Breast Cancer Diagnosis in Israel
The average risk for a woman to develop breast cancer is presently 1 in 8, over an 80-year life span. Although this makes breast cancer the most common cancer in women, the rate of death from female breast cancer has been declining steadily since 1989 – largely due to early screening and more precise diagnostics. In fact, early detection can lead to a total cure. At the Meirav Breast Center at Sheba Medical Center, we use the latest state-of-the-art technologies for breast cancer diagnosis in Israel.
Procedures that check for breast cancer are categorized as follows: screening tests to find breast cancer as early as possible; diagnostic tests to confirm a suspicion of breast cancer or to gather more information about an existing tumor; monitoring tests to assess how the treatment is working or to inspect for signs of recurrence. Regardless of which type of testing you require for breast cancer diagnosis in Israel, Sheba offers an experienced team of experts and the most advanced techniques to ensure comprehensive, detailed results.
Breast Cancer Symptoms
Even if you schedule regular screening tests for breast cancer diagnosis, it is essential to be aware of any changes in how your breasts normally look and feel, as well as to be familiar with the signs and symptoms of breast cancer, including:
- New lump or mass
- Skin dimpling (similar to an orange peel)
- Swelling of part or all of the breast, even with no lump
- Nipple retraction (turning inward)
- Nipple discharge (not breast milk)
- Breast or nipple skin that is dry, red, flaking, or thickened
- Swollen lymph nodes (such as under the arm or around the collar bone)
If you experience any of these symptoms, report them to a physician immediately so the cause of the problem can be diagnosed. Finding breast cancer early is the best way to promote successful treatment.
Tests for Breast Cancer Diagnosis in Israel
At Sheba, the Breast Imaging Unit uses a range of imaging procedures to diagnose benign and malignant breast disorders:
Professional medical organizations worldwide recommend starting regular mammograms at the age of 40. This procedure uses minimal radiation to generate a high-definition X-ray of the breasts. During routine mammography, four images are taken – two for each breast. In order to take the pictures, each breast is pressed between two hard surfaces. Some discomfort is felt, but only for a few seconds.
Mammography with contrast (iodine) may also be performed. It is similar to a standard mammogram, except that iodine is injected into the woman’s vein before the test.
A radiologist who specializes in breast imaging analyzes the X-rays. While mammograms are an important diagnostic tool, they do have some limitations. In the following cases, it is strongly recommended to also have an ultrasound:
- Dense breast tissue
- After mastectomy and radiation
- Following breast augmentation
This is a state-of-the-art version of mammography, and it features several advantages. Digital mammography offers more accurate breast cancer diagnosis in Israel for young women and women with dense breast tissue. Also, the electronic imaging results are stored in Sheba’s digital archive, so they cannot be lost.
Ultrasound sends high-frequency sound waves through the breasts and converts them into pictures. It must be performed by a medical professional who specializes in breast imaging, and there is no radiation involved. Ultrasound can determine if an abnormality is solid (such as breast cancer) or filled with fluid (such as a benign cyst).
Ultrasound is not used alone as a screening test. Rather, it is done to complement other types of screening. It is an optimal choice of imaging to help with breast cancer diagnosis in young women of childbearing age, pregnant women, and nursing mothers. It is also advised for women with dense breast tissue.
3D Ultrasound/Automated Breast Volume Scanner (ABVS)
3D breast ultrasound is the latest supplemental screening technique used for women with dense breast tissue. This innovative technology serves as an alternative to traditional hand-held ultrasound devices. The scans provide a 3D volumetric image of the entire breast, which enables radiologists to inspect the breast from various angles, leading to a clearer interpretation. The entire procedure is shorter than a standard ultrasound and takes as little as seven minutes to complete. At Sheba, our clinic is equipped with the highly advanced Automated Breast Volume Scanner (ABVS) by Siemens Healthcare.
Breast MRI (Magnetic Resonance Imaging)
MRI uses magnets and radio waves to create detailed cross-sectional pictures of the inside of your body. It does not use X-rays, so there is no exposure to radiation. MRI, the most sensitive imaging procedure, is particularly useful for screening women at a high risk for breast cancer, either because of genetics (BRCA carriers) or a strong family history. It is often used for preoperative evaluations in a patient with known cancer, to assess response to chemotherapy, or to gather additional information about an area found to be suspicious on a mammogram.
At Sheba, we are pleased to offer 3D Metabolic Imaging and Risk Assessment (3D MIRA), a new test for breast cancer diagnosis in Israel. It uses innovative optical imaging to identify metabolic activity in the breast. The procedure is entirely non-invasive and works by analyzing infrared breast images to determine an objective level of risk for breast cancer.
The patient is placed in a specialized room and a scan is performed. Then, the patient wears cold gloves for one minute before another scan is performed. In response to the cold, blood vessels in normal breast tissue contract, in contrast to abnormal blood vessels in a tumor – which remain the same. 3D MIRA is highly useful for women for whom mammography is not accurate, such as for women with dense breasts.
Invasive Breast Tests
When women undergo mammography, ultrasound, or MRI and the test results are inconclusive, an imaging-guided biopsy may be recommended for a definitive breast cancer diagnosis in Israel.
Breast biopsy: This procedure yields the most accurate diagnosis; it is performed under local anesthesia.
Intact® breast lesion excision system: This is an alternative biopsy technique that can also be used to help the patient avoid conventional surgical excision of lumps from the breast.
Preoperative markers: In order to mark a lump for accurate removal, a needle attached to a flexible metal coil is inserted and the metal coil is placed where the lesion is located.
Galactography/ductography: Mammography and a contrast material are used to generate pictures of the inside of the milk ducts. This testing is generally done to find the cause of non-milk discharge from the breast nipple when the mammogram is normal.
Stages of Breast Cancer
Breast cancer is staged by the size of the tumor and how extensively the cancer has spread:
Stage 0: There are abnormal cells, but they are found only in the breast tissue; this stage is also called pre-cancer or carcinoma in situ
The tumor is small and has not spread to any lymph nodes, or only to a few
The tumor is small but has grown, or the cancer has spread to nearby lymph nodes
The tumor is large or there is now significant involvement in at least four nearby lymph nodes
The cancer is metastatic, having spread to other organs and distant lymph nodes
Meet Our Team
Miri Sklair-Levy, MD
Head of the Breast Imaging Center, Meirav Breast Center
Dr. Sklair-Levy specializes in Diagnostic Radiology and Breast Imaging, and her primary interests are in imaging-guided chest biopsies, mammography, US, and MRI. She is highly experienced in the removal of lumps using an RF Intact needle and in imaging implants. Dr. Sklair-Levy has published dozens of articles in medical literature.
Sheba Medical Center
Miri Sklair-Levy, MD
Renata Faermann-Weidenfeld, MD
Senior Physician, Breast Imaging Center, Meirav Breast Center
Dr. Faermann-Weidenfeld is an experienced, highly trained breast imaging specialist. She received her medical degree from the Faculty of Medical Sciences at the Universidade Federal do Rio Grande do Sul (UFRGS), Brazil, and studied diagnostic radiology at the Tel Aviv Sourasky Medical Center (Ichilov Hospital). From 2014-2015, she also specialized in breast imaging at the Women’s Breast Health Center at Ottawa Hospital, Canada. Her particular research focus is in mammography, breast ultrasound examination, breast MRI, and MRI-guided biopsies.
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