When it comes to assessing breast health, there are various modalities available, each serving a specific purpose. These investigations can range from routine screening to diagnostic examinations tailored to individual symptoms and concerns.
Screening typically involves mammography, an X-ray of the breast used to detect early signs of breast cancer in asymptomatic individuals.
Diagnostic imaging is conducted to evaluate specific symptoms or abnormalities detected during screening.
Diagnostic imaging may include additional mammogram views, ultrasound scans, or even MRI scans. Advanced techniques such as contrast mammography enhance sensitivity and can aid in identifying abnormalities more accurately.
Ultrasound scans utilise sound waves to create images of the breast and are particularly useful for evaluating lumps or other symptoms in women under 35 years old. Ultrasound can be used as a complementary test alongside mammography, providing additional information for assessment.
MRI (Magnetic Resonance Imaging) is a sophisticated test that utilises a combination of magnets and intravenous contrast to identify abnormalities in the breast. While highly sensitive, MRI has both pros and cons:
Pros:
- MRI is more accurate than mammography in detecting invasive breast carcinoma.
- It serves as an excellent screening tool for women in high-risk groups, including those with genetic predispositions or a strong family history of breast or ovarian cancer.
- For high-risk individuals, alternating between mammography and MRI every six months is recommended for comprehensive screening.
Cons:
- MRI may not be as effective as mammography in detecting less aggressive non-invasive breast cancers such as DCIS (Ductal Carcinoma In Situ).
- There is a risk of false positives, leading to unnecessary biopsies for lesions that are not cancerous.
- MRI is a more expensive test compared to mammography and may involve the use of intravenous contrast agents, which some individuals may be sensitive to.
Decisions regarding further evaluation, such as biopsy, depend on the level of suspicion raised by these imaging tests. Factors like breast density also influence the choice of investigation, with options like tomosynthesis offering enhanced accuracy, particularly in dense breast tissue.
In summary, understanding the available modalities for breast imaging is essential for informed decision-making regarding breast health. Through a collaborative approach with healthcare providers, individuals can navigate these options effectively to ensure optimal breast care and early detection of any abnormalities.
Additionally, for a full assessment of breast health, every woman aged 20 and above should undergo a formal risk assessment by a qualified healthcare provider. This assessment, conducted by a doctor familiar with breast health or a breast surgeon, can provide personalised recommendations for further surveillance and screening assessments.