Imaging in Breast Cancer

Abstract

The role of imaging is essential in breast cancers. Mammography and ultrasound are used for early diagnosis as screening tests or for characterization of palpable lesions. Methods using contrast media (MRI or CT) have an additional value when mammography and ultrasound are inconclusive or not decisive for a decision making. When morphologic abnormalities are observed without any clinical symptom, fine needle aspiration or biopsy can be guided by these modalities. Histopathology is crucial to detect malignant lesions and provide biologic data useful for the therapeutic decision. Detection of loco-regional involvement, especially in lymph nodes, which has a prognostic value, as well as distant lesions is also provided by imaging. These data have a strong impact on the decision making. Imaging modalities are also widely used to preoperatively target non palpable lesions. Sentinel lymph node is a well accepted procedure and generally uses isotopic method because it allows an easier per-operative detection of this lymph node. Imaging methods are also used for the follow-up of patients presenting a significant metastatic risk looking for local, regional or distant lesions.