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: Ammu Susheela, M.D. [2]
Overview
Other diagnostic studies for breast cancer include scintimammography 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 tumours 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 tumour 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), a type of thermography used in the screening of breast cancer, uses an infrared thermal camera to take a picture of the areas of different temperature in the breasts. The camera displays these patterns as a sort of heat map.
The presence of a cancerous growth is associated with the excessive formation of blood vessels and inflammation in the breast tissue. These show up on the infrared image as areas with a higher skin temperature.
Benefits It is a non-invasive, non-contact procedure, which does not compress the breast. It does not involve exposure to radiation, and so it can be used safely over time. 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. It has a high false-positive rate, which can result in the woman having to have the standard mammogram anyway. It has a high false-negative rate, which can lead to avoidance of the standard mammogram as a woman may feel she has been adequately screened. It is rarely covered by medical insurance. A false-negative result is one that suggests that cancer is not present when it is. It is important to stress the high levels of false-positive and false-negative rates, as there are other screening options available.
- The high false-positive and false-negative rates associated with thermography often mean that the woman will need a standard mammogram anyway.
Other options
ultrasonography magnetic resonance imaging (MRI) Ultrasonography and MRI are the recommended follow-up procedures when a woman has a positive mammogram. Ultrasonography is particularly effective for telling apart a solid mass from a fluid-filled cyst.
Small buildups of calcium are hard to see with just an ultrasound, so it is often combined with mammography for a more thorough evaluation of breast tissue.
A breast MRI uses magnetic fields to create an image of the breast. It is used to look at the size of the cancer, and look for other tumors.