Ultrasound and MRI often are the next level of cancer detection, beyond mammograms

Contributing ColumnistsOctober 11, 2013 

Most women understand that regular mammogram screenings are key to breast cancer prevention. In fact, mammograms remain the gold standard for detecting early breast cancer. When you or your doctor identify a change or abnormality in your breast tissue, or when your regular screening results aren't clear, you may be referred to a radiologist for additional testing.

According to the Centers for Disease Control and Prevention, breast cancer is the second-leading cause of cancer deaths and the most common cancer among women in the United States. Breast ultrasound and MRI are two important types of diagnostic imaging that often are used as a second tier of breast cancer testing to catch this deadly disease in its early stages. The primary goal of these diagnostic evaluations is to determine whether an abnormality is cause for concern and if a biopsy procedure is necessary.

Breast ultrasound involves the use of sound waves to create images of different tissue types. It can accurately distinguish fluid-filled masses (benign cysts) from solid masses that could be malignant. In addition, it displays other characteristics that radiologists use to determine whether a particular finding is cause for worry. Ultrasound can also be used to guide a physician during biopsy procedures.

Physicians frequently recommend that their patients undergo an ultrasound to evaluate questionable lumps found during a physical exam. In most cases, those "lumps" represent normal tissue rather than cancer, but it's important to err on the side of caution.

MRI is a much more expensive and complex test that uses magnetic field and radio waves to create images of different parts of the body. Breast MRI can accurately detect cancerous masses, even those smaller than a pea, in nearly 100 percent of cases. However, some benign masses can mimic cancer on an MRI, and require further testing.

The American College of Radiology's guidelines for the use of breast MRI include:

■ Determining the extent of newly diagnosed cancers to help guide the most effective treatment;

■ Searching for cancer when a patient displays enlarged lymph nodes under the arm;

■ Monitoring the effectiveness of chemotherapy;

■ Assessing for recurring or remaining breast cancer after surgery;

■ Screening for women at high risk of developing breast cancer, including those with certain genetic tendencies.

Once a mass that is cause for concern has been detected, your doctor may recommend a biopsy procedure. A small incision is made in the skin, and a portion of the mass is removed and sent for testing. Lab results will show whether the mass is malignant or benign.

A biopsy, in combination with diagnostic testing, will ensure that your doctor develops the most effective treatment plan for your circumstances. This combination of testing will ensure a minimal number of surgical procedures, as well as better cosmetic outcomes.

Facilities that specialize in breast cancer offer a number of different imaging tests. Radiologists who are trained in the field of breast imaging are uniquely qualified to determine which of these tests are best for each individual patient. A physician will contact you about whether you need additional testing. If you have any causes for concern, this second level of testing might provide just the reassurance you need.

Dr. Marta Kenney and Dr. Kimberly Stigers are with Saint Joseph Hospital, part of KentuckyOne HealthDr. Marta Kenney and Dr. Kimberly Stigers are with Saint Joseph Hospital, part of KentuckyOne Health

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