WITH BREAST CANCER SCREENING, consider all your options.
There are many options to consider when looking at breast health. As a patient you should be aware of the different risk factors for developing breast cancer, the advantages of different scans, and where you can go for additional information.
Below we have put together information on all of these subjects, along with links to their source materials. We hope this helps to inform and empower you to take control of your well being.
ADVANTAGES OF A BREAST MRI
Magnetic resonance imaging (MRI) of the breast uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of the structures within the breast.
Recent studies have shown 3T MRI to have 100% sensitivity for detecting breast cancer, which is “more sensitive than mammography and sonography in the detection of breast cancer and the characterization of small lesions.” 1
Breast MRI is a useful tool for several patients, including:
- Patients that are known to have breast cancer. The MRI can be used pre-operatively to determine the extent of the disease.
- Patients that have a high risk for developing breast cancer. Find out more about risk factors in the Breast Density and Other Risk Factors sections below. (Click here for a risk assessment tool)
- Patients with silicone breast implants. The FDA recommends biannual screening of silicone breast implants after year three to check the integrity of the implant.
To ensure the clearest images are produced, MRI exams for breast imaging use a contrast material called gadolinium that’s injected into a vein in the arm during the exam, which helps to clearly show breast tissue details. (This is not the same as the contrast dye used in CT scans.)
ABBREVIATED BREAST MRI
Big Sky Diagnostic Imaging is proud to offer the Abbreviated Breast MRI. We are the first facility in Montana to offer this new procedure. The Abbreviated Breast MRI offers most of the benefits of a full diagnostic breast MRI, in a faster, more cost-effective package used for screening purposes.
“To date, (breast) screening MRI has been restricted to high-risk women for a variety of reasons… Abbreviated Breast MRI represents a promising new screening tool and may be the optimal supplemental imaging for average and intermediate risk women, especially in women with dense breasts. Given its high cancer detection rate, biennial screening with AB-MR could prove to be a more efficient and cost-effective supplement to mammography compared to annual whole breast screening ultrasound.” 2
Benefits of the Abbreviated Breast MRI include:
- Quick: the process takes less than 30 minutes
- No prescription is required
- The increased clarity offered by an MRI can allow for early detection of cancer. According to the American Cancer Society, when breast cancer is detected early the 5-year relative survival rate is 99%. 3&4
- No radiation exposure
- Ideal option for patients with breast density or a family history of breast cancer
- The low cost of $500 includes the MRI and interpretation by a radiologist trained in breast imaging. (At this time this procedure is not billable to insurance)
See the handout for additional information:
Full Diagnostic Breast MRI
A full diagnostic breast MRI requires a doctor’s order and in certain circumstances may be covered by insurance.
A full diagnostic breast MRI lasts about 45 minutes to an hour offering a more in-depth scan that is often used to diagnose the extent of the disease in a patient that is already diagnosed with breast cancer. 5
Mammograms are considered the standard test for breast cancer screening in America. For many women, a mammogram will be the only scan she may ever need. For other women at higher risk, a mammogram may just be the starting point. Find out more about the risk factors in the sections below.
Big Sky Diagnostic Imaging does not offer mammograms at this time.
While mammograms are the standard test for diagnosing breast cancer, they do have limitations. Both false-negative and false-positive results are possible and can require a patient to complete additional screenings.
With a false-negative mammogram, the scan can look normal even though breast cancer is present. According to the American Cancer Society, screening mammograms do not find about 1 in 5 breast cancers. This can happen when dense breast tissue obscures cancers from appearing on a mammogram. False-negative mammograms can give women a false sense of security, thinking that they don’t have breast cancer when in fact they do. 6
In cases where a patient has elevated risk, an elective supplemental screening such as the Abbreviated Breast MRI can help detect cancers obscured in their mammogram.
WHAT IS BREAST DENSITY
Breasts are made up of a mixture of fibrous and glandular tissue and fatty tissue. Your breasts are considered dense if you have a lot of fibrous or glandular tissue but not much fat. Having dense breast tissue is common, with approximately 50% of all women being classified as having dense breasts. 7
Breast density is determined by the radiologist — the doctor who reads your mammogram. Dense breast tissue cannot be felt in a clinical breast exam or in a breast self-exam. Your doctor should be able to tell you whether you have dense breasts based on where you fall on the density scale during your mammogram. 8
The image below provides examples of mammograms showing the four classifications of breast density as defined by the American College of Radiology.
Why is BREAST DENSITY important
Dense breasts affect patients in multiple ways, the first of which is that dense tissue can hide cancers on mammograms. Fibrous and glandular tissue looks white on a mammogram. So does a possible tumor. Because it’s hard to tell the difference between a tumor and dense breast tissue on a mammogram, a small tumor may be missed. 9
Women with dense breasts also have a higher risk of developing breast cancer than women with fatty breasts, and the risk increases with increasing breast density. This increased risk is separate from the effect of dense breasts on the ability to read a mammogram. 7&8
Other risk factors and cases for additional screening
Additional breast screening, such as a breast MRI, can be useful for patients that have a high risk for developing breast cancer. There are certain guidelines for using Breast MRI as a screening tool. Women who qualify for a Breast MRI screening are:
- Those with a 20-25% or greater lifetime risk (Click here for a risk assessment tool)
- Those with a BRCA1, BRCA2, PTEN, or TP53 mutation
- Those with a first-degree relative with a BRCA1 or BRCA2 mutation, even if they have yet to be tested themselves
- Those who have received radiation treatments to the chest between the ages of 10-30
- Those with Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or may have one of these syndromes based on a history in a first-degree relative
If you feel that any of these guidelines apply to you, speak with your doctor to find out if additional screening may be necessary.
consulting your doctor
Supplemental screening should be a thoughtful choice after a complete risk assessment with your doctor. We are happy to provide information to further educate the public, but we cannot make or suggest care options to any individual. We encourage women to seek information from their doctors for a more complete discussion.
Sources and Additional reading
- Elsamaloty H, Elzawawi MS, Mohammad S, et al. Increasing accuracy of detection of breast cancer with 3-T MRI. AJR 2009; 192:1142-1148
- Janice S. Sung, MD, FSBI, Abbreviated Breast MR, Society of Breast Imaging
- Early Detection, National Breast Cancer Foundation Inc.
- Survival Rates for Breast Cancer, American Cancer Society
- Breast MRI, American Cancer Society
- Limitations of Mammograms, American Cancer Society
- Breast Density: Breast cancer screening, American College of Radiology
- Dense Breasts: Answers to Commonly Asked Questions, National Cancer Institute
- What Does It Mean to Have Dense Breasts?, Centers for Disease Control and Prevention