Breast cancer other imaging studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]Ammu Susheela, M.D. [3]

Overview

Other diagnostic studies for breast cancer include modified MRI utilities such as high-field strength MRI, magnetic resonance spectroscopy, diffusion weighted imaging.Among the other imaging modalities are breast-specific gamma imaging, and positron emission mammography as well as scintimammography, thermography and bone scan.

Scintimammography

• Scintimammography uses a radioactive material (known as a radioactive isotope) and a special camera to take pictures of the breast. It is done:

• to check breast lumps that do not show up clearly on a mammogram because of:

• scar tissue from previous surgery or radiation therapy
• dense breast tissue
• breast implants

• when multiple tumors are seen in the breast
• to scan the lymph nodes in the armpit (axilla) to see if they contain cancer

• Scintimammography is not commonly used. It does not replace mammography, which is still the standard imaging test used to diagnose breast cancer. At present, scintimammography is considered a second-line diagnostic tool. It may be used in some women to assess breast abnormalities after a mammogram.

Bone Scan

• A bone scan uses bone-seeking radioactive materials (radiopharmaceuticals) and a computer to create a picture of the bones. It is used to see if breast cancer has spread (metastasized) to the bones.
• A bone scan may be done if:

• Alkaline phosphatase in the blood is increased
• There are lymph nodes in the armpit (axillary lymph nodes) that can be felt
• The primary breast tumor is larger than 5 cm
• The woman has aches and pains that may be caused by bone metastases

• A bone scan is not done in women who have stage I breast cancer.

Thermography

• Digital infrared thermal imaging (DITI) is a type of thermography which is used in the screening of breast cancer
• An infrared thermal camera takes pictures of the areas of different temperature in the breasts.
• The camera displays these patterns as a sort of heat map.
• Since the presence of cancerous growth is associated with the excessive formation of blood vessels and inflammation in the breast tissue.
• On the infrared images, these higher temperatures could be detected.

Benefits

• Non-invasive procedure
• Non-contact procedure (does not compress the breast)
• No exposure to radiation, (safe)
• It can detect vascular changes in breast tissue associated with breast cancer many years in advance of other methods of screening.
• It can be used for all women, including those with dense breast tissue and breast implants.
• Hormonal changes do not affect results.

Drawbacks

• High false-positive rate
• High false-negative rate
• Rarely covered by medical insurance
• The high false-positive and false-negative rates associated with thermography often mean that the woman will need a standard mammogram anyway.