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Breast Care Options Header

This outline will walk you through the various modern breast care options available to patients today. The methods covered will be Self Breast Exam (SBE), Clinical Breast Exam (CBE), Screening and targeted ultrasound, Screening and Diagnostic X-ray Mammography, Magnetic Resonance Imaging (MRI) and Infrared Mammography. We'll be discussing how each method works, what to expect, or in the case of SBE, how to perform each examination.

Self Breast Exam Illustration

Breast Self Exam (BSE)

Beginning in their 20s, women should be told about the benefits and limitations of breast self exam (BSE). Women should be aware of how their breasts normally look and feel and report any new breast changes to a health professional as soon as they are found. Finding a breast change does not necessarily mean there is a cancer.

A woman can notice changes by being aware of how her breasts normally look and feel and by feeling her breasts for changes (breast awareness) or by choosing to use a step-by-step approach (see below) and using a specific schedule to examine her breasts.

If you choose to do BSE, click on the link in the sidebar for a step-by-step approach for the exam. The best time for a woman to examine her breasts is when the breasts are not tender or swollen. Women who examine their breasts should have their technique reviewed during their periodic health exams by their health care professional.

Clinical Breast Exam Illustration

Clinical Breast Examination (CBE)

CBE is an exam of your breasts by a health care professional, such as a doctor, nurse practitioner, nurse, or doctor's assistant. For this exam, you undress from the waist up. The health care professional will first look at your breasts for abnormalities in size or shape, or changes in the skin of the breasts or nipple. Then, using the pads of the fingers, the examiner will gently feel (palpate) your breasts.

Special attention will be given to the shape and texture of the breasts, location of any lumps, and whether such lumps are attached to the skin or to deeper tissues. The area under both arms will also be examined.

During the CBE is a good time for the health care professional to teach breast self exam to the woman who does not already know how to examine her breasts. Ask your doctor or nurse to teach you and watch your technique.

IR Camera Illustration

Infrared Mammography

Infrared mammography is a passive and functional type of study. Thermology does not use any form of ionizing radiation (unlike X-ray) as it evaluates the features of activity and operations of distinct areas of the body. The equipment we use (an infrared thermograph camera) makes tens-of-thousands detailed measurements of skin temperature at a distance of five to eight feet. The images produced are really electronic data of absolute temperature measurements that can be viewed as an electronic image presenting a spectrum of colors that indicate increased or decreased levels of infrared radiation (heat) being emitted from the body's surface.

Thermology is the branch of medicine that derives diagnostic indications of naturally radiating infrared energy (heat) from the human body by objective and quantitative methodologies. In this study guide you'll be learning about the history and developments of Thermology, as well as its scientific and clinical principals. You will receive a comprehensive tour of the entire imaging process using hands-on guides and helpful interactive tools.

Ultrasound Illustration

Ultrasound or Sonography

Ultrasound is a painless procedure that produces a picture of the internal structures of the breast. Images are captured in real time to show structure, movement and blood flow to help your doctor diagnose breast abnormalities found on a physical exam and/or learn more about potential abnormalities seen on a mammogram. They can provide information to help determine whether an abnormality is solid (which may be a non-cancerous lump of tissue or a cancerous tumor) or fluid-filled (a benign cyst). No X-rays are involved.

Women who benefit from ultrasound when abnormalities are not found on physical exam or mammogram include those who (a) have dense breasts, (b) are at high risk for breast cancer based on family history, (c) are pregnant and should not be exposed to X-rays, and (d) have silicone breast implants and very little tissue can be included on the mammogram.

MRI Illustration

Magnetic Resonance Imaging (MRI)

MRI is a noninvasive test that helps physicians diagnose and treat medical conditions. An MR image of your breasts produces detailed pictures that can be examined on a computer or printed. MRI does not use X-rays.

MRI of the breast is a supplemental tool for detecting and staging breast cancer and other breast abnormalities. It allows doctors to better evaluate breast conditions (including breast tissue density and cysts) that may not be assessed adequately by mammography or ultrasound.

Among the most common uses of breast MRIs are (a) evaluation of abnormalities detected by mammography, (b) identification of early breast cancer in women with dense breast tissue, and (c) identification of early breast cancer in women at high risk for the disease, including women who carry or whose primary relative (parent, sibling, child) carries an altered BRCA1 or BRCA2 gene; women who had chest wall radiation as a child or young adult; and women who have a personal history of breast cancer.

X-Ray Illustration

X-Ray Mammograms

A mammogram is an x-ray of the breast. A diagnostic mammogram is used to diagnose breast disease in women who have breast symptoms. Screening mammograms are used to look for breast disease in women who are asymptomatic; that is, they appear to have no breast problems. Screening mammograms usually involve 2 views (X-ray pictures taken from different angles) of each breast. For some patients, such as women with breast implants, more pictures may be needed to include as much breast tissue as possible. Women who are breast-feeding can still get mammograms, although these are probably not quite as accurate.

Although breast X-rays have been done for more than 70 years, the modern mammogram has only existed since 1969. That was the first year X-ray units specifically for breast imaging were available. Modern mammogram equipment designed for breast X-rays uses very low levels of radiation, usually a dose of about 0.1 to 0.2 rads per picture (a rad is a measure of radiation dose).

For a mammogram, the breast is pressed between 2 plates to flatten and spread the tissue. Although this may be uncomfortable for a moment, it is necessary to produce a good, "readable" mammogram. The compression only lasts a few seconds. The entire procedure for a screening mammogram takes about 20 minutes. This procedure produces a black and white image of the breast tissue either on a large sheet of film or as a digital computer image that is read, or interpreted, by a radiologist (a doctor trained to interpret images from X-rays, ultrasound, MRI, and related tests).

Positron Emission Tomography (PET) Illustration

Positron Emission Tomography (PET)

PET is an imaging modality that uses a radioactive contrast liquid to generate images of active tissues in the body. Doctors typically use PET scans of the breast to search for tumor metastasis. Due to its extremely high expense and difficulty to produce contrast liquid PET has not become a widespread modality.

While PET is generally not practical for screening women for breast disease it has been shown to be useful in instances where cancer is already known to be present. PET is commonly used in both localizing breast disease and determining the extents of the disease. Many surgeons use PET scans to help determine what their best course of action should be.

Disclaimer: This material is not intended to replace the medical advise of a physician. It is an educational resource. For questions about specific heath conditions and the best screening options for you, consult your primary physician.