At Mount Sinai, we use the latest and most accurate diagnostic technologies to manage breast health and detect breast cancer. Our tools range from 3D mammography and breast magnetic resonance imaging (MRI) to image-guided biopsies, and also include artificial intelligence (AI) to enhance diagnosis. In addition, our genetic counseling and testing services can help you assess your risk. If you are at elevated risk, we can help you develop habits to lower your risk.

Types of Breast Exams

Breast imaging is an important part of diagnosis. It allows us to see what is happening inside your breast. We use a variety of breast imaging services, including the following:

• 3D mammography is a low-dose digital mammography. It takes many pictures of the breast, allowing doctors to see even more clearly than traditional mammography. The approach is also known as digital breast tomosynthesis.
• Breast ultrasound evaluates problems found during a physical exam, screening, or mammogram. Some women routinely receive a breast ultrasound, in addition to a mammogram, for screening.
• Breast MRI produces clear, highly detailed images of breast tissue use magnets and radio waves. It does not use radiation, like an X-ray does. We often use it for particularly high-risk groups of women, in addition to mammography.
• Bone scans detect areas where abnormal bone growth may indicate tumors, fractures, or infection. We use this test when your doctor suspects that breast cancer has spread.
• Multiple-gated acquisition (MUGA) scans evaluate how well your heart pumps and moves blood around your body. We typically use this scan before chemotherapy and during the course of chemo treatment.
• Positron emissions tomography (PET/computed tomography (CT) scans take 3D images of your breast to help us see if the cancer has spread (metastasis). We use this test for women already diagnosed with breast or other cancers when we are concerned about spread. 

At Mount Sinai, we use the power of artificial intelligence (AI) to achieve a more precise diagnosis. AI is a tool that gives a second opinion on a mammogram or ultrasound. It does not replace the radiologist, but it assists in finding breast cancers, especially small cancers. Your radiologist reads your mammogram or ultrasound on the computer—there is no substitute for the radiologist’s expertise. AI reads the mammogram or ultrasound at the same time and highlights areas that need extra attention.

Fine Needle Aspiration

This approach is useful when a lump in your breast is obvious to the touch and easily located. Our doctors use a thin, narrow needle to extract a tiny amount of breast tissue. Then we examine the tissue under a microscope for diagnosis.

Types of Core Needle Biopsies

To accurately diagnose a suspicious area, the medical team may perform a breast biopsy. This involves extracting a small sample of cells and examining them under a microscope. To be sure that we sample the suspicious cells, we use imaging to guide the extraction. Your medical team may have you remain awake during the biopsy under a local anesthetic. Core needle biopsies are the standard of care and best way to make a breast cancer diagnosis. They do not spread cancer. There are various types of core needle biopsies, including:

• Stereotactic breast biopsy uses mammogram images taken from different angles to guide the radiologist’s instruments.
• Ultrasound-guided breast biopsy uses ultrasound imaging to guide the radiologist's instruments.
• MRI-guided breast biopsy uses magnetic resonance imaging (MRI) to guides our extraction.