Breast-Specific Gamma Imaging
When a mammogram is inconclusive, your physician may order a test using a breast specific gamma imaging.
Breast-specific gamma imaging images the metabolic activity of breast lesions using a gamma camera. The camera can detect early stage cancers, see lesions even in dense tissue, and provide multiple angle views.
Cancerous cells have a higher rate of metabolic activity and will show up as “hot spots,” in the exam.
What is breast specific gamma imaging?
While mammography remains the primary method of early detection, diagnostic challenges can occur due to the complexity of the breast tissue. Sometimes additional testing, such as breast specific gamma imaging, is necessary.
Breast-specific gamma imaging (BSGI) aids in diagnosis when a mammogram is inconclusive and reveals important information that can help your doctor more accurately determine if an area of concern is cancerous.
During the procedure images are taken showing the metabolic activity of breast lesions using a gamma camera.
The high-resolution camera creates pictures so doctors can see cancers as small as 3 millimeters. It can detect early stage cancers, see lesions even in dense tissue, and provide multiple angle views.
The result is quicker and more acute detection of breast cancer than with mammography alone.
What can breast-specific gamma imaging tell my doctor?
BSGI is a valuable tool for situations where mammography cannot answer all the questions and further evaluation is needed, especially when patients have:
- Dense breast tissue
- Scaring from previous surgeries
- Suspicious areas on a mammogram
- Lumps that can be felt but not seen with mammography or ultrasound
- Post-surgical or post-therapeutic mass
- Implants and breast augmentation
- Hormone replacement therapy
BSGI can also help your doctor determine if biopsy is necessary. Biopsies, preventable in some cases, can be traumatic and leave scars. Some women are told to "wait and see" for months for a follow-up mammogram. These scenarios prolong the fear and anxiety of diagnosis. BSGI can prevent this anxiety in many cases by providing accurate and detailed information in a short amount of time.
Is BSGI right for me?
I have been told I have dense breasts.
X-rays do not penetrate dense breast tissue very well, which makes it harder for your doctor to interpret the mammogram. In addition to younger and pre-menopausal women, dense tissue often occurs in women going through hormone replacement therapy or those who have undergone radiation treatment. BSGI detects cellular changes that a mammogram may miss, regardless of breast density.
I am a breast cancer survivor.
Scar tissue trauma or radiation therapy can look suspicious on a mammogram. It can be difficult to differentiate scarring from tumors with mammography. BSGI can see hidden areas and reveal cancerous lesions.
My mammogram shows multiple areas of concern.
Calcium deposits are frequently detected in mammography. While calcifications are benign, some are suggestive of the presence of a malignancy, even with no associated lesion. In such a case, further investigation is necessary. BSGI allows doctors to evaluate the entire breast at different angles to help identify any cancerous lesions and take the appropriate steps.
I have breast implants.
Implants can complicate image interpretation even with special compression views of the breast. BSGI does not require compression of the breast and its detection of cancer is not hindered by implants.
How do I prepare for my exam?
Women should inform their physician or tech if there is any possibility that they are pregnant or if they are breastfeeding. Inform your physician and tech performing the exam of any medications you are taking, including vitamins and herbal supplements. Also inform them of any allergies or recent illnesses or other medical conditions.
How is the test performed?
Breast specific gamma imaging is a nuclear medicine procedure. Radioactive material or a radiotracer is injected into your bloodstream, swallowed or inhaled as a gas.
Nuclear medicine imaging exams focus on depicting physiologic processes within the body, such as rates of metabolism or levels of chemical activity at the site being examined, rather than focusing on anatomy and structure.
As radioactive material accumulates in the breast, cancerous cells will show up as “hot spots” because cancerous cells have a higher rate of metabolic activity.
One breast at a time will be placed next to the BSGI gamma camera and compressed with a flat plate, similar to a screening mammogram. Each image takes about 10 minutes. The exam can take 40 to 60 minutes in most cases depending on how many images need to be taken.
You will need to remain as still while the images are taken. In most cases, the patient is seated during the imaging. Breast compression must be firm to keep the breast from moving while the image is being obtained, but is not usually as tight as for a regular mammogram.
There may be some discomfort from having to remain still or to stay in one particular position during imaging. If you think you may have difficulty remaining still or tolerating breast compression during the examination, inform your tech before the exam.
Are there risks?
Because the doses of radiotracer administered are small, diagnostic nuclear medicine procedures result in low radiation exposure, acceptable for diagnostic exams. The radiation risk is very low compared with the potential benefits.
How will I find out my results?
A radiologist will analyze the images and send a report to your primary care physician or the physician who referred you for the exam, who will share the results with you. In some cases the radiologist may discuss results with you after your examination.