Future Directions in Breast Imaging

Breast cancer imaging has improved dramatically over the last decade, with higher and more uniform quality standards for mammography, the increasing use of sonography and magnetic resonance imaging (MRI), and the widespread availability of imaging-guided percutaneous biopsy for clinically occult disease. This review paper describes the limitations that exist in the current state of the art for breast cancer imaging for detection and diagnosis. Four broad areas of future investigation are described in detail. First, we discuss the use of newer versions of mammography, such as digital mammography, with tomosynthesis and digital subtraction mammography. Secondly, new screening for occult disease might be improved through individualized strategies that stratify by patient risk, for example, through more rigorous screening with new and different tools for women at high risk. Third, the use of tools that might be useful for less invasive therapy of breast cancer with imaging to monitor the efficacy of the therapy is discussed. Finally, we describe the use of imaging to monitor and adjust neoadjuvant chemotherapy regimens in the course of therapy for advanced breast cancers when the risk of death is high

Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer

Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities.  We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS) was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC) curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p < 0.001), while the difference between breast tomosynthesis and breast MRI was not significant (p = 0.20)

Cosmetic Outcomes for Accelerated Partial Breast Irradiation Prior to Surgical Excision of Early Stage Breast Cancer Using Single Dose Intraoperative Radiotherapy

Determine cosmetic outcome and toxicity profile of intraoperative radiation delivered prior-to tumor excision for patients with early stage breast cancer

Cancer Cases from ACRIN Digital Mammographic Imaging Screening Trial: Radiologist Analysis with Use of a Logistic Regression Model

To determine which factors contributed to the Digital Mammographic Imaging Screening Trial (DMIST) cancer detection results