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 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 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.
Other options
- Ultrasonography and MRI
- The recommended follow-up procedures when a woman has a positive mammogram.
- Ultrasonography is particularly effective to distinguish between a solid mass and a fluid-filled cyst.
- It is often combined with mammography for a more thorough evaluation of breast tissue.
- Because Small calcium buildups are hard to detect with ultrasound
- A breast MRI is used to look at the size of cancer, shreds of evidence of metastases as well s presence of other tumors in certain cases.
- Also recommended for screening of the high-risk patients wherein serial mammography might increase the likelihood of developing cancer in them.