Preliminary Diagnosis: Breast Cancer
I. What imaging technique is first-line for this diagnosis
- Dedicated mammographic evaluation of the bilateral breasts.
II. Describe the advantages and disadvantages of this technique for diagnosis of Breast Cancer.
Advantages
- Highly sensitive and specific imaging modality in detecting abnormalities of the breast.
- Gold standard in detecting breast abnormalities.
- May help guide percutaneous intervention, i.e. stereotactic breast biopsies.
Disadvantages
- Exposes patients to ionizing radiation.
- Limited in evaluation of breast tissue for patients with breast implants.
III. What are the contraindications for the first-line imaging technique?
- May be limited in evaluation in patients with breast implants.
IV. What alternative imaging techniques are available?
- Ultrasound of the breasts
- MR imaging
V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of Breast Cancer.
Ultrasound of the breasts
Advantages
- Offers better evaluation of the breast tissue in patients with breast implants.
- Does not expose patients to ionizing radaition.
- Warranted in patients with palpable lesions.
- May help guide percutaneous intervention.
- May help evaluate the vascularity of breast abnormalities.
- Highly portable.
Disadvantages
- Highly operator dependent.
MR imaging
Advantages
- Does not expose patients to ionizing radiation.
- Highly sensitive and specific in detecting the extent of an invasive lobular or ductal carcinoma and can better help evaluate for multifocal and multicentric disease.
- May help evaluate breast tissue in patients with breast implants.
- Useful in guiding MR guiding biopsies.
Disadvantages
- Expensive
- Time consuming
- May be subject to motion and susceptibility weighted artifact
VI. What are the contraindications for the alternative imaging techniques?
Ultrasound of the breasts
- No specific contraindications to sonographic imaging exist.
MR imaging
- Contraindicated in patients with non MR compatible hardware.
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