Breast Cancer Diagnosis in Israel

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 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.

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.

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.