SUPPLEMENTAL BREAST EXAMS.

Screening mammography is the current standard for breast cancer detection with a reduction of breast cancer mortality by nearly 40% in randomized controlled trials. The American College of Radiology and the Society of Breast Imaging recommend annual screening mammography for all women of average risk starting at age 40.

However, studies have shown the sensitivity of mammography for detecting cancer decreases from 85-88% in a fatty breast to 62-68% in an extremely dense breast due to the masking effect, leading to more interval cancers (cancers diagnosed within one year of a normal mammogram) in women with dense breasts.

Personalized breast care.

Women with dense breasts may benefit from more personalized breast care, including supplemental screening. As an accredited Breast Imaging Center of Excellence, Inland Imaging now offers multiple supplemental screening options for women with dense breasts.

WHOLE BREAST ULTRASOUND AND AUTOMATED BREAST ULTRASOUND (ABUS)

Invenia ABUS (GE) is the only ultrasound technology FDA-approved for breast cancer detection in women with dense breasts. The exam is comfortable for patients, does not require IV contrast, and does not use radiation. Research shows that supplemental ultrasound, used in addition to a yearly mammogram, can detect 3 additional cancers per 1000 women. ABUS is covered by most insurance plans. ABUS is purely a screening exam for asymptomatic patients and should not be used for diagnostic purposes.

Which patients should consider ABUS:

  • Average or intermediate-risk women with dense breasts and a normal mammogram within 1 year

  • High-risk women who cannot undergo a screening breast MRI due to physical limitations

BREAST MRI AND ABBREVIATED BREAST MRI. WHAT IS RIGHT FOR YOU?

Full protocol screening Breast MRI

Full protocol breast MRI is the most sensitive screening exam available, more sensitive than mammography or ultrasound. Supplemental screening with breast MRI has been shown to increase cancer detection in high-risk women (estimated lifetime risk >20%). It does not use radiation. Most insurances cover screening breast MRI in high-risk women.

Which patients should consider Breast MRI:

  • High-risk women, defined as 20% or greater lifetime risk of developing breast cancer

  • Women with a personal history of breast cancer and dense breasts

  • Women with a personal history of breast cancer before the age of 50

  • Women with a known genetic mutation such as BRCA 1 or BRCA 2 (starting at age 25)

  • Women with a personal history of atypia or lobular carcinoma in-situ (LCIS)

Abbreviated Breast MRI (AB-MRI)

Abbreviated Breast MRI is a shortened version of a breast MRI intended to screen for breast cancer in average-risk women with dense breasts. AB-MRI has been shown to detect up to 16 more breast cancers per 1000 women. AB-MRI does not use radiation. It does require contrast (gadolinium) through an IV. It is a shorter exam compared to a full protocol breast MRI. It is self-pay and not currently covered by insurance. It is not yet approved for use in the screening of high-risk women or women with known breast cancer.

Which patients should consider AB-MRI:

Average or intermediate-risk women with dense breasts and a normal mammogram within 1 year.

BREAST BIOPSY

If a mammogram or other imaging study shows a change in your breast, a breast biopsy may be recommended. A breast biopsy is a medical procedure that removes a small sample of tissue so that it may be examined by a Pathologist.

At Inland Imaging, we use special equipment to perform your breast biopsy. The type of biopsy you have is decided by one of our specialized breast radiologists after reviewing your images. Our current image-guided procedures include tomosynthesis or stereotactic guided biopsy (mammography), ultrasound-guided biopsy or MRI-guided biopsy. Each of our radiologists has extensive experience in all breast procedures.

All of our procedures are performed on an outpatient basis without general anesthesia. A breast biopsy will not require an overnight stay. These image-guided biopsies are safe and accurate procedures resulting in little discomfort and scarring.

BREAST WIRE AND WIRELESS LOCALIZATION

Localization procedures allow our radiologists and technologists to accurately locate an abnormality that will later be surgically removed. Using the appropriate imaging modality, a localization wire is placed in the breast to accurately target suspicious tissue that will be surgically removed later that same day.

In other cases patients may be able to use wireless location technology that uses radar to target the anomaly, which has been marked by the insertion of a tiny reflector. This can be done at the patient’s convenience days before their surgery is scheduled.

During surgery, surgeons can electronically access the images showing the location of the targeted cells. Imaging tests are done on the surgically excised specimen to verify removal of the abnormality. Results are then phoned to the surgeon.