Detective Stories
Know your breast-cancer tests

When it comes to something as serious as breast cancer, you just want to know: Do I have it?

Unfortunately, there is no single perfect test for breast cancer.

Although it has recently gotten a lot of bad press, mammography is the only test proven to decrease mortality from breast cancer, even though there are many other methods of detection.

Most are used in conjunction with mammography, which is critical to the accurate interpretation of the other imaging studies.

Here’s a run-down of the tests and how they can help you know for sure:


A mammogram is a special X-ray of the breast.

The machines are different from all other X-ray machines. They produce “soft” rays that do not penetrate as deeply as the regular ones.

Mammography is the only approved method for screening the general population, and it is very effective in detecting early breast cancer in most patients. It is still the only reliable method of detecting tiny calcium deposits, which can be cancerous or pre-cancerous.

Breast implants can obscure the tissue on standard mammography, and so extra images, with the implants pushed out of the way, are needed. This means increased radiation exposure.

Plus, when the fibrous capsule around the implant becomes hard, it is difficult to get the implant out of the way.


Usually doctors recommend a breast ultrasound only when a patient has an abnormal mammogram or is experiencing a problem, such as a lump or discharge of blood from the nipple.

Ultrasound uses high-frequency sound waves to create an image. It can distinguish benign cysts from other abnormalities and is frequently used as a guide for procedures such as biopsy (tissue sampling) or cyst aspiration (fluid withdrawal).


Like the Ultrasound, a breast MRI is performed only after an abnormality has been detected on a mammogram.

An MRI is a highly technical and expensive test in which a very powerful magnet is used to obtain hundreds of images of the breasts, before and after an intravenous injection of dye material.

During the study, which takes an average of 45 minutes, patients must hold very still. Any movement can make the test less accurate.

Breast MRI is very sensitive and detects both cancerous and non-cancerous lesions.

As some cancers and benign findings can appear similar, breast MRI can lead to unnecessary biopsies and undue anxiety.

Positron Emission Tomography Scan

The PET scan is performed only on patients who have been diagnosed with breast cancer. Radioactive glucose is injected intravenously, and then a special camera takes images of the whole body.

Recently, PET scanners have been merged with computed tomography (CT) scanners. The fused PET-CT images are able to locate an abnormality with greater precision.

Experimental Procedures

Researchers continue to explore other ways of detecting breast cancer.

Sestamibi scintimammography (SSM) is one example. Sestamibi is a radioactive substance used extensively to evaluate blood flow to the heart.

Because intravenous sestamibi also can be taken up by breast tissue, it has been studied for many years as a possible way to detect the disease.

Until recently SSM (renamed molecular breast imaging by some authors) could not reliably pick up small cancers.

Another procedure that’s undergoing testing is thermography, which uses an infrared camera to measure temperature differences on the breast surface.

Although deemed safe by the U.S. Food and Drug Administration, it is not approved as a stand-alone screening test for cancer.

Also, it is not recognized by the American Cancer Society or the American College of Radiology as a reliable diagnostic tool and currently is not covered by insurance.


The Good News

The Big C is scary. But here’s some reassurance: As many as 65 percent of all cancers may be prevented by adopting a healthy lifestyle.

Here are some things you can do to reduce your overall risk:

• Don’t smoke.

• Maintain an appropriate weight for your body size.

• Engage in daily moderate and weekly vigorous exercise.

• Eat five or more servings of vegetables and fruits a day.

• Try to avoid eating more than three ounces of red meat a day.

• Reduce your consumption of fatty foods, particularly those of animal origin.

• Limit alcoholic drinks to one a day.