The fight against breast cancer begins with the initial screening and detection of breast cancer. The Saint Louis University Hospital Breast Imaging Center has a radiologist primarily dedicated to mammography. Patients with abnormalities found on a screening mammography or by a physical exam receive a diagnostic work-up. Additional imaging may be used to further determine the extent of the disease. The radiologist and the SLU Cancer Center physicians work closely together to ensure each area of clinical concern is imaged and evaluated thoroughly to provide the best possible care. Imaging technology plays a key role in the fight against breast cancer.

Imaging modalities currently utilized at Saint Louis University Hospital:

Digital Mammography

Digital mammography is a technique for recording x-ray images in computer code instead of on x-ray film, as with conventional mammography. The images are displayed on a computer monitor and can be enhanced (../../lightened%20or%20darkened.jpg) and the images can also be manipulated; the radiologist can magnify or zoom in on an area. Digital mammography has advantages over conventional mammography. The images can be stored and retrieved electronically, which makes long-distance consultations with other mammography specialists easier. Because the images can be adjusted by the radiologist, subtle differences between tissues may be noted.

Ultrasound (US)

A breast ultrasound uses sound waves to make a picture of the tissues inside the breast. A breast ultrasound can show all areas of the breast, including the area closest to the chest wall, which is hard to study with a mammogram. Breast ultrasound does not use X-rays or other potentially harmful types of radiation.

A breast ultrasound is used to see whether a breast lump is filled with fluid (../../a%20-a%20href--/-%20target--_blank---span%20style--color-windowtext-text-decoration-none-text-underline-none--cyst-/span--/a-.jpg) or if it is a solid lump. An ultrasound does not replace the need for a mammogram, but it is often used to check abnormal results from a mammogram.

Magnetic resonance imaging (../../MRI.jpg)

Magnetic resonance imaging (../../MRI.jpg) is a test that produces images of the human body without the use of X-rays. Breast ../../MRI.jpg uses a large magnet, radio waves and a computer to produce these images.

Breast ../../MRI.jpg may be used to distinguish between benign (../../non-cancerous.jpg) and malignant lesions, which can reduce the need for breast biopsies. It is used primarily to evaluate breast implants for leaks or ruptures and to assess abnormal areas that are seen on a mammogram or are felt after breast surgery or radiation therapy. It can be used after breast cancer is diagnosed to determine the extent of the tumor in the breast. Breast ../../MRI.jpg is also useful in screening high risk women or dense breast tissue, which is often found in younger women, and in viewing breast abnormalities that can be felt but are not visible with conventional mammography or ultrasound.

Image Guided Breast Biopsy

Lumps or abnormalities in the breast are often detected by physical examination, mammography, or other imaging studies. However, it is not always possible to tell from these imaging tests whether a growth is benign or cancerous.

A breast biopsy is performed to remove some cells—either surgically or through a less invasive procedure involving a hollow needle—from a suspicious area in the breast and examine them under a microscope to determine a diagnosis. Image-guided needle biopsy is not designed to remove the entire lesion, but most of a very small lesion may be removed in the process of biopsy.

Ultrasound Biopsy – Saint Louis University Hospital has the ability to perform core biopsies and vacuum assisted core biopsies with ultrasound guidance which can assist in the diagnosis of breast cancer.

Stereotactic Biopsy – Stereotactic biopsy is a procedure that uses a computer and imaging performed in at least two planes to localize a target lesion (such as a tumor or microcalcifications in the breast) in three- dimensional space and guide the removal of tissue.

../../MRI.jpg-guided Biopsy (../../MRI.jpg) – ../../MRI.jpg-guided breast biopsy is a diagnostic procedure that is used to evaluate suspicious findings detected on a recent ../../MRI.jpg exam and is often a preferred alternative to surgical biopsy. It is used when ultrasound or mammogram (stereotactic) guided biopsy is not appropriate because the area of concern is not well seen by a mammogram or ultrasound.

In addition, Saint Louis University Cancer Center is a provider of the Missouri's Show Me Healthy Women (../../SMHW.jpg) program. The ../../SMHW.jpg program provides breast cancer screenings free to age and income eligible women.

Christina Doherty, M.D.

Director of the Breast Imaging Center