The Art of Interpretation: Expert Readers Decode Breast Images

Mammography is widely recognized as the gold standard in detecting breast cancer – but the accurate interpretation of a breast image relies upon the expertise of the person viewing it.

At Community Medical Center, the Women's Imaging Center offers an expert team of trained breast imagers who skillfully read mammogram screenings. Highly trained in their field, these professionals are able to detect abnormalities and know the best methods to go about decoding suspicious readings.

The technologist will compress your breast and take two views of each breast. "The idea is that if you thin out the breast by compression, it's easier to visualize hard-to-see areas like calcifications. It also helps to limit patient movement so images are clear, not blurred," says board certified diagnostic radiologist Jorge Pardes, MD, Director of Breast Imaging at the Women's Imaging Center at Community Medical Center in Toms River.

Despite being the gold standard in prevention, the National Cancer Institute reports that screening mammograms miss about 20 percent of breast cancers that are present at the time of screening, and the main cause of false-negative results – or mammograms that appear normal even though breast cancer is present – is high breast density.

Density is the relative amount of different tissues present in the breast. Dr. Pardes says that radiologists are mandated to classify breast density using four categories when evaluating mammograms. The categories describe the relative proportion of fibroglandular tissue (which is white on mammography) to fat (which is gray on mammography) in the breast.

"When breasts are predominately fatty (or the least dense), mammogram images are fairly simple to interpret. When more glandular tissue is present (or when breast density is higher), mammography images become more difficult to read," says Dr. Pardes. "On a mammogram, normal glandular tissue is white, and tumors are also white, making it difficult sometimes to discern between healthy and potentially harmful tissue."

Women with dense breasts often have difficulty with the reliability of screening with mammography alone. For these women, Dr. Pardes says additional diagnostic tests such as whole breast ultrasound or breast MRI are sometimes recommended. Another test, called breast specific gamma imaging (BSGI), is an alternative for women who cannot undergo MRI.

"We've come a long way in detecting and battling breast cancer, but it's still the most common form of cancer among American women," says Sumy H. Chang, MD, a fellowship-trained board-certified breast surgeon on staff at Community Medical Center. She encourages women to see a doctor at the very first sign of any change or abnormality, stressing that women should feel at ease seeking care as they play a significant role in determining their treatment approach.

"While the options may differ from woman to woman, I explain, in complete detail, what these options entail and what to expect," says Dr. Chang. "Working closely with the patient, I will recommend the best path for her."

To schedule an appointment at the Women's Imaging Center in Toms River and Whiting, please call 732.557.8150.