Breast Imaging
with Judy Destouet, MD
What is new in breast imaging at GBMC?
Breast cancer is the second leading cause of death in American women, but new imaging techniques are helping save more lives. Mammography, ultrasound, breast magnetic resonance imaging (MRI) and positron emission tomography (PET) scans are changing the way breast cancer is diagnosed. They are also helping detect cancer in its earliest, most treatable stages. “Our goal is to find cancer while it is as small as possible,” says Judy Destouet, MD, Head of Mammography for Advanced Radiology at GBMC. “When cancer is found during its earliest stages, women are more likely to have a normal life expectancy.”
The most common tool for breast imaging is mammography. During a mammogram, the patient’s breast is compressed into two different projections. The results are compared with old images to check for any changes. “Mammography is still the gold standard for breast imaging,” says Dr. Destouet. “If we see something on the mammogram or if the patient or doctor feels a lump or thickening, the next step is an ultrasound.”
Ultrasounds are able to determine if a breast abnormality is just normal breast tissue or if it is a solid lump that could be cancerous. “If we find a solid lesion we need to do a biopsy,” says Dr. Destouet. “We can sometimes tell whether a solid lesion is benign or malignant by its appearance. If it is very well defined, has smooth borders and is homogeneous in texture, it is most likely we are dealing with a benign lesion. If it is more irregular or shadows out the echoes, it becomes more likely it might be cancer.” After a lump is determined to be suspicious, a biopsy is done to see if cancer is present. During a biopsy a small piece of tissue from the lump is removed and analyzed by pathologists.
Breast MRI and PET scans are newer methods for breast imaging. “Breast MRI is reserved for high-risk women and we usually do not recommend it for the general population. While it is very sensitive and can find abnormalities, it is not very specific,” says Dr. Destouet. “PET scans do not have the same level of sensitivity as mammograms or ultrasound. We primarily use it to evaluate and stage cancer for women who have already been diagnosed with breast cancer. It is also good for determining if cancer has spread to the lungs, liver, bones or lymph nodes.”
Digital mammography is the latest innovation in breast imaging. GBMC is currently transitioning to this new technology to provide better imaging for very dense breasts. “Digital mammography allows us to change the imaging parameters so we can better see through the breast tissue,” says Dr. Destouet. “This is a clear advantage for young women who are pre-menopausal and women who have dense breast tissue.”
At GBMC, it is common for radiologists, pathologists, medical oncologists and surgeons to collaborate to determine the best way to manage each individual patient who has been diagnosed with breast cancer. “We have staff that is very dedicated to patient care,” says Dr. Destouet.
