Breast Imaging

Breast cancer is the second leading cause of death and the most commonly diagnosed non-skin cancer in American women. It is estimated that almost 300,000 women will be diagnosed with breast cancer in the U.S. this year, breast with approximately 40,000 dying from the disease. Recent advances in technology, experience and expertise make it easier to diagnose breast cancers at an earlier stage, leading to a higher chance of successful treatment and cure.

The clinical mission of the Division of Breast Imaging is to provide individually tailored comprehensive evaluations for the early detection and diagnosis of breast diseases. Our Breast Imaging Division, accredited by the American College of Radiology, provides screening and problem-solving multi-modality imaging for outpatients at the Hospital of the University of Pennsylvania and its satellites.

Penn's Breast Imaging Center includes four 3D digital mammography units, two dedicated breast ultrasound machines, a prone digital stereotactic core biopsy unit and a dedicated breast MRI unit. More than 24,000 breast imaging studies and approximately 3,000 interventional breast biopsy procedures are performed each year. The studies are interpreted by six board-certified and breast fellowship-trained radiologists. The technical staff is all sub-specialty certified in mammography.

The division is fully equipped for all forms of interventional procedures including stereotactic, ultrasound, and MR guided biopsies. Since the center is a large referral center, the number of diagnostic studies and the volume of biopsies is quite high. In addition, there are very close clinical and research collaborations with the departments of Surgery, Radiation Oncology and Medical Oncology.

3D Digital Mammography
Mammography continues to be the best screening method available for breast cancer. Improvements in imaging, such as tomosynthesis or 3D mammography, produce a quicker, sharper and overall enhanced image to aid in developing faster and more accurate results.

3D Digital mammography offers potential and practical advantages over traditional mammography, and often allows for better cancer detection. These advantages include:

  • With digital images, the radiologist can zoom in, magnify, change the contrast of the breast image, or view it in slices, resulting in more precise images and helping reduce the need for repeat screenings.
  • Flexible plates for greater comfort
  • Digital images can be sent and stored electronically, providing women with the ability to maintain an electronic file of mammograms as a reference to help radiologists better track changes. Additionally, the digital images are available almost instantly and can be transmitted electronically around the world.
  • 3D mammography has been shown to reduce the number of false positive cases (decreasing unnecessary additional imaging) while also increasing the cancer detection.

2D mammogram

3D Mammogram showing invasive cancer

The most important advantage to digital mammography, and especially 3D mammography, is the ability to use advanced computer and electronic technologies to manipulate the image in order to better "see" certain breast tumors that are difficult to identify on a standard mammogram or may be obscured due to overlapping breast tissue that is reduced with the 3D imaging format.

Breast MRI
Women who have indeterminate findings on either a mammogram or sonography may benefit from breast magnetic resonance imaging (MRI). MRI may specifically characterize a questionable lesion to determine whether a biopsy is needed. Women at high risk for developing breast carcinoma (e.g., family history or carriers of predisposing gene) may benefit from MRI screening to determine if no occult breast tumor is present.

Breast MR

Breast MRI is a non-invasive procedure that uses powerful magnetic fields and radio waves to construct internal images of the breast. Penn physicians say it is a useful tool for further examination of uncertain findings. It is also used to assess the size and location of cancer that has been detected in the breast for determining the appropriate treatment. Breast MRI is more sensitive than a mammogram. Breast MRI is performed in conjunction with mammography and the two types of imaging used together allow physicians to see additional areas of breast tissue.

MRI is effective for high-risk patients. A recent American College of Radiology Imaging Network study of high-risk women newly diagnosed with breast cancer found that adding the MRI scan to mammography led to the detection of more than 90 percent of cancers in the opposite breast missed by mammography.

Earlier detection of more extensive cancer can mean less chemotherapy and breast cancer-related surgery for many women.

Breast Imaging Services

  • Tomosynthesis imaging is performed for all screening and diagnostic studies
  • Hand-held breast ultrasound
  • Breast MRI

Interventional procedures:

  • Core biopsies, fine needle aspirations and cyst aspirations under ultrasound guidance
  • Stereotactic core biopsies
  • MR guided core biopsies

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