Hoag Breast Care Center

Mammography Overview | Digital Mammography | FAQ about Mammography | Additional Imaging: Ultrasound, MRI, Tomosynthesis

Breast Imaging

Mammography Overview

Mammography is a special, low dose X-ray procedure that produces highly detailed pictures of the breast. Routine annual mammograms, called Screening Mammograms, play an important role in the early detection of breast cancer. That’s because they can show subtle changes in the breast well before a woman or her physician can feel them.

In addition to discovering abnormalities that might otherwise go undetected, mammography also helps physicians evaluate the nature of suspicious areas in the breast. If a finding or spot seems abnormal, the radiologist may recommend further diagnostic studies.

Diagnostic Mammography is used to evaluate an abnormality found either through screening mammography or during a clinical breast examination. Typically, specifically tailored mammographic views of the breast are obtained to assist in evaluating an area of initial concern. These studies are then interpreted by the radiologist.

Additional breast imaging studies such as ultrasound and breast MRI may also be utilized to further investigate a suspicious area. For certain high risk women, and women recently diagnosed with breast cancer, Hoag is studying the efficacy of a new 3-D breast imaging technology called tomosynthesis.

Digital Mammography

Direct-to-digital mammography is the latest technology in mammography and represents a significant advance in early breast cancer detection. Hoag Breast Care Center was the first direct-to-digital mammography facility in Orange County and remains at the forefront of its rapid evolution.

Direct-to-digital mammography works by converting X-rays into electric signals, allowing breast images to be instantly viewed on a computer screen. This technique provides higher contrast resolution images and may eliminate the need for multiple X-rays because the radiologist can zoom in on suspicious areas to better determine if there is cause for concern.

Unlike indirect-to-digital mammography, whose image quality is compromised by light scatter, the direct-to-digital system uses direct conversion technology to achieve the sharpest digital images. With direct-to-digital mammography, the magnification, orientation, brightness and contrast of the mammogram image can be altered after the exam is complete to help the radiologist clearly see certain areas of the breast. The radiologists ability to digitally manipulate the breast image often alleviates the need to take additional images

Hoag Breast Care Center also employs mammographic computer aided detection. This sophisticated pattern recognition software functions as a computer generated second opinion by identifying and marking suspicious regions that may be indicative of cancer.

Frequently Asked Questions About Mammography

Many women have questions about mammography, click here for answers to the most common questions.

Additional Breast Imaging

Mammography alone is not always enough to fully evaluate whether an abnormality is benign or malignant. Additional breast imaging studies such as ultrasound or MRI may also be utilized to further investigate the suspicious lesion.

Hoag Breast Care Center offers a full range of state-of-the-art breast imaging services performed by an expert team of radiologists and technologists. If additional breast imaging tests are necessary, our Breast Care Center has the capability to perform these tests without delay, providing added peace of mind and convenience to our patients.

Why is additional imaging sometimes necessary?

There are times when further evaluation is necessary to clarify an image. In most cases additional views reveal that there is no significant abnormality and no cause for concern. Therefore it is important that women not be alarmed if called back for additional views. If the additional views are not sufficient to completely reassure the radiologist, then further diagnostic tests such as a breast ultrasound may be utilized.

Ultrasound

Breast ultrasound is the second most common imaging technique utilized to examine the breast. It is a non-invasive and painless process using harmless, high frequency sound waves to form an image. During the exam, gel is spread over the breast and an instrument called a transducer is placed against the skin, which translates images onto a monitor. Ultrasound is not an alternative to, nor a replacement for mammography. Rather, mammography and ultrasound are adjuncts, they work together, providing more information than either alone. In most cases the ultrasound images are evaluated along with the mammographic images to enhance our physician’s ability to make a diagnosis.

Ultrasound can distinguish a generally harmless fluid-filled cyst from a potentially concerning solid mass. It is also utilized to evaluate whether a solid mass is benign or appears to be malignant. Ultrasound is especially useful when evaluating masses in young women and women with dense breasts whose mammograms may be difficult to interpret. In addition, breast ultrasound is beneficial when studying breast abnormalities in pregnant woman, and when assessing leakage or rupture of breast implants. Breast ultrasound is also an excellent tool for guiding needles during core needle biopsy, cyst aspiration, fine needle aspiration and needle localization before a breast biopsy.

Breast MRI

Breast Magnetic Resonance Imaging (MRI) is another non-invasive imaging tool that produces detailed images of the breast. MRI utilizes a magnetic field and radio waves, as well as an intravenous injection of a contrast agent, to highlight breast abnormalities. Hundreds of cross-sectional images of the breasts are produced during the exam, allowing a three-dimensional rendering of the breast.

During the procedure, the patient rests quietly inside the opening of a large tube-like machine, called a magnet. There, a computer acquires images of the breasts. Several scans through the breasts, in one-minute increments, are taken during a 20-minute exam. Contrast-enhanced breast MRI is used to screen high-risk patients, such as those with a strong family history of breast cancer; those with a personal history of breast or ovarian cancer; or individuals who are BRCA 1 or 2 (genetically) positive.

Breast MRI is also used to investigate breast concerns first detected via mammography, physical exam, or other imaging tests. It can successfully image problematic conditions like dense breasts and implants. MRI is also useful for staging breast cancer, helping to determine the most appropriate treatment, and for patient follow-up after breast cancer treatment.

Hoag Breast Care Center is home to Orange County’s first dedicated breast MRI system. Located within our breast center, this MRI unit is specifically designed for MR imaging of the breast. For patients, this means seamless access to the latest adjunct technology with no need for inconvenient offsite appointments. And as the highest volume provider of breast MRI in the area, it also means that women can rest assured that their care is in the hands of experts.

Digital Tomosynthesis

As a leader in innovative breast care, Hoag is the only hospital in Southern California and one of only 11 test sites in the nation to participate in a multicenter clinical trial studying the latest generation of breast imaging technology – digital tomosynthesis. Click here for details.

Dr. Gary Levine on Tomosynthesis

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