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Dedicated Tomographic Single Photon Systems
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
For breast imaging, dedicated breast SPECT or molecular breast tomosynthesis systems have been proposed to improve lesion detection as compared to planar molecular breast imaging systems [55–59]. As the molecular breast tomosynthesis systems usually cover a limited angular range (less than 180°), this chapter will focus on the dedicated breast SPECT systems that can provide fully 3D images.
Preoperative radiological assessment
Published in Steven J. Kronowitz, John R. Benson, Maurizio B. Nava, Oncoplastic and Reconstructive Management of the Breast, 2020
Advanced functional imaging techniques are also available in specific patient populations to aid in the detection and staging of breast cancer. Positron emission–computed tomography (PET)/computed tomography (CT) imaging is considered in patients with inflammatory or locally advanced breast cancer for the detection of distant metastatic disease.38 Molecular breast imaging remains largely investigative in the context of breast cancer staging, but shows promise for improved sensitivity and specificity when further evaluating mammographically suspicious lesions, particularly in patients with dense breast tissue.
Role of breast density measurement in screening for breast cancer
Published in Climacteric, 2018
A 2015 systematic review of supplemental breast cancer screening for women with dense breasts reported that supplemental modalities identify additional cancers but are also associated with higher recall rates, additional biopsies and high false-postive rates2. Supplemental ultrasound (+ mammography) has been shown to significantly improve cancer detection rates but also has a high false-positive rate2. Supplemental MRI has been shown to significantly improve cancer detection rates2 but is relatively expensive and may also increase the false-positive rate90. The ongoing DENSE trial, a randomized controlled trial, will help determine the additional value of MR imaging where one group undergoes mammography and the other group undergoes mammography and MR imaging90. Trials investigating whether tomosynthesis could benefit women with dense breasts are still in the early stages91 and it is also unclear/too early to determine whether tomosynthesis reduces interval cancer detection rates. Further investigations of alternative supplemental modalities such as molecular breast imaging92,93 and contrast enhanced spectral mammography94 could also provide additional options for women with dense breasts. It is not clear whether any additional breast cancer detection relates to added benefit or added overdiagnosis (or both)2.