Breast Cancer

Contributed by Kim Parker, for Wake Radiology

A woman has about a one in eight chance of developing breast cancer in her lifetime, with the likelihood increasing with age and after menopause.
While breast cancer is common, its associated death rates have steadily decreased over the past decade. The chance of dying from the disease is now about one in 35.

This decrease is due to advanced screening, diagnostic and treatment options. Currently, it’s estimated that there are more than 2.5 million breast cancer survivors in the United States.

Mammography is the only proven modality demonstrated to decrease breast cancer mortality and is the gold standard for screening in the industry, says Duncan Rougier-Chapman, MD, co-director of Breast MRI Services at Wake Radiology.

Newer magnetic resonance imaging offers better detection for some forms of the disease, and is recommended by the American Cancer Society for screening in certain high-risk populations.

MRI creates images using magnets and radio waves. To get detailed views of the breast, MRI combines state-of-the-art three-dimensional imaging with computer-aided detection to uncover abnormalities.

During an exam, thousands of sectional images are taken and then evaluated and enhanced through the CAD system. A final interpretation by a subspecialty trained radiologist provides clinicians with a number from one (normal) to six (known cancer) using a national scoring system called BIRADS — Breast Imaging Reporting and Data System. The BIRADS score helps doctors determine the most appropriate course of treatment for the patient.

Breast MRI can be helpful in these situations:

    •    Imaging dense breasts often found in
        younger women, and those with fibrocystic
        breast changes when mammography and
        ultrasound fail to detect or characterize a
        palpable abnormality.

    •    Determining the extent of a
        known cancer.

    •    Differentiating between surgical scar and
        recurrent cancer in patients who have
        already been treated for breast cancer.

    •    Identifying cancer not detected by
        mammography in high-risk patients.

    •    Evaluating response to cancer treatment.

“When used in conjunction with the clinical exam, mammography and sonography, breast MRI can result in improved patient management and better treatment planning for women with known breast malignancies,” said Dr. Rougier-Chapman.

A breast MRI exam takes 30 to 40 minutes. Patients lie face down on a table and are moved into the MRI machine; an intravenous injection enhances images and highlights tumors. Images are taken of both breasts simultaneously before and after the contrast agent is administered, so that the images can be compared.

The exam is sensitive to changes in hormone levels, so pre-menopausal patients and women taking hormone replacement therapy  should  schedule exams based on their radiologist’s recommendations.

Dr. Rougier-Chapman notes that breast MRI does not replace screening mammograms, as recommended by the American College of Radiology and American Society of Breast Surgeons. Women who have breast MRI should continue to have a yearly mammogram, or as recommended by their physician.

Related links
American Cancer Society,
www.cancer.org
National Cancer Institute,
www.cancer.gov
Susan G. Komen For the Cure,
www.komen.org

Wake Radiology serves the Triangle area with 14 locations and 59 board-certified radiologists, with imaging subspecialties available at each location, to provide a full array of radiology services coupled with high levels of technical expertise and patient service. For more information, and an online Breast Cancer Risk Calculator, visit www.wakerad.com.