Within the past year, a newer type of screening method has been used for women with dense breasts. This test is molecular breast imaging, otherwise known as “Breast Specific Gamma Imaging” (BSGI).
Researchers screened 940 women with both BSGI and mammography. All of these patients were diagnosed as high risk for breast cancer and had a breast density >50%. The investigators found 13 tumors in 12 patients, with BSGI finding 10 tumors and mammography only 3. Molecular breast imaging was more sensitive than mammography (75% vs. 25%) and more specific (93% vs. 91%).
Even though this test has an important role in finding cancers that are stealth to mammography, investigators are not advocating replacing mammography with BSGI. About 10-15% of breast tumors are missed on mammography for women with dense breast tissue. This is a common phenomenon in alot of women, especially those in their 40’s.
The goal is to use this tool as a low cost alternative to breast MRI which runs around $3500.00. Ouch! Molecular breast imaging in my town runs around $800.00. Radiologists find this test appropriate for women with extremely dense breasts and strong family history of breast cancer, and those with abnormal mammograms to determine whether biopsy is necessary. BSGI is a good adjunct screening tool in addition to mammography.
This is a test that can be individualized for women at high risk for breast cancer. It is my hope that we can personalize medicine better with these type of tests for certain populations. We need to get away from one size-fits-all in terms of screening approaches and direct certain tests for an individual women based on her risk and the characteristics of her breast tissue.
Reference: Hruska CB. HemOnc Today. “2008 Breast Cancer Symposium- Washington, Sept. 5-7. Molecular breast imaging found more tumors in dense breasts”, 2008.