Breast Imaging Test Comparison: Which is Best for You?

Author: Qin Naishan, Chief Physician, Peking University First Hospital

Reviewer: Song Guohong, Chief Physician, Peking University Cancer Hospital

Breast diseases, as a major threat to women's health, have always attracted much attention. Mastitis, breast hyperplasia and even breast cancer, these terms make many women shudder. In order to detect lesions early and reduce the troubles of the disease, breast imaging examinations have become an indispensable line of defense.

There are many types of breast imaging examinations, each with its own strengths. Common breast imaging examination methods include mammography, breast ultrasound, and breast magnetic resonance imaging. These methods are based on different imaging principles and provide doctors with a variety of diagnostic tools.

Mammography and breast ultrasound are convenient to operate and are the most commonly used breast examination methods in clinical practice. Mammography is particularly sensitive to calcification, making it an important means of screening and diagnosing breast cancer. Breast ultrasound is more accurate in detecting and identifying masses and is also the preferred method for screening and diagnosing breast cancer. Magnetic resonance imaging provides new ideas for the diagnosis and treatment of breast cancer. Magnetic resonance imaging has become an indispensable member of breast cancer diagnosis due to its extremely high soft tissue resolution. It can detect microscopic lesions at the millimeter level and can distinguish between benign and malignant breast masses. Magnetic resonance imaging has unique advantages, especially in tumor blood supply analysis. By injecting contrast agents to observe the degree of tumor enhancement, breast cancer and normal glandular tissue can be effectively distinguished. Although magnetic resonance imaging also has problems such as long examination time, high cost, and potential risks of contrast agents to renal function, it plays an important role in preoperative staging of breast cancer, evaluation of the efficacy of neoadjuvant therapy, and follow-up after breast cancer surgery, which is difficult to replace by other examination methods. After breast cancer is diagnosed, PET/CT evaluates lymph node metastasis and distant metastasis through whole-body imaging, helping clinicians to more accurately stage the disease and develop treatment plans.

X-ray and ultrasound are the first choice for breast cancer screening. When asymptomatic healthy women want to find or exclude early breast cancer through medical examinations, X-ray photography and ultrasound examinations become the most suitable options. Both are quick to operate, and the entire examination takes about 5-10 minutes. Compared with other examination methods (MR and PET/CT), they are also more economical and are ideal for large-scale breast cancer screening. Regarding breast cancer screening, X-ray photography and ultrasound each have their own advantages. For young women, ultrasound is more suitable as the first choice of examination method due to its characteristics of no radiation hazards. Especially for people at high risk of breast cancer, ultrasound examinations should be performed regularly at a younger age (starting at 35 years old). Ultrasound examinations are excellent in detecting masses and distinguishing cystic and solid lesions. X-ray photography has unique advantages in detecting breast calcifications, and can detect early breast cancer with only calcification as the main manifestation. In addition, X-ray examinations can save detailed and comprehensive imaging data, which is convenient for subsequent observation and comparison. However, it is difficult for ultrasound examinations to save comprehensive breast imaging data. Domestic and foreign studies have confirmed that the combination of X-ray and ultrasound can bring higher lesion detection rates and diagnostic accuracy.

Once a patient develops symptoms such as breast lumps, nipple discharge, or orange peel-like thickening of the skin, it often indicates that there is a disease in the breast. At this time, imaging methods are needed to make a clear diagnosis of breast lesions. In addition to breast X-rays and ultrasound examinations, breast magnetic resonance imaging also plays a key role. It can detect tiny lesions and show the characteristics of lesions more subtle and accurate, making its diagnosis more accurate. Therefore, for the diagnosis of breast diseases, X-rays, ultrasound, and breast MR are all very important and commonly used examination methods.

Figure 1 Original copyright image, no permission to reprint

For patients with mastitis, the examination method should be chosen with caution. For patients in the acute stage of mastitis, the breasts are accompanied by symptoms such as redness, swelling, heat and pain. At this time, X-ray examinations may aggravate the patient's discomfort, and breast compression may even cause the spread of inflammation. Therefore, for patients with mastitis, ultrasound or magnetic resonance imaging is more recommended to avoid unnecessary compression and discomfort.

Figure 2 Original copyright image, no permission to reprint