Diagnostic Testing

Mammogram

Screening vs. Diagnostic mammograms:

A screening mammogram is an x-ray of the breast used to detect breast changes in women who have no signs or symptoms of breast cancer. It usually involves two x-rays of each breast. Mammograms make it possible to detect tumors that cannot be felt. Mammograms can also find microcalcifications (tiny deposits of calcium in the breast) that sometimes indicate the presence of breast cancer.

A diagnostic mammogram is an x-ray of the breast that is used to check for breast cancer after a lump or other sign or symptom of breast cancer has been found. Signs of breast cancer may include pain, skin thickening, nipple discharge, or a change in breast size or shape. A diagnostic mammogram also may be used to evaluate changes found during a screening mammogram, or to view breast tissue when it is difficult to obtain a screening mammogram because of special circumstances, such as the presence of breast implants (see Question 13). A diagnostic mammogram takes longer than a screening mammogram because it involves more x-rays in order to obtain views of the breast from several angles. The technician may magnify a suspicious area to produce a detailed picture that can help the doctor make an accurate diagnosis.

Women age 40 and older should have mammograms every 1 to 2 years. However, women who are at higher than average risk of breast cancer should talk with their health care providers about whether to have mammograms before age 40 and how often to have them.

Digital mammography is different from conventional (film) mammography. Both digital and conventional mammography use x-ray radiation to produce an image of the breast; however, conventional mammography stores the image directly on film, whereas digital mammography takes an electronic image of the breast and stores it directly in a computer. This allows the recorded data to be enhanced, magnified, or manipulated for further evaluation. The difference between conventional mammography and digital mammography is like the difference between a traditional film camera and a new digital camera. Aside from the difference in how the image is recorded and stored, there is no other difference between the two.

Ultrasound

Ultrasound imaging also called sonography uses high-frequency sound waves to produce pictures of the inside of the body. Because ultrasound images are captured in real-time, they can show the structure and movement of the body's internal organs, as well as blood flowing through blood vessels. This is a noninvasive medical test that helps physicians diagnose and treat multiple medical conditions.

A Doppler ultrasound is a special technique that evaluates blood as it flows through a blood vessel, including the body's major arteries and veins in the abdomen, arms, legs and neck. During a breast ultrasound examination the sonographer or physician performing the test may use Doppler techniques to evaluate blood flow or lack of flow in any breast mass. This may in some cases provide additional information as to the cause of the mass.

Ultrasounds can help to determine if an abnormality is solid (which may be a non-cancerous lump of tissue or a cancerous tumor) or fluid-filled (such as a benign cyst) or both cystic and solid. Ultrasound can also help show additional features of the abnormal area.

Today, ultrasound is being investigated for use as a screening tool for women who:

• have dense breasts

• have silicone breast implants and very little tissue can be included on the mammogram

• are pregnant or should not to be exposed to x-rays (which is necessary for a mammogram)

• are at high risk for breast cancer based on family history, personal history of breast cancer, or prior atypical biopsy result.

Ultrasound-guided Breast Biopsy When an ultrasound examination cannot characterize the nature of a breast abnormality, a physician may choose to perform an ultrasound-guided biopsy. Because ultrasound provides real-time images, it is often used to guide biopsy procedures.

Karen Moody ...© All rights reserved