Diseases & Conditions

Breast Health Breakthrough for 50 Percent of Women

By on 05/25/2017

About half of all women have dense breast tissue, making it harder to detect abnormalities with mammography alone.

Now, with an additional 40-minute procedure, doctors can get a much clearer and earlier inside view of tumors in the breast.

(Tomosynthesis is 3D mammography.)

Molecular breast imaging, or MBI, is used as a supplement to mammography in women with dense breasts. Unlike mammography, MBI uses an injection of nuclear medicine to help doctors visualize tumors. Einstein Medical Center Philadelphia is the first hospital in Pennsylvania to offer this technology.

“The way this technology works is that there is a nuclear medicine tracer that is injected into the bloodstream,” explains Debra Somers Copit, MD, director of Breast Imaging for Einstein Healthcare Network. “This tracer gets picked up by cancerous cells. Because it goes to cancerous cells and it’s a nuclear medicine agent, a nuclear medicine camera can detect that activity in the cancer cells, and then it creates an image that we can read.”

On a mammogram, both dense breast tissue and tumors show up as white. MBI makes tumors stand out.

Research finds that molecular breast imaging significantly increases the detection of breast cancer in women with dense breast tissue. Einstein Philadelphia uses the LumaGEM Molecular Breast Imaging system. A 2016 study in the American Journal of Roentgenology showed that the LumaGEM system detected 7.7 cancers per 1,000 women that were not found using mammography. About 85 percent of these cancers were invasive. Even more striking, 82 percent of the invasive cancers were found earlier, translating into a better prognosis.

Mammography remains the gold standard, says Dr. Copit, but she notes that it’s harder to detect cancers in dense breast tissue. Moreover, having dense breast tissue also raises a woman’s risk of developing breast cancer. Through mammography, Dr. Copit says, women with dense breast tissue are identified, and then offered the option of molecular breast imaging. MBI screening is done within a year of a woman’s mammogram.

Einstein Philadelphia has had this technology for just a few weeks. Dr. Copit was its first patient.

The procedure, she says, is straightforward. A woman requesting molecular breast imaging is injected with the nuclear tracer through a small IV. Each picture of the breast takes about eight to 10 minutes, and there are two pictures of each breast. There’s minimal discomfort—you can even watch TV while the test is going on.

MBI has one other potential use, she adds. “We also think it will be useful for newly diagnosed breast cancer patients to help determine how much disease is in their breast. That’s just another area that we think will be worthwhile.”

The technology for this test has been around for years, Dr. Copit says. The tracer used in molecular breast imaging is the same as what is used in cardiac stress testing. Although the technology isn’t new, it took a while to get to the point where the dose of radiation would be low enough. “The dose is really not just to the breasts, but to the whole body,” she says. “But it’s eliminated pretty quickly and it’s no more radiation than the background radiation you would get if you flew from here to Los Angeles.”

The new procedure is recommended every other year, but mammography continues to be recommended every year.

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