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Breast Imaging
1500 East Duarte Road
Duarte, CA 91010-3000
800.826.HOPE
www.cityofhope.org
MED 8116 0607 25M
Breast
Imaging
Benefits of Early Detection
One out of eight women in the U.S. will develop
breast cancer in her lifetime. Fortunately, when
detected early, the great majority of breast
cancers are curable. In fact, 96 percent of women
treated for early stage breast cancer are still free
of disease five years after diagnosis. This makes
routine breast imaging an important part of a
woman’s health care, so that problems can be
detected when they are most treatable.
Several different technologies are available for
breast imaging today. This brochure outlines the
choices available at City of Hope. It explains how
they work, and when they may be most useful.
Breast imaging services are provided at the Rita
Cooper Finkel and J. William Finkel Women’s
Health Center at City of Hope. As an NCIdesignated Comprehensive Cancer Center, we
take a multidisciplinary approach that ensures
a woman receives the best possible care. In
addition to breast imaging, we offer a full
range of diagnostic procedures and treatments,
as needed.
Mammography
A mammogram is a safe and reliable lowdose X-ray exam that provides a view inside
breast tissue. It allows specially trained doctors
(radiologists) to examine the internal structure
of the breast, and to detect growths and other
potential problems.
In recent years, new technologies have reduced
the amount of radiation needed to obtain
mammogram images. Also, computer systems
are now being used to examine mammograms,
aiding in their interpretation.
Breast Cancer Screening
analysis by the radiologist. You may bring these
products to use afterward.
City of Hope follows guidelines recommended by
the National Comprehensive Cancer Network:
When you arrive at the mammography suite, a
dressing area will be provided. You will be asked
to undress down to your waist, and will be given
an examination gown.
For women age 20 to 39:
•
A monthly breast self-exam
•
A clinical breast exam by a trained health
professional every one to three years
For women age 40 and older:
•
A monthly breast self-exam
•
A yearly clinical breast exam by a trained
health professional
•
A yearly screening mammogram starting
at age 40
Health Watch
A mammogram can detect
an abnormality long before
it can be physically felt.
These screening guidelines apply only to women
with no unusual symptoms or breast problems.
If you have an increased risk of breast cancer
because of family history or other reasons,
ask your doctor about beginning screening
mammograms at an earlier age, or having more
frequent exams. You may also want to discuss
other options, such as breast MRI (described
in this brochure).
To learn how to perform a breast self-exam,
please ask for a copy of the City of Hope
brochure, Your Guide to Breast Self-exam.
Preparing for Your Mammogram
On the day of your mammogram, please avoid
using powders or deodorants, because these can
show up on the X-ray and interfere with the
Screening Mammogram
A specially licensed radiologic technologist will
take your mammogram. First, a compression
paddle will be lowered slowly onto your breast.
This prevents any movement and allows the
maximum amount of tissue to be examined.
You may experience some brief discomfort
from the compression.
Then, a series of images will be taken and
checked for quality. If no additional images are
needed, you should be finished with the exam.
Results
Your mammogram will be read by a qualified
radiologist trained to detect any abnormal
areas of breast tissue. The mammogram will
also be scanned by a computer-aided detection
(CAD) system programmed to detect very small
abnormalities. This system works rapidly, so you
can get your results as soon as possible.
You will receive a letter with your results and
information on any additional steps to take,
if needed.
Diagnostic Mammogram
Similar to a screening mammogram, a diagnostic
mammogram is performed when there is a known
problem, such as a lump. It may also be used if
you are experiencing other symptoms such as
pain, or if you have had a previous breast cancer.
In a diagnostic examination, the radiologist will
review your results while you are at the Cooper
Finkel Women’s Health Center. That way, he or
she can decide immediately if additional views are
needed, or if another procedure is needed, such as
a diagnostic ultrasound.
Additional views allow the radiologist to see the
breast from different angles and magnifications.
This helps to get a better look at areas of
overlapping tissue, or microcalcifications (tiny
specks of calcium that sometimes indicate a small
cancer). The radiologist can then decide if a followup mammogram will be required, or if a biopsy is
recommended to examine a tissue sample directly.
This procedure takes between 15 and 45
minutes. First, a warmed gel is placed on the
breast to help transmit sound waves. Then, the
technologist uses a hand-held device to obtain
an ultrasound image, placing it on the breast and
moving it back and forth to create an image on
the viewing screen.
Digital Mammography
Breast MRI
This state-of-the-art advance in mammography
uses X-rays, but images are captured by electronic
detectors instead of traditional film. Generally,
digital mammography is comparable to film
mammography for screening and diagnostic
imaging. However, recent studies show it can
detect breast cancer more effectively in certain
groups of women, including:
MRI (magnetic resonance imaging) technology
combines magnetic fields, radio waves and a
computer system to obtain cross-sectional threedimensional images. Breast MRI is especially
useful for women with breast implants, as well
as women with dense breast tissue that can be
difficult to image with regular mammography.
It can also detect small lesions that may not be
visualized with mammography.
•
Younger women (such as women in their 40s)
•
Women with dense breast tissue
Digital mammography has other advantages.
Procedures are faster, image contrast can
be enhanced, digital files replace the need
for film storage, and images can be
transmitted electronically.
A CAD system is also used with digital
mammography to perform a second reading
that can detect very small abnormalities in
breast tissue.
Going Digital
Digital mammograms
appear to be better at
detecting breast tumors in
certain women.
Diagnostic Ultrasound
Ultrasound uses high-frequency sound waves
to produce an image on a viewing screen. For
women with a breast lump, it can help to tell the
difference between a fluid-filled cyst and a
solid mass.
Breast MRI does not replace mammography. It
is used as an additional way to detect, evaluate
and stage breast cancer. Staging helps doctors
determine how advanced a cancer has become,
and how it should be treated.
Breast MRI can also help doctors evaluate breast
tissue density and check for leaking or ruptured
breast implants, cysts, enlarged ducts and
hematomas (pooled blood). It can locate multiple
tumors, and can sometimes distinguish between
scar tissue and tumors that have returned.
A special contrast material is used with MRI
to give doctors an enhanced image. This can
help them determine whether an abnormality is
benign (noncancerous) or malignant (cancerous),
assess the location and size of any suspicious
growths, and check for enlarged lymph nodes.
Important Information Before
Undergoing MRI
You may be asked to provide a urine sample
before your exam. This is needed for a pregnancy
test. Normally, pregnant women do not receive
MRI because potential risks to the fetus are not
yet known.
You may continue to take your usual medications
before your exam, unless told not to.
If you have fears of being in an enclosed space
(claustrophobia), you can ask your doctor to
prescribe a mild sedative.
Before you receive contrast material, you may be
asked if you have any allergies. Having a serious
health problem such as kidney disease or sickle
cell anemia may prevent you from receiving
contrast material.
This exam will take about 1½ hours total. You
may be permitted to wear your own loose-fitting
clothing if it has no metal fasteners, or else you
may need to change into a hospital gown. Leave
jewelry and accessories at home if possible.
Metal and electronic objects can interfere with
the magnetic field or be damaged by it, and are
not permitted. These include:
•
Jewelry, watches, credit cards, hearing aids
•
Pins, hairpins, zippers, removable dental work
•
Pens, eyeglasses, pocket knives
Tell the radiologist if you have:
•
Artificial heart valves, artificial limbs or
joint prostheses
•
Implanted drug infusion lines or ports, nerve
stimulators or other electronic devices
•
Metal pins, screws, plates or surgical staples
Magnet Power
Combined with mammography,
MRI helps assess many
problems affecting the breast.
MRI is usually safe for patients with metal
implants, but recent implants may require
another imaging procedure. Having metal
objects in the body such as shrapnel may require
a preliminary X-ray. Tattoo dyes containing
iron may heat up during an MRI, but are
rarely a problem.
MRI Procedure
If you are going to receive contrast material,
a nurse will give you an intravenous (IV) line.
You will lie face down on a moveable bed
with your breasts hanging down in cushioned
openings. Earphones and music will be
provided to relax you.
The bed will be moved into the MRI unit’s
magnetic field. Then, the radiologist and
technologist will go into an adjacent room.
You will need to lie still while the machine
creates the images. When images are being
recorded, you will hear loud tapping or
thumping sounds from the equipment. Each
imaging sequence takes from one to 15
minutes. You can relax between sequences.
After the initial series, the contrast material
will be injected, and an additional series of
images obtained.
After the exam is finished, you will wait on
the table briefly while the images are
evaluated to ensure no more need to be
taken. Then the IV line will be removed.
There is usually no recovery time needed,
and you can resume normal activities.
Breast MRI Results
A radiologist experienced in MRI will
analyze the results. You will most likely
receive these results from your primary
care physician or your referring physician.
Following Breast MRI
Sometimes, even breast MRI cannot always
tell the difference between benign and
malignant disease. The results may indicate
that cancer is present, or it may be something
else such as a fibroadenoma (a benign breast
lump). Only a biopsy can determine this.
If additional care is needed, City of Hope
provides women with a full range of
biopsy procedures, as well as standard and
advanced cancer treatment options.
Breast Biopsy
For more details about biopsies, please ask
for a copy of our brochure, City of Hope
Breast Biopsy.
For Appointments and Information
For more information, or to become a patient at
City of Hope, please call 800-826-HOPE or visit
us at www.cityofhope.org.