Best and Brightest: The Future of Breast Imaging

Mary Mahoney, director of breast imaging at UC Health Barrett Cancer Center, has a much clearer view when diagnosing breast cancer.

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I love radiology because it’s like an investigation—the patient presents with certain symptoms, and imaging is a big piece of the puzzle. I also love the technical aspects of radiology and really enjoy patient interaction. We see patients year after year for their annual mammograms, so I get to develop relationships with them.

If one of our patients comes in for a mammogram and we see an abnormality, we have them return for different kinds of imaging to determine what it is. If it’s a lump, we send them straight to diagnostics to set up an appointment for a biopsy. A little over a decade ago, a patient had to go to the operating room to have a biopsy. Now with percutaneous biopsy, we mark the area, clean it, insert a needle and get the sample we need. The patient is awake and can watch what we’re doing the entire time. There’s no need for anesthesia, no incision, no visit to the OR. It’s also less expensive, less invasive, less overwhelming, has fewer complications, leaves less scarring, and it’s equally accurate. It’s changed the way I practice—now I get to manage my patients from the time they come in for their screening to the time I share their biopsy results.

It is amazing how much better we’ve gotten at detecting cancers because we can see so much more now. If I showed you mammograms from 10 years ago versus today, the difference would be startling. We can now shift our focus to identifying what we see—that is, whether it’s benign or malignant.

We’re also adding more tools to our toolbox. Tomosynthesis is a way of capturing a three-dimensional picture of the breast—instead of the traditional top-to-bottom and left-to-right pictures we get with mammography, tomosynthesis gives us a group of  individual “slices” of the breast tissue. The breast is still compressed like it would be for a mammogram, but the machine moves in an arc. It improves specificity of normal versus abnormal, and gives us better visuals, especially for women with dense breasts. It’s still new and just got FDA approval, but there’s a lot of potential.

The future of radiology is molecular imaging. We won’t just be able to see the anatomy, we’ll be able to mark areas for targeted treatment. For example, with spectroscopy, instead of just looking at the size and shape of a tumor, we’ll be able to tell what compounds are in it and learn the physiology of the mass. That’s still in the research phase.

UC is an American College of Radiology accredited Breast Imaging Center of Excellence, the only hospital in Greater Cincinnati accredited for breast MRI. It’s great to go to national meetings and have people recognize UC as a great institution. With teaching, research, and busy clinical days seeing patients, the days can be very long. But I love the work I do.

Originally published in the January 2012 issue.

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