September 23, 2017

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Mammograms, Breast Ultrasounds and MRI’s: What’s It All Mean?

MammogramThe key to saving lives from breast cancer is early detection.  When women reach the age of 40 (or earlier if at high risk), it is recommended that an annual mammogram test is completed.  Mammograms can’t keep women from getting breast cancer; their primary purpose is to assist in detecting breast cancer sooner than it can be felt.

Mammography

Mammography is considered to be the gold standard and is the best tool for detecting all shapes, sizes and forms of breast cancer.  A mammogram uses a dedicated x-ray machine to take images of the breast. The images are evaluated by the Radiologist who will look for subtle changes in the breast tissue, which may be an indicator of developing cancer.

Having routine mammograms makes these changes easier to detect.

A change in the breast tissue may appear as a small density, or as microcalcifications that show on the x-ray image. Any time these changes are seen on a mammogram, the Radiologist will want to follow with additional images to further evaluate. If you are asked to return after your screening mammogram, it does not necessarily mean you have cancer; it just means that additional information is needed to make an accurate diagnosis.

Breast Ultrasounds

Breast ultrasounds are considered to be a good complimentary tool that helps to evaluate an abnormality that may be seen on a mammogram.  It can help decide if the area in question is a cyst (a fluid filled sack), or if it is something to be more concerned about.  A breast ultrasound can also help to confirm if the abnormality is a mass or not, or if there is blood flow to an area which is sometimes a characteristic of cancer.

A breast ultrasound is a good secondary method of evaluating the breast but is not used by itself.  It can’t detect the small subtle changes that a mammogram can.  Ultrasound is best used when you know the exact area in question, not to scan the entire breast.

Magnetic Resonance Imaging (MRI)

MRIs are very sensitive and are great if used to diagnose small abnormalities in the breast.A woman that is at high risk for breast cancer may benefit by having a screening mammogram done followed by an MRI 6 months later, and repeating this cycle. The combination of these two tests will help to pick up small changes in the breast tissue.

MRI testing is also helpful when there is known cancer in one of the breasts.  The surgeon will want to use an MRI scan to look at the extent of the cancer and if or how much of the other breast is involved.  Mammograms and breast ultrasounds aren’t always able to pick up the extent of just how invasive the cancer is, so an MRI is used to help the surgeon recommend if a small portion or the entire breast should be removed.

Digital Mammography

ACMC clinics have been offering digital mammograms since 2008.  Clinical trials have been done to compare digital mammograms vs. analog, where digital were found to be 28% more effective in detecting breast cancer in women under the age of 50, or for those with dense breast tissue.  There is also less exposure to radiation which is important to consider since this is a yearly examination for women over 40 years old, or earlier if at high risk.  Even though the exposure to radiation is low, at ACMC it is important that we do what we can to help reduce radiation exposure to our patients.  Digital mammography is offered in the following ACMC clinics: Willmar, Marshall, and Redwood Falls and our providers partner with facilities in the following locations to provide off-site digital mammography: Benson, Granite Falls and Litchfield.

What is a breast biopsy?

A breast biopsy is where a tiny tissue sample is taken from the breast and sent to a pathologist for review under a microscope.  A breast biopsy is requested when an abnormality is seen on a mammogram or on a breast ultrasound that either looks suspicious for cancer or if what it is can’t determined.  Approximately 80% of breast biopsies are benign (non-cancerous) but if the tissue in question is in the other 20%, we want to know sooner rather than later.

What if I am told I have breast cancer?

For men or women that are told they have breast cancer, the next step would is to be seen by a surgeon.  The surgeon will sometimes do more testing to help reccommend whether to remove a portion of the breast or if a mastectomy (removal of the entire breast) is needed.  Once the surgery has been completed, a consultation with a radiation oncologist might be suggested to talk about treatment options such as chemotherapy or radiation therapy.  Treatment options will largely be determined by the stage of the cancer.

Kari Westby

Kari Westby, ACMC Radiation Safety & QA Manager

We have several surgeons available at ACMC, so you don’t have to travel into the metro area if you would rather stay closer to home.  We also work with the Willmar Regional Cancer Center for comprehensive cancer treatment and follow up care.

Cancer can potentially affect anyone reading this blog, and although you may not have a family history, it is important to know that history has to start somewhere and just may start with you.  70-80% of people that are stricken by breast cancer have no family history.  It is important to be screened regularly according to the guidelines by the American Cancer Society, the American College of Radiology and the Society of Breast Imaging.

Do you have questions about mammogram screening tools?  We want to know!