Constance D. Lehman, MD, PhD, professor of Radiology, chief of Breast Imaging, Department of Radiology at Massachusetts General Hospital, discusses how 3D mammography has been an efficient and beneficial screening tool in the field of breast cancer.

3D mammography, also known as tomosynthesis, should be considered as the new and standard mammogram, Lehman explains. This technology takes three-dimensional views—described as thin slices&mdash;of the breast. The strongest impact of this tool is that there are lower recall rates for patients, she adds.

Some evidence suggests that this screening tool can also detect hidden cancers between dense breast tissue. However, it is important to properly educate radiation oncologists on 3D mammography, Lehman says. 

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Constance D. Lehman, MD, PhD, professor of radiology and chief of Breast Imaging in the Department of Radiology at Massachusetts General Hospital, discusses how 3D mammography has been an efficient and beneficial screening tool in the field of breast cancer.

Dr. Lehman on 3D Mammography in Screening for Breast Cancer

Constance D. Lehman, MD, PhD, Vice Chair, Radiology Department, University of Washington School of Medicine, Medical Director, Imaging, Seattle Cancer Care Alliance, discusses how imaging can guide a women with breast cancer to make treatment decisions.

Lehman says that she has noticed a trend towards women opting for mastectomy rather than breast conservation surgery. Some physicians across the country were concerned that this trend was due to MRI in the sense that it could show more disease than expected on mammogram or ultrasound. In this situation, women may make a quick decision rather than wait to determine the best course of action.

The American College of Radiology Imaging Network (ACRIN) conducted a study in which women who underwent breast MRI at the time of diagnosis were analyzed. The study found that younger women, women with family history of breast cancer, and women with DCIS were all more likely to have mastectomy.

The study did not show that breast MRI was correlated with mastectomy, Lehman says. These findings are reassuring, Lehman says, as she does not want women to make decisions on mastectomy based on a suspicious MRI.

Constance D. Lehman, MD, PhD, from the Seattle Cancer Care Alliance, discusses how imaging can guide a women with breast cancer to make treatment decisions.

Dr. Lehman on Breast MRI and Mastectomy

Constance D. Lehman, MD, PhD, Vice Chair, Radiology Department, University of Washington School of Medicine, Medical Director, Imaging, Seattle Cancer Care Alliance, discusses breast imaging across various cancer centers.

Advanced imaging technology, whether tomosynthesis, breast MRI, or PET exams, is not the same. For example, Lehman says, in breast MRIs, there are several ways to obtain and interpret a breast MR exam.

Lehman says that she is pleased that the American College of Radioology is supporting a rigorous accreditation program. This program requires sites to submit images and provide information about radiologists to demonstrate high-level performance. This type of accreditation process, which was piloted by the Seattle Cancer Care Alliance, provides crucial information to patients and the community.

Constance D. Lehman, MD, PhD, from the Seattle Cancer Care Alliance, discusses breast imaging across various cancer centers.

Dr. Lehman on Breast Imaging Across Cancer Centers

Constance D. Lehman, MD, PhD, Vice Chair, Radiology Department, University of Washington School of Medicine, Medical Director, Imaging, Seattle Cancer Care Alliance, discusses the use of breast MRI.

Breast MRI is often used in patients with high-risk disease for screening purposes. Research has demonstrated that node-positive disease can be all but completely eliminated in patients at high risk when screened annually with breast MRI. This is exciting news, Lehman says.

Breast MRI is also used in patients who have been recently diagnosed with breast cancer. This is a controversial area, Lehman says. Research is being conducted to better understand how to use breast MRI in the pre-operative setting as well as the potential benefits and risks.

View more from the 2013 ASCO Annual Meeting

Constance D. Lehman, MD, PhD,  Vice Chair, Radiology Department, University of Washington School of Medicine, Medical Director, Imaging, Seattle Cancer Care Alliance, discusses the use of breast MRI.

Constance D. Lehman, MD, PhD

Articles

Dr. Lehman on 3D Mammography in Screening for Breast Cancer

Dr. Lehman on Breast MRI and Mastectomy

Dr. Lehman on Breast Imaging Across Cancer Centers

Dr. Lehman Discusses the Use of Breast MRI