St. Joseph’s adopts the latest in breast imaging technology

Contrast-enhanced mammography and 3D mammography are resulting in quicker, more accurate diagnosis of breast cancer for patients of St. Joseph’s Breast Care Program.

The latest wave in breast imaging technology has arrived at St. Joseph’s Hospital and is making a significant difference in precision and confidence in diagnosing or ruling out breast cancer.

Quicker, more accurate diagnosis of breast cancer


Contrast-enhanced mammography and tomosynthesis (three-dimensional mammography), are both now in use by St. Joseph’s Breast Care Program. The cutting-edge, new imaging tools are resulting in more accurate diagnoses, reducing the need for follow-up visits, decreasing unnecessary biopsies, enhancing critical information required by breast surgeons, and speeding up the overall diagnostic process, which improves access to breast assessment for all patients.

“We have been practicing the same way for 30 years,” says Dr. Anat Kornecki, Breast Radiology Lead at St. Joseph’s. “Now change has arrived, and it’s here. It shifts the entire paradigm of how we think when it comes to assessing breast abnormalities.”

In July 2017, St. Joseph's became the first hospital in Canada to install the Senographe Pristina mammography machine from GE Healthcare, a groundbreaking new breast imaging platform designed to increase patient comfort and make the exam easier and faster. Since being installed, the unit has been used for routine breast screening at St. Joseph’s. Three additional

Senographe Pristina units are now in place for breast assessment and diagnosis – when an abnormality has been found. These new units have the added capability of performing contrast-enhanced mammograms and tomosynthesis. 

Contrast mammography, developed in the early 2000s and refined and validated over the past decade, combines conventional digital diagnostic mammography with the administration of a contrast agent, explains Dr. Kornecki. The contrast agent – radiographic dye containing iodine – is injected into a vein in the patient’s arm before the mammogram images are taken.

Alternative to MRI

With contrast-enhanced mammography, the area of concern within the breast is highlighted in much more detail and can be an alternative to MRI, says Dr. Kornecki. It can pinpoint cancers that can’t be seen with standard mammography and is particularly effective in assessing dense breasts. 

“When the contrast mammogram rules out the presence of cancer, we can trust that there is nothing there. We have confidence in telling the patient that they don’t have cancer. If cancer is detected, it tells us how extensive it is.”

Those considered for contrast mammography are patients who have had a screening mammogram that indicated something suspicious, or those with a lump they can feel that is considered concerning. It’s a quick exam, eliminates having to wait for an MRI, and can be followed by a biopsy on the same day.

Creating three-dimensional images of the breast

Tomosynthesis creates three-dimensional images of the breast, providing radiologists with many more views than is possible with a standard mammogram. It also eliminates overlapping shadows of a standard mammogram, reducing call backs of patients for further investigation.

“The images walk us through the breast layer by layer,” explains Dr. Kornecki.

St. Joseph’s will be one of eight Canadian centres taking part in a U.S. study – the Tomosynthesis Mammographic Imaging Screening Trial – comparing the standard two-dimensional mammography to tomosynthesis. The study will look at whether tomosynthesis should be used as a screening tool, which Dr. Kornecki feels would dramatically advance early detection of breast cancer. Currently, the technology is not approved for routine breast screening in Ontario.

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