Holiday 2004 Newsletter: Update on Breast Cancer Diagnosis at the University of Chicago Breast Imaging Center

By Dr. Gilliam Newstead Associate Professor, Department of Radiology Director of Clinical Services, Mammography

The diagnosis of breast cancer requires an integrated and multidisciplinary approach. New technology allows the radiologist to detect and evaluate breast cancer more effectively. The advent of digital mammography, enhanced ultrasound techniques, computer-aided diagnosis, and magnetic resonance imaging provide enhanced methods for diagnosis.

At the University of Chicago the team of breast radiologists, Drs Robert Schmidt, Charlene Sennett, Madonna Kral, Hiroyuki Abe and Gillian Newstead provide a full range of diagnostic services to about 20,000 patients each year.

Under the leadership of Dr Newstead, breast magnetic resonance imaging techniques have become an important addition to our methods of breast cancer detection. Last year we examined more than 600 patients with MRI, many of whom were referred for evaluation with a newly diagnosed breast cancer. Breast MRI allows more precise determination of the extent of cancer within the breast, and thus provides more accurate information to the treating physicians. Breast MRI allows the detection of breast cancer which is occult by other screening methods. We have embarked on a funded program, led by Dr Funmi Olopade, to screen high risk women with digital mammography, whole breast ultrasound and MR imaging.

New MR research techniques have been developed under the guidance of Dr Gregory Karczmar. A team of researchers includes physicists Milica Medved, Cheng Yang, Marta Zamora and Sunny Arkani.

Programs currently include the investigation of high temporal resolution techniques for the evaluation of ductal carcinoma in situ, and high spectral and spatial resolution methods for evaluation of small breast lesions.

The breast diagnostic program is closely involved with the imaging research performed at the Rossmann laboratories. Multimodality Computeraided diagnostic methods will soon be introduced into the diagnostic area.

Dr Robert Schmidt, in collaboration with Philips Medical Systems, will lead a program to evaluate a prototype whole breast ultrasound device. This machine will provide 3D breast images and may lead to a new way of screening the breast with ultrasound. Ultrasound screening could also be used in the future for the screening of women with dense breast tissue. Mammography screening in these women is limited, and small cancers may be obscured.

These new diagnostic methods for breast cancer diagnosis should result in improved detection and more accurate assessment of the breast cancer patient.