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Montefiore in the News

November 11, 2005

Breast Imaging Expertise, Prompt Scheduling for Mammograms

New York City, NY (Nov. 11, 2005)  — Women in the tri-state area can now receive state-of-the-art mammography services at Montefiore Medical Center, including magnetic resonance imaging (MRI), the latest technology to fully evaluate cases of breast cancer. 

"For women who have a personal or family history of breast cancer or who have a gene associated with the disease, this new technology is the best available for a complete evaluation," said Tova Koenigsberg, MD, division chief of breast imaging with expertise in MRI.  "Its sensitivity approaches 100 percent."

Although MRI has been used for years to create detailed pictures of the body's soft tissues, technical developments have only recently enabled its application in imaging the anatomy of the breast.

"MRI is so sensitive it can pick up virtually any abnormality in breast tissue, but not every irregularity is malignant.  Consequently, the technology is not useful for screening," Dr. Koenigsberg said.  "However, once a breast lump has been diagnosed as cancerous, MRI is invaluable in delineating the extent of the disease, including whether there are any malignancies in the other breast."

"That information makes MRI an important tool for surgical planning, helping to determine, for example, whether a lumpectomy (removing the tumor while leaving the breast intact) or more aggressive treatment (removal of the entire breast) is appropriate," she said.

Increased accuracy with digital technology

Montefiore has two dedicated breast imaging centers, one on each of its campuses, offering all available diagnostic tools and procedures.

Both centers are equipped with two digital mammography units, in addition to standard x-ray machines for imaging the breast and ultrasound equipment.  The centers also offer computer-aided detection (CAD), a software system that has been demonstrated to significantly increase breast cancer detection.

A recent study published in the New England Journal of Medicine found that digital mammograms were 15 percent more accurate than standard film X-rays in women under the age of 50.  They also proved more effective in women with dense breasts and women not yet in menopause.  For all other women, standard mammograms worked just as well as digital mammograms.

According to the study, digital machines account for only eight percent of mammography equipment today, largely because they are so costly.

The CAD system, essentially an extra pair of eyes reading a mammogram, has been shown to increase the detection of cancer, in one study by as much as 21 percent.

Prompt scheduling, diagnosis

Additional diagnostic procedures, all available at Montefiore's two breast imaging centers, include biopsies to obtain a sample of the abnormal tissue without surgery.  Stereotactic biopsies are performed with the aid of mammography to pinpoint the exact location of the abnormality.  Biopsies conducted under ultrasound guidance enable the physician to watch as the needle is inserted in the breast lump, ensuring adequate sampling of the area in question.

According to Dr. Koenigsberg, the wait time for an appointment at one of the Montefiore facilities is two weeks or less for a diagnostic mammogram, used to analyze a lump in the breast, and currently about a month for a screening mammogram.  The goal is to keep appointment times under six weeks.  If a patient is scheduled for a diagnostic mammogram, a sonogram is performed the same day to differentiate cysts, or harmless fluid-filled sacs, from hard tumors, which would require further evaluation. 

The Montefiore staff, all women, includes six radiologists who are dedicated to interpreting breast imaging studies.  While federal regulations require that mammographers read 240 mammograms a year to be certified, Montefiore's radiologists are more experienced, readig a few thousand mammograms per year, Dr. Koenigsberg said.

More than 30,000 mammograms are performed each year in Montefiore's breast imaging centers.

"We have a woman-friendly environment and a terrific staff devoted to women's health," Dr. Koenigsberg said.  "In fact, Montefiore's breast imaging centers are our staff's first choice for family and friends who need mammograms."