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Diagnostic Imaging

Diagnostic breast imaging refers to methods that take pictures (images) of what is happening inside the breasts. The purpose of diagnostic imaging is to investigate breast abnormalities and determine the cause of symptoms you may be experiencing.

The two most common imaging methods are diagnostic mammographyMammogram (also called mammography):
A low-dose X-ray of the breast. It is used to take images of the breasts and is an important screening tool for the earlier detection of breast cancer.
and breast ultrasoundUltrasound:
An imaging technique that uses sound waves to take a picture of structures in the body, such as the breast.
. These are usually the first diagnostic tests used to investigate a breast abnormality. For most women, a diagnostic mammogram and/or ultrasound is able to confirm when a breast change is benignBenign:
Not cancerous. This is also referred to as non-malignant.
and rule out cancer.

Diagnostic Mammogram

A diagnostic mammogram works like a screening mammogram. It is a low-dose X-ray of the breast that is taken to get a better picture of any breast changes noticed on a screening mammogram, during a clinical breast examinationClinical breast exam (CBE):
A physical examination of the breasts by a health-care provider.
or by a woman being breast aware.

A diagnostic mammogram may take longer than a screening mammogram, because the technologist may take more images and may magnify certain areas of the breast to get a better picture.

Breast Ultrasound

Ultrasound uses sound waves to get a picture of the breast. If you have a breast lumpLump:
A mass that can be found in the breast or elsewhere in the body. This can also be called a nodule.
, ultrasound can be used to find out if the lump is a solid tumourTumour:
An abnormal mass of tissue that occurs when cells divide more than they should or do not die when they should. Tumours may be benign (not cancer) or malignant (cancer). A tumour is also called a neoplasm.
or a fluid-filled cystCyst:
A fluid-filled sac that is usually benign (non-cancerous). The fluid may be removed for analysis.
. Ultrasound can be used to see lumps that are not clear on a mammogram and is sometimes used as a way of visually guiding a health care provider during other procedures, such as a biopsyBiopsy:
A procedure in which tissue samples are removed from the body for examination under a microscope to determine if cancer or other abnormal cells are present.
.

During an ultrasound, a gel is spread on your skin in the area being examined, and a small hand-held instrument is passed over the area. The device sends out sound waves (too high frequency for you to hear), and the reflected sound waves form a picture that appears on the ultrasound’s screen.

Other Imaging Techniques

There are other imaging methods that may be used to investigate breast changes and diagnose breast cancer, such as magnetic resonance imagingMagnetic Resonance Imaging (MRI):
An imaging technique that uses powerful magnetic fields and radio waves to create detailed, 3-dimensional images of the organs and tissues in the body, such as the breast.
(MRI), which uses powerful magnetic fields and radio waves to create 3D images of the breast.

An MRI is not routinely used to diagnose breast cancer, but may be used when results from a diagnostic mammogram and/or ultrasound are unclear. It may also be used to determine the extent of breast cancer in the breast tissue, or to assess for the few types of breast cancer that are less easily detected by mammogram and/or ultrasound.

If you are referred for any type of diagnostic imaging, ask your health care provider about how to prepare and what to expect during the procedure.

What happens after my test?

Once you have completed your mammogram and/or ultrasound, the images will be sent to a radiologistRadiologist:
A doctor who specializes in reading tests such as ultrasounds and X-rays. A radiologist may also perform core biopsies and use imaging techniques to guide cancer treatment.
to be read. A radiologist is a medical doctor who specializes in reading and interpreting X-rays and other medical images. The radiologist’s report will be sent to your health care provider and they will follow up with you. If there is still concern that the abnormality may be cancerous, you will be referred for additional tests to confirm a diagnosis, such as a biopsy.

Being called back for additional tests and waiting for a diagnosis can be a stressful time. During your test, don’t be afraid to ask the technologist about when you can expect to receive results, or to take the initiative to follow up with your health care provider.

Improving Wait Times

The Working Group on the Integration of Screening and Diagnosis of the Canadian Breast Cancer Screening Initiative has set targets for the wait time between receiving an abnormal breast cancer screening result and diagnosis. These target wait times are for abnormalities that are found during screening as part of an organized screening program. If a tissue biopsy is not required, the target is for at least 90% of cases to have a diagnosis within 5 weeks. Currently, median wait times for diagnosis for women who do not require a biopsy can range from 2 to 5 weeks, but can take longer in some parts of Canada.

 

Sources:

Canadian Partnership Against Cancer (2012). Breast Cancer Control in Canada: A System Performance Special Report. Accessed January 2, 2014.

Diagnosing Breast Cancer. Canadian Cancer Society. Accessed January 2, 2014.