Breast Imaging and Image-Guided Biopsy Techniques

Abstract

Breast imaging is an essential component of breast cancer diagnosis and guides surgery and treatment options. Imaging techniques such as mammography, ultrasound (US), and magnetic resonance imaging (MRI) enable the detection of breast cancer at earlier stages. Mammography remains the standard screening examination; however, additional imaging studies are useful in evaluating the breast. US is utilized primarily in the diagnostic setting to characterize mammographic or palpable findings and assess axillary lymph nodes. Supplemental screening US may also be useful in patients with intermediate risk for developing breast cancer and dense breasts to increase cancer detection. In addition to mammography, high-risk patients may also have annual MRI or screening US if they are unable to undergo MRI. MRI is also performed to evaluate the extent of disease, the response to neoadjuvant chemotherapy, and silicone implant integrity. In addition, these imaging modalities are also used to guide percutaneous biopsy, enabling minimally invasive tissue diagnosis. There is insufficient evidence to support the screening use of investigational imaging modalities, such as nuclear medicine breast imaging, and positron emission mammography. However, these topics are briefly discussed for completeness.