Screening and Diagnostic Studies of the Breast
Screening annual mammogram after the age of 40 is our most effective way of diagnosing breast cancer at an early stage. Studies have shown that screening mammography decreases breast cancer mortality by 30%. Digital mammography benefits a certain subset of patients which includes women under 50 years old, women with dense breasts, and in the evaluation of calcifications. Women with a positive family history of breast cancer should begin screening mammograms ten years before the age of the earliest diagnosed relative.
Ultrasound is not a good screening tool. However, for patients with symptoms, ultrasound is an excellent next step. Diagnostic ultrasound is used to evaluate symptoms such as a palpable lump, breast pain, nipple discharge, and enlarged lymph nodes. It is also used to further evaluate an abnormal mammogram. We have 2 ultrasound units in the office.
Breast MRI uses magnetic resonance imaging (no radiation) to look specifically at the breast. Each exam produces hundreds of images of the breast. It is not presently considered useful for every patient. Currently, women who should undergo regular MRI examination include those recently diagnosed with breast cancer, women with a BRCA 1 or 2 mutation, and women who received prior mantle radiation for treatment of Hodgkin’s disease. Other indications include women considered at very high risk of breast cancer, such as those having a strong family historyof breast cancer, or previous histologic diagnosis of ADH or LCIS. MRI of the breast can also be used to evaluate for implant rupture.
PEM, positron emission mammography, and 3D ultrasound are currently being evaluated for use in both the screening and diagnostic settings.
Marla W. Dudak, MD PA
9325 Glades Rd. #101
Boca Raton, Florida 33434