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Breast Cancer Investigation

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Ultrasound (sonography)
Also called “Sonography” this risk–free test relies on sound waves that bounce off and create a video picture of internal tissues. Many women have their first experience with this test during pregnancy, when it may be used to check on the status of the fetus.

When breast cancer is suspected, ultrasound may be recommended after a mammogram reveals an abnormality that cannot be readily identified as a cyst or a suspicious growth. Usually, ultrasound can reliably distinguish between the two, since the sound waves will bounce back if the lump is solid, but travel right through a fluid–filled cyst.

Magnetic Resonance Imaging (MRI)
Magnetic Resonance Imaging stage Magnetic Resonance Imaging stage
Magnetic Resonance Imaging (MRI) is a highly useful adjunct to mammography for detecting breast cancer early. Clinical investigation shows that MRI is exquisitely sensitive in finding some breast cancers that mammography cannot detect. Mammography remains the main way to detect breast cancer early, but it doesn’t find all cancers. MRI can help locate some hidden cancers.

Magnetic Resonance Imaging stage Magnetic Resonance Imaging stage
In addition, MRI can help radiologists and other specialists determine how to treat breast cancer patients by identifying the stage of the disease. If physicians can be sure of the stage of the breast cancer, they can better choose the form of treatment that is likely to be the most effective.

Magnetic Resonance Imaging stage Magnetic Resonance Imaging stage
There are also cases where we can’t be sure if a patient has breast cancer and MRI can confirm the diagnosis.
MRI can be particularly useful in diagnosing and staging of breast cancer in women with dense breasts or in those who have implants. MRI is an addition to and not a replacement for mammography, which remains a highly effective breast cancer screening procedure.

3D Doppler Ultrasound
Blood Flow Ultrasound detects hidden breast cancer.
When a woman feels a lump in her breast or gets mammogram results that show a possible problem, she often faces weeks of uncertainty until a biopsy comes back – is it cancer, or just a harmless cyst?.

Now, a new medical imaging approach is being developed which gives patients and doctors a way to tell even before biopsy if most masses inside the breast are malignant or benign. It may also provide a way to detect tumors long before a mammogram or breast self–exam could, and to track a tumor’s response to treatment faster.

Called 3–D color Doppler ultrasound, the technique uses sound waves and sophisticated computerized equipment to allow doctors to see how quickly blood is moving in the vessels around a suspicious area – and to see that area in three dimensions.

Because cancer cells grow rapidly and need extra blood to feed their spread, the technique can distinguish between tumors and benign masses. It can also pick up signals of increased blood flow and formation of new blood vessels in a cancerous area before any other imaging method can.

The 3D ultrasound measurements of vascularity, or blood flow measure which gives basic information about the breast tissue, which is full of ligaments, ducts and other structures that vary from woman to woman and must be distinguished from suspicious masses.

Like all ultrasound images, it is made by sending focused high–frequency sound waves from a hand–held wand into the body, and then measuring the echoes that bounce off structures within the tissue and come back to the scanner. An attachment for the conventional hand–held ultrasound wand is created that records its precise position in three dimensions as it is moved slowly across the breast. They have developed software that can take the results from a series of these side–to–side blood flow scans, combine them into a three–dimensional picture, and provide reproducible measurements related to blood flow.

The new technology helps us be precise about the blood flow in the breast, which needs to be accurately measured so it can be a reliable indicator of whether a mass might be cancerous or harmless.

While the new 3D color Doppler ultrasound can detect blood vessels that the X–rays in a mammogram simply can’t see, it isn’t foolproof for every kind of breast cancer. Masses can also be distinguished by the amount of calcium in them, but ultrasound can’t reveal calcium.
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