Mammogram 101 

A mammogram is a low-dose x-ray that a radiologist can view to check for any changes in the breast tissue. Regular self-breast exams are a good start. But a mammogram can detect cancer when it’s small enough to not feel with your fingers. 

The smaller the lump, the easier it is to treat. Mammograms are used in two different ways:

Screening mammograms - used to look for signs of breast changes in women who haven’t reported any symptoms or issues. These images are usually taken from two different angles. 

Diagnostic mammograms - This type of imaging is used as a follow-up for women who report symptoms or had changes detected during a screening mammogram. The radiologist may include images from different angles that aren’t included in a screening mammogram. This type of mammogram is also used for women who’ve been treated for breast cancer in the past. 

Other standard breast cancer screening 

Most women book an annual appointment for mammograms, but there are two other common types of breast cancer screening:

Breast ultrasound - this type of screening uses sound waves to view inside the breast. Ultrasound shows certain breast changes that are harder to identify on mammograms. You may get an ultrasound if you feel lumps that aren’t showing up on a mammogram or you have dense breast tissue. It may also be used as a follow-up option to take a second view of breast changes that showed up on a mammogram. Ultrasounds can show the difference between fluid-filled cysts and solid masses, rendering further testing such as a biopsy. 

Breast MRI (magnetic resonance imaging) -  this type of screening uses radio waves and strong magnets to create images inside the breast. Doctors may request an MRI for women with a cancer diagnosis to measure the size of the tumor or search for other existing tumors within the breast tissue. 

Newer technology emerging in breast imaging 

Imaging centers are using newer technology, while other imaging solutions are still in the experimental phase. If these types of imaging are as good or better than current technology, it could save more lives and help with early detection. 

Molecular breast imaging (MBI) is a type of nuclear medicine imaging for breast tissue. A radiologist will inject a radioactive chemical into the bloodstream and then use a camera to see inside of the breast. This test is currently in the experimental phase as a way to follow up with an abnormal mammogram. It may also provide more in-depth imaging for existing breast cancer. One potential drawback is that it exposes the whole body to radiation. So this would not be a type of screening women get annually.  

Positron emission mammography (PEM) - this type of imaging is similar to a PET scan.  PEM is a newer imaging test of the breast that is very similar to a PET scan. A radiologist will inject a form of sugar attached to a radioactive particle into the bloodstream to detect cancer. A PEM scan is being tested to see if it can detect small clusters of cancer cells within the breast.  Like MBI, it exposes the whole body to radiation, so it would not be part of an annual screening protocol. 

Several other types of imaging are in the experimental phase. If successful, we may see better imaging and more precise ways of treating cancer. For now, schedule your annual mammogram and don’t skip them. It could save your life.