Breast imaging
[3] Lastly, scintimammography is used in a subgroup of patients who have abnormal mammograms or whose screening is not reliable on the basis of using traditional mammography or ultrasound.
[4] Mammography is the process of using low-energy X-rays (usually around 30 kVp) to examine the human breast, which is used as a diagnostic and screening tool.
[medical citation needed] For the average woman, the U.S. Preventive Services Task Force recommended (as of 2009[update]) mammography every two years in women between the ages of 50 and 74.
[6] The Canadian Task Force on Preventive Health Care (2012) and the European Cancer Observatory (2011) recommends mammography every 2–3 years between 50 and 69.
[15] Presently, Cochrane Collaboration recommends that women should at least be informed of the benefits and harms of mammography screening and have written an evidence-based leaflet in several languages that can be found on www.cochrane.dk.
[22] since it is able to overcome the primary limitation of standard 2D mammography which had a masking effect due to the overlapping fibroglandular tissue, whereas DBT is able to distinguish between benign and malignant features, particularly in dense breasts.
[23] DBT has also been found to be a reliable tool for intraoperative surgical margin assessment in non-palpable lesions thus reducing the volume of breast excision without increasing the risk of cancer recurrence.
[24] No longer in widespread use, xeromammography is a photoelectric method of recording an x-ray image on a coated metal plate, using low-energy photon beams, long exposure time, and dry chemical developers.
In a study published by Schulz-Wendtland R et al., investigators made more mistakes when using only ductal sonography compared to when they used contrast-enhanced galactography with tomosynthesis which allowed for generated synthetic digital 2D full-field mammograms to diagnose suspicious lesions.
The available literature suggests that the sensitivity of contrast-enhanced breast MRI in detection of cancer is considerably higher than that of either radiographic mammography or ultrasound and is generally reported to be in excess of 94%.
[36] Additionally, MRI Is also shown to be more accurate than mammography, ultrasound, or clinical exam in evaluating treatment response to neoadjuvant therapy.
[40] Recent studies have shown that shear wave elastography in primary invasive breast carcinoma could be useful for indicating axillary lymphadenopathy.
A recent study found 100% ultrasound localization with negative margins obtained in both non-palpable and palpable lesions at initial procedure.
Additionally, the combined use of MRI and CEUS in lesions > 20 mm has been shown to optimize the diagnostic specificity and accuracy in breast cancer prediction.
In the scintimammography procedure, a woman receives an injection of a small amount of a radioactive substance called technetium 99 sestamibi.
[44] Research has also shown that Tc-99 Sestamibi wash out rate is a reliable test for predicting tumor response to neoadjuvant chemotherapy in locally advanced breast cancer.
