What's New Radiologists at The George Washington University Hospital are using nuclear medicine to diagnose breast cancer in some women ill-served by mammography.

The Big Picture Mammography remains the gold standard for detecting breast cancer. But for women with particularly dense or fatty breasts, the technology can fall short and tumors can be hard to see, said Rachel Brem, GW's director of breast imaging and intervention. Some images are so faint a biopsy is needed to rule out a malignancy. Relying on mammography alone to detect new cancerous growths in women already diagnosed with cancer or who have breast cancer in their family can be particularly dicey.

The Scan In a test that takes about an hour, the Dilon 6800 gamma camera tracks the path of a radioactive fluid injected into the blood vessels in a patient's arm or foot. In a clinical study slated for publication in Radiology Magazine, the camera identified early stage breast cancer in two of 94 high-risk women. The cancers would not have been found using regular mammography, which detects breast cancer in two to six women per 1,000 screened, according to Brem. GW is the world's only hospital to use gamma imaging for breast cancer detection, he says.

The Rest Gamma imaging, said Brem, is meant to complement traditional mammograms, not replace them. "It's a problem solving tool, not a screening tool." The diagnostic procedure is covered by insurance. Still unclear, however, is whether the gamma scan will reduce the need for biopsies -- particularly among women with breast implants, who frequently develop calcifications that may initially appear cancer-like. But the procedure does have one definite plus: no more smushing. "The breasts may undergo some light pressure during the test, but nothing like a mammogram," Brem said.

-- Rita Zeidner