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Early detection and treatment is the key to surviving breast cancer. Mammograms can help save lives, often detecting lumps before they can be felt.
Mammography is a type of imaging that uses a low-dose X-ray system to examine breasts and assist in the diagnosis of breast diseases. In a mammogram procedure, the breast is flattened between two plates to get a clear image of the tissue. It is painless in most women, although the breast compression may be somewhat uncomfortable.
All radiology services Cedars-Sinai are performed at accredited facilities by certified providers. Mammography services are available at the Marcia Israel Mammography Center and at the S. Mark Taper Foundation Imaging Center at Cedars-Sinai. The Marcia Israel Mammography Center is located in the same building as the Saul and Joyce Brandman Breast Center. It offers:
- Digital mammogram and ultrasound
- Minimally invasive outpatient stereotactic biopsy procedures
- Needle localization and ultrasound-guided biopsy
- An advanced breast biopsy system
The two categories of mammograms are screening and diagnostic. Both types of mammograms include four standard X-ray views of the breasts (two of each breast) and are:
- Performed using the accreditation and/or certification standards defined by the American College of Radiology (ACR), American Cancer Society (ACS) and Medicare
- Interpreted by the same board-certified physicians (radiologists)
- Performed by the same certified mammography technologists
A screening mammogram is for patients without symptoms (no discharge or lumps). It is a recommended screening test that looks for very small breast cancers that cannot be felt. Screening mammograms generally begin at age 40, though women with a strong family history or other known risk are often advised to begin at a younger age. The screening mammogram entails:
- No consultation with a physician (radiologist)
- Results mailed to the patient and her physician, generally within 48 hours
- Possible need to return at a later date for further diagnostic tests (additional mammogram images, breast ultrasound, or MRI)
Digital mammography is the best technique for the early detection of breast abnormalities. With the use of digital technology, screening mammograms can now be performed within 10-12 minutes. Images are obtained and stored electronically, eliminating the risk of lost films.
In addition to serving as a screening tool to detect early-stage breast cancer in women experiencing no symptoms, mammography is used to evaluate patients with abnormal findings on screening mammogram or patients with symptoms such as breast lumps, pain, or nipple discharge. Diagnostic mammogram differs from screening mammogram in that:
- A physician (radiologist) directly supervises the radiology technologist to determine how many and what types of images are performed
- Results are conveyed to the patient and her physician at the conclusion of the examination
For more information on the mammography procedure, including preparation, follow-up, click here.
An ultrasound is an additional imaging tool for evaluating a palpable lump or area of abnormality identified on a mammogram or other imaging test. Ultrasound uses high-frequency sound waves to create an image of the breast tissue, which is displayed on a video screen and photographed for analysis. Ultrasound is usually performed to evaluate a specific problem, though in some special situations, it may be used in addition to mammography for screening women without any breast symptoms. It is not meant to replace screening mammograms. This approach can often reveal whether a lump is solid like a tumor or is a fluid-filled, non-cancerous cyst. It is also useful for examining both silicone and saline implants, and may be used to guide needle biopsy or surgery.
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of organs, soft tissues, bone, and virtually all other internal body structures. It can offer valuable information about many breast conditions that couldn’t be obtained through mammography or ultrasound.
MRI of the breast is not a replacement for mammography or ultrasound, but rather a supplemental tool for detecting and staging breast cancer and other breast abnormalities. Each exam produces hundreds of cross-sectional images of the breast, in all three directions (side-to-side, top-to-bottom and front-to-back).
A breast MRI is done to:
- Evaluate abnormalities detected by mammography
- Identify early breast cancer not detected through other means, particularly in women with dense breast tissue and those at high risk for the disease
- Determine the location of a suspected malignancy (how close is it to the chest wall, skin and nipple), how big it is, and if there are enlarged lymph nodes
- Evaluate breast implant integrity and detect breast cancer in women with augmentation or scar tissue that might jeopardize an accurate result from a mammogram
- Look for other tumors in those considering breast conservation for their cancer
- Determine how much cancer has spread beyond the surgical site after a breast biopsy or lumpectomy
- Assess the effects of chemotherapy done prior to surgery (neoadjuvant chemotherapy)
- Provide additional information on a diseased breast to help inform treatment decisions
Breast MRIs are performed at the S. Mark Taper Foundation Imaging Center, located on Gracie Allen Drive east of San Vicente Blvd, under the guidance of Rola Saouaf, MD. By meeting the American College of Radiology’s high standards, the center is an accredited provider of MRI as well as mammography.
An appointment can be made by calling (310) 423-8000 after you have received a referral from your Saul and Joyce Brandman Breast Center physician.
For more information and the steps to take prior to a breast MRI, please click here.