The Latest on Breast Imaging

Easier to spot

A digital (top) versus a standard (bottom) mammogram makes a white cancerous lump stand out more clearly against breast tissue, which also appears as white.

Do you need an MRI or digital mammogram to protect your breast health? Here’s some guidance from Barbara Cavanaugh, M.D., diagnostic radiologist specializing in breast cancer detection at Lehigh Valley Hospital and Health Network:

Mammography is still the best way to detect breast cancer at its earliest, most curable stage. “If the radiologist sees something suspicious, you’ll need further mammograms and/or ultrasound—but 95 percent of such women will not have cancer,” Cavanaugh says. “Start yearly mammograms at age 40. If your mother or sister had breast cancer before age 50, begin yearly screenings 10 years earlier than her diagnosis (for example, begin at age 30 if she was diagnosed at 40).”

Digital mammography uses digital images rather than film. Radiation dose is a bit lower, and the radiologist can fine-tune the image to make tiny abnormalities more visible. A recent study found that digital was significantly more accurate than standard mammography in certain women—those under age 50, those with dense breasts and pre- or early-menopausal women.

MRI (magnetic resonance imaging) hasn’t been studied long enough to know its value for screening, Cavanaugh says. But it can be useful in conjunction with mammography in specific situations. Your doctor will determine if it’s appropriate for you. MRI uses radio frequency pulses (not X-rays) to track blood flow. “It’s more sensitive than mammography, but less specific,” she says. “No one should start with an MRI. This is a promising but still-emerging technology.”

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