BreastCentre Zurich

Mammography is one of the most effective examination methods for the early detection of breast cancer. It is an X-ray examination of the breasts. Using the latest technology, we take two images of each breast to enable an accurate diagnosis. The examination is carried out in a standing position. It only takes a few minutes, the compression of the breast only a few seconds.

Sonography makes it possible to visualise tissue structures using sound waves. This allows us to recognise changes in normal breast tissue and measure their size. A gel is applied as a contact medium so that the sound waves can glide optimally through the tissue. The transducer can then be guided over the breast with a certain amount of pressure. We also examine the armpits in this way.

This examination does not normally cause any pain, although the pressure can be uncomfortable if the breasts are sensitive, for example in the second half of the cycle. Using ultrasound, we can also visualise the blood flow or the condition of the tissue in colour-coded form. In contrast to mammography, which is based on X-rays, ultrasound does not involve any radiation exposure.

Ultrasound is the preferred examination method for young women in particular, as mammography is often less informative in dense breast tissue. For women before the menopause, the second week of the cycle is the optimal time for the examination. During this phase, the tissue is loosened due to the menstrual cycle, which leads to optimum image quality.

If there is an abnormality that stands out from the surrounding tissue structure, there are various criteria that can be used to determine whether the finding is benign or malignant. However, we can only obtain a definitive statement by analysing the tissue in the pathology department using fine tissue examination (histology).

Magnetic resonance imaging (MRI, also known as magnetic resonance imaging) is a useful addition to conventional examination methods such as ultrasound and mammography. Unlike X-rays, MRI is based on a strong magnetic field that acts on the atomic nuclei of the hydrogen atoms contained in the body. As the human body consists of 70 per cent water, MRI often reveals differences in water content between altered and healthy tissue. By adding contrast agents, altered blood flow patterns in the tissue can also be visualised. In this way, the MRI information provides precise information about the location and size of tumours. If you are suspected of having breast cancer, MRI can provide further important information as a gentle and radiation-free diagnostic method.

MRI plays an important role in the diagnosis of breast cancer. We use it in the following situations:

• To identify very small, malignantly altered areas that are not visible on a mammogram, especially in the case of an already known tumour
• To assess the lymph nodes in the armpit and chest
• To monitor tumour development during therapy
• To differentiate between scar tissue after breast surgery and a new tumour (recurrence)
• For patients with breast implants
• In the early detection examination for patients with a high risk of developing the disease due to a family history of breast and/or ovarian cancer
• In the early detection examination for patients in whom mammography is not meaningful due to dense glandular tissue

We use computed tomography (CT) to detect metastases (metastases in the body) in breast cancer. This procedure, also known as "staging", is carried out before chemotherapy, for example, in order to plan the optimum treatment strategy for an aggressive tumour. During a CT scan, numerous X-ray slices are made through the body and converted into three-dimensional images. This method makes it possible to assess the possible spread of breast cancer throughout the body.

In positron emission tomography (PET), we first inject a weakly radioactive, sugar-like substance. This accumulates in cells with an increased metabolism, such as cancer cells or inflammatory cells. With the help of a special camera, we can image regions with altered metabolism in three dimensions in order to identify metastases. PET-CT combines both imaging techniques and enables more precise localisation of possible metastases throughout the body.

Bones consist mainly of calcium and phosphate and are subject to constant build-up and breakdown. In diseases such as inflammation, tumours or metastases, certain areas of bone can exhibit accelerated cell division compared to healthy tissue. By injecting a phosphate compound labelled with technetium, a radioactive substance, and integrating it into the bone metabolism, we can visualise these changes. The technetium accumulates in diseased bone areas, which is captured by a special camera.

In breast cancer diagnostics, scintigraphy (nuclear medicine examination method) is used to visualise bone metastases:

• visualise bone metastases.
• monitor the response of known metastases to therapy.
• identify bone inflammation or fresh bone fractures.

Scintigraphy has several advantages. It can enable the diagnosis of bone metastases even if they are still too small for conventional X-ray diagnostics. However, scintigraphy has a limited ability to differentiate between benign and malignant changes in the bone. Additional examinations are therefore recommended for further differentiation.