Breast Imaging

Breast imaging includes imaging modalities used for breast cancer screenings and planning therapy once cancer is detected. Mammography is the primary modality used. Mammogram technology is moving from 2D full-field digital mammography (FFDM) to breast tomosynthesis, or 3D mammography, which helps reduce false positive exams by allowing radiologists to look through the layers of tissue. Overlapping areas of dense breast tissue on 2D mammograms appear similar to cancers and 3D tomo helps determine if suspect areas are cancer or not. About 50% of women have dense breast tissue, which appears white on mammograms, the same as cancers, making diagnosis difficult. Radiologists use the Breast Imaging Reporting and Data System (BI-RADS) scoring system to define the density of breast tissue. Many states now require patients to be notified if they have dense breasts so they understand their mammograms might be suboptimal and they should use supplemental imaging that can see through the dense areas. This includes tomosythesis, breast ultrasound, automated breast ultrasound (ABUS), breast MRI, contrast enhanced mammography and nuclear imaging, including positron emission mammography (PEM).

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When it comes to breast imaging, a few new technologies have improved the visualization of lesions and diagnostic procedures. But a new modality could change the game completely.

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Constance "Connie" Lehman, MD, PhD,, chief of breast imaging, co-director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital, and professor of radiology at Harvard Medical School, discusses trends in breast imaging.

VIDEO: Connie Lehman discusses trends in breast imaging

Connie Lehman, MD, PhD, chief of breast imaging, co-director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital, and professor of radiology at Harvard Medical School, discusses trends she sees in breast imaging.

October 24, 2022
Breast screening mammogram during the COVID pandemic. COVID significantly impacted breast imaging. Image courtesy of Novant Health

VIDEO: Impact of COVID on breast imaging

Connie Lehman, MD, PhD, chief of breast imaging, co-director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital, discusses the challenges of the COVID-19 pandemic on breast screenings, increased cancer rates and issues with the vaccines causing false positives on mammograms.

October 21, 2022
Contrast-enhanced mammography uses iodine contrast injected into a patient and mammography system to image contrast uptake or areas of increased vascular activity, which is typical of cancers. This can help image through dense breast tissue to find cancers that are otherwise masked by dense breast tissue.

VIDEO: Why contrast enhance mammography might be the ideal supplemental imaging

Connie Lehman, MD, PhD, chief of breast imaging, co-director of the Avon Comprehensive Breast Evaluation Center at the Massachusetts General Hospital, explains why she thinks contrast-enhanced mammography will likely become the go-to supplemental imaging modality for women with dense breasts.

October 20, 2022
An example of commercially available artificial intelligence (AI) automated grading of breast density on mammograms from the vendor Densitas..

VIDEO: Role of AI in breast imaging with radiomics, detection of breast density and lesions

Connie Lehman, MD, chief of breast imaging, co-director of the Avon Comprehensive Breast Evaluation Center at Massachusetts General Hospital, discusses how artificial intelligence (AI) is being implemented in breast imaging.

October 18, 2022
Example of a cancer that is difficult to see in dense breast tissue, but can be seen easier using 3D mammography digital breast tomosynthesis (DBT) breast imaging because the radiologist can go through the breast layer by layer if tissue..

VIDEO: The rapid adoption of 3D mammography and use of AI to address dense breasts

Stamatia Destounis, MD, a radiologist and managing partner at Elizabeth Wende Breast Care in Rochester, New York, chair of the American College of Radiology (ACR) Breast Commission, explains the rapid adoption of 3D mammogram digital breast tomosynthesis (DBT) technology.
 

October 14, 2022
Society of Breast Imaging (SBI) President John Lewin, MD, explains some of new initiatives and technology in mammography to increase earlier breast cancer detection. #SBI #breastimaging #mammography

VIDEO: SBI president outlines trends in breast imaging

Society of Breast Imaging President John Lewin, MD, explains some of the new initiatives and technology in mammography that are designed to increase early breast cancer detection.

October 14, 2022

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