First-line tool for detection of breast CA. 

Sensitivity for detecting CA: screening  68-90%, diagnostic up to 93%.

Digital breast tomosynthesis (DBT) is standard of care for breast CA screening and diagnostic imaging. Compared to digital mammo, DBT decreases recall rate and increases CA detection rate. 

Important tool for evaluating sx patients when mammography is negative.

Whole breast US can detect an additional 2-4 CA per 1,000 women over mammography alone but w increased cost.

Indications:

• Characterization of palpable abnormalities

• Further characterization of mammographic findings

• First line evaluation of breast abnormality in pt < 30 yo

• Pregnant or lactating women

• Guidance for interventional procedures

• Evaluation of breast implants

• Supplemental screening in women with dense breasts or those at high risk and unable to undergo MRI surveillance

Most sensitive modality for breast CA detection and is the most definitive imaging modality in evaluation of implant integrity. 

Indications:

• Screening in high risk patients (.20% lifetime risk of developing breast CA)

• Evaluation of extent of disease in patient newly diagnosed w breast CA

• Evaluation of neoadjuvant chemotherapy response

• Assessment for residual disease after positive surgical margins or for tumor recurrence after breast conserving treatment

• Evaluation for occult breast CA in a pt w/ axillary metastases

• Assessment of breast implants