13th August 2023, NIA Diagnostic Imaging
A 49-year-old lady presented with pain in her right breast. There is a strong family history of breast cancer. Breast examination was difficult because of “lumpiness” of the breasts. She was referred for a breast ultrasound at NIA. Ultrasound showed two lesions in the right breast – one at 3 o’clock, 2cm from the nipple and another at 7 o’clock, 2cm from the nipple.…
29th January 2023, Spectrum Medical Imaging
Breasts not only come in different sizes and shapes but have different composition and densities. The breast density also changes with age, body composition and genetic factors. 50% of women in the US have dense breasts and dense breast tissue can camouflage early breast cancer. Yet, we only have standardised mammography and screening schedules. The Volpara is an AI software platform that provides an individualised risk assessment and screening recommendations based on the composition of the breast of the woman.…
14th January 2023, NIA Diagnostic Imaging
Despite the availability of modalities such as mammography, MRI and galactography, ultrasound still has a role in breast imaging. Ultrasound provides high resolution portrayal of normal and abnormal breast parenchyma as well as clear depiction of lactiferous ducts and the terminal duct-lobular unit where masses can form (4). This is particularly useful when investigating women presenting with a bloody nipple discharge.…
31st May 2022, Spectrum Medical Imaging
We know that different women have different breast types. Some breasts are more dense than others. Some breasts have more adipose tissues than others. Obviously, with age, those features will change. Thus, the ideal imaging techniques will be different and will depend on the breast type, the age and the underlying risk of the woman, amongst many other things.…
1st January 2022, Dr Chee L Khoo
This definitely wasn’t in the curriculum when I left med school (alright, it was more than 30 years ago now) but I don’t remember being updated about its relevance. I am talking about the epidermal growth factor receptor (EGFR). It is not really in the realm of general practice as such but we do have patients coming back from the oncologist with a tumour bearing an EGFR gene mutation.…
26th September 2019. Spectrum Medical Imaging
Breast cancer is the most common cancer affecting women. In 2019, it is estimated that 19,535 Australians will be diagnosed with breast cancer. However it is important to remember that most women survive breast cancer. Diagnosis of breast cancer patients in early stages is one of important aspects of breast cancer treatment. Among of many diagnostic platforms, imaging techniques are main diagnostic approaches which could provide valuable data on patients with breast cancer.…
26th September 2019. Dr Chee L Khoo
We put patients at high risk of cardiovascular events on statins as primary prevention. We sometimes put patients with high risk of cerebrovascular disease on aspirin to prevent strokes. What about patients who are at high risk of breast cancer? Now, these are not patients who already had breast cancer. We are talking about patients who have not had cancer but are at higher than average risk of developing breast cancer.…
22nd June 2019, Dr Chee L Khoo
Screening mammography has been shown in many prospective, randomised, clinical trials to reduce breast cancer deaths by between 25-40% (1-4). Unfortunately, small but high-grade cancers can be masked by the presence of dense breast tissues or may be confused as benign breast disease in mammograms. In fact, in countries that have national breast screening mammography programs, advanced breast cancers have not decreased (5,6).…
22nd June 2019, Spectrum Medical Imaging
Dynamic contrast enhanced breast – MRI must contain a minimal number of MRI sequences that is necessary to detect small enhancing breast lesions. What if we cut down the number of sequences but yet have enough accuracy to detect small early cancers? That’s what AB-MRI is – less number of sequences but yet enough to detect small lesions. …
Many countries now recommend annual MRI screening in conjunction with mammography for high risk groups. The only problem is that different countries define high risk differently. Medicare item 63464 can be used for the surveillance and diagnosis of women under 50 years of age at high risk of developing breast cancer, and who have no signs or symptoms of the disease.…
30th September, 2018, Dr Chee L Khoo
There is no question that screening mammograms have led to a decline in late stage breast cancers. There have been a gradual decrease in breast cancer mortality, at least partly, due to the introduction of screening mammograms over the last 25 years. But screening mammograms are not perfect. In women with dense breast tissue, the sensitivity of mammogram decreases.…