Diagnosis

mammographyThe George Washington University Hospital's Center for Breast Care Services has a comprehensive, technologically-advanced art imaging center for breast cancer diagnosis. Radiologists, also called breast imaging physicians, are all women dedicated exclusively to the diagnosis of breast cancer.

Unlike the majority of radiologists who interpret mammograms, center radiologists are dedicated exclusively to breast imaging. They are specially trained in breast imaging, and are recognized regionally, nationally, and internationally for their expertise. Their dedication exclusively to the diagnosis of breast cancer, as well as their expertise, make them uniquely qualified in the Washington DC area, as well as regionally, to interpret and detect the earliest cancers. For these reasons, many women obtain their mammograms at George Washington or contact us for a second opinion for evaluation of their mammogram.

Mammography

The most widely used and recognized imaging method for the detection of breast cancer is a mammogram. This low radiation x-ray often can detect abnormalities in the breast before anything can be felt. Women who are age 40 and older are strongly advised to have a yearly mammogram**. GW's Breast Care Center also offers digital mammography, which is particularly useful for evaluating dense breast tissue, usually found in younger women. Though mammography is a very effective method for detecting breast cancer, in certain cases, additional imaging tests are needed for complete evaluation. Therefore, additional tests such as ultrasound, MRI or scintimammography may be recommended.

Ultrasound

Ultrasound is a technique whereby sound waves are used to create an echo and the echoes are transformed into a picture that can be read on a video screen. Ultrasound can be effective in distinguishing certain abnormalities in the breast such as lumps, solid masses and cysts. Also, ultrasound can detect certain characteristics such as contour, shape and size of the breast abnormality. It can also be used to guide procedures, such as biopsy or aspiration. The George Washington Breast Imaging Center utilizes high-resolution ultrasound in all of its studies.

Scintimammography/Breast-Specific Gamma Imaging

With scintimammography, a radioactive compound called a tracer is injected into a vein, similar to the way a blood test is perfromed. The tracer will adhere to a tumor as it will absorb more of the tracer than the surrounding breast tissue. A special camera is then used to identify whether there is evidence of an abnormal area. In this test, the tissue in the breast is evaluated in a physiologic approach (the way the tissue functions) compared to the anatomic approach of mammography and ultrasound (the way the tissue looks). The GW Breast Center has a unique high-resolution nuclear medicine camera, which can be used to detect the earliest breast cancers. This may be most advantageous in women with dense breast or in whom physical examination or mammography is difficult to interpret, such as women who have previously had breast surgery.

Magnetic Resonance Imaging (MRI)

An MRI measures the electromagnetic signals that your body emits by using magnet and radio waves. Signals are then converted into exact images of the body to detect abnormalities including cancer. MRI is used as a problem-solving tool to evaluate either a lump in the breast or something found on a mammogram. MRI is also the optimal imaging technique for evaluating breast implants. The decision to use MRI should be made jointly by you, your physician and the radiologist.

Recommendations for Breast Cancer Screening

Rachel Brem, MD, Director of the GW Breast Imaging and Intervention Center, recommends that women continue to have mammograms beginning at age 40, regardless of family history, to optimize their chances for early detection and treatment. Dr. Brem recommends that women follow the American Cancer Society guidelines* for early cancer detection.

If you have an appointment scheduled at the GW Breast Imaging Center, please keep your appointment and take the time to discuss any concerns you have with your physician. To make an appointment for an annual mammogram, please call 202-741-3003.

American Cancer Society Guidelines for Early Cancer Detection

  • Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.
  • Clinical breast exam (CBE) should be part of a periodic health exam, about every three years for women in their 20s and 30s and every year for women age 40 and over.
  • Women should know how their breasts normally feel and promptly report any breast change to their health care providers. Breast self-exam (BSE) is an option for women starting in their 20s.