Mammi can help me

Early diagnosis

Mammi allows tumors as small as 2 mm to be visualized, which is essential for early breast cancer detection.

Individuals with dense breasts or a positive immediate family history are considered to be high-risk patients in whom the normal screening tests are not enough to have a reliable and accurate diagnosis of the breast. Having undergone previous surgery would also be considered a complex case in which early diagnosis is an additional benefit. In these cases, the doctor can recommend a specific screening plan for early detection and Mammi can meet your individual needs and provide you peace of mind, avoiding inconclusive tests and misdiagnosis.

I have dense breasts. What does that mean?

It is estimated that about 50% of all women have dense breasts. 40% have heterogeneously dense breasts (Bi-RADS 3) and 10% have extremely dense breasts (Bi-RADS 4).(26)

As we have seen, the breast is made up of fatty tissue and connective/fibrous tissue. A dense breast has more fibrous tissue and less fatty tissue.

The connective tissue appears white on a mammography and breast cancer also appears white. This means that tumors can be hidden or masked by the dense tissue, making them harder to detect.

Breast can be classify by their density:

Mostly fatty:
The breasts are made up of mostly fat and contain little fibrous and glandular tissue. This means the mammography would likely show anything that was abnormal.

Scattered density:
The breasts have quite a bit of fat, but there are a few areas of fibrous and glandular tissue.

Consistent density:
The breasts have many areas of fibrous and glandular tissue that are evenly distributed through the breasts. This can make it hard to see small masses in the breast.

Extremely dense:
The breasts have a lot of fibrous and glandular tissue. This may make it hard to see a cancer on a mammography because the cancer can blend in with the normal tissue.

The US and many other countries use the Breast Imaging Reporting and Database System, or BI-RADS, to report and categorize the findings of mammograms. Talk to your doctor about what category your result falls into and what follow-up plan he or she recommends.

Breast Imaging Reporting and Database System (BI-RADS)

0 Need additional imaging evaluation: means that more studies are necessary to gather
more information.
Additional imaging needed before a category can be assigned
1 Negative: means that there is no significant or noticeable abnormality to report. Continue annual screening mammography (for women over age 40).
2 Benign (noncancerous) finding: means that there has been a finding, such as benign calcifications or fibroadenoma, which are not cancerous. Continue annual screening mammography (for women over age 40).
3 Probably benign: means that there is a finding that is most likely benign, but should be followed in a shorter period of time to see if the area of concern changes. Receive a 6-month follow-up mammography.
4 Suspicious abnormality: means that there are suspicious findings that could turn out to be cancer. May require biopsy.
5 Highly suggestive of malignancy (cancer): means that there are findings that look like and probably are cancer. Requires biopsy.
6 Known biopsy-proven malignancy (cancer): means that any findings on the mammography have already proven to be cancer through a biopsy. Biopsy confirms presence of cancer before treatment begins.

Additionally, research has shown that dense breasts can be 5 times more likely to develop cancer. Breast density can be inherited, so if your mother has dense breasts, it is likely you will have it too.(27)

Mammi provides functional images, which are able to distinguish between small tumors and healthy tissue even in dense breasts, providing your doctor with a clear image of your breast tissue and allowing the doctor to see if there is any abnormal glucose metabolism in it.

Mammi can accurately clarify the inconclusive results without the need for all the conventional tests.

I have a family history of breast cancer. What should I do?

About 5-10% of breast cancer cases are a direct result of gene defects (known as mutations) passed on from a parent.It is not unusual that one or two people in an family have had breast cancer. Women with close relatives who have been diagnosed with breast cancer have a higher risk of developing the disease.

In some cases, a strong family history of breast cancer is linked to having an abnormal gene associated with a high risk of breast cancer, such as the BRCA1 or BRCA2 gene. In other cases, an abnormal CHEK2 gene may play a role in developing breast cancer.

If you have a family history of breast cancer, conventional screening tests may not be enough for you. Mammi can be the perfect technique for you in these complex cases, in this case scenario, secondary higher level of imaging studies may be indicated like MRI and/or molecular techniques like Mammi, thanks to its real 3D images and its high resolution that allows clear visualization and characterization.

Accuracy & reliability

It is important to be aware that false-positive and false-negative results are possible in all medical screening tests.

A false-negative scan looks normal even though breast cancer is present. It is normal that women with dense breasts have more false-negative results (in a mammography, a lesion has a white appearance, as does the dense tissue, and can therefore hide a tumor). A person who receives a false-negative test result (one that shows there is no cancer when there really is) may delay seeking medical care even if there are symptoms.

A false-positive scan looks abnormal, but no cancer is actually present. Abnormal results require extra testing to find out if the abnormality is cancer. False-positive results are more common in women who are younger, have dense breasts, have had breast biopsies, have breast cancer in the family or are taking estrogen.

The extra tests needed to ensure there is no cancer present, are time consuming and expensive. It is stressful and physically uncomfortable for any woman.

Mammi significantly reduces the false-negative results of a mammography or WB-PET, ensuring an accurate diagnosis of breast cancer, even in complex cases or small tumors. Mammi also reduces the false positives from MRI, reducing the “false alarm” of breast cancer and avoiding the extra cost of more tests.

Mammi provides your doctor with an accurate and efficient diagnosis in just one scan.

Less aggressive

Mammi is a dedicated PET, in which a small dose of radioactive sugar is injected into your blood.

The most used radiotracer is 18F-FDG, but there are other radiopharmaceuticals that will be availables in a near future, improving imaging the tumor’s response to therapies and the tumor’s receptors expression, even before the biopsy procedure.

Mammi uses low radiotracer dose (4mCi) so more dedicated Breast PET ´s tests can be performed to monitor your lesion.

Its ring configuration is close to your breast to improve the sensitivity and resolution of the scanner.

Mammi scans the breast in a comfortable prone position, while your breast is hanging on the hole of the bed, and the small ring scans your breast without any compression or discomfort.

If you have implants from a previous breast reconstruction, you might not have radiodiagnostic images with compression as your implant could be affected. Mammi allows you to have a clear image of your breast in a harmless procedure while laying down on a bed.

Mammi is performed on an open bed, making the scan highly recommended for claustrophobic individuals, unlike MRI or WB-PET where the bed is part of a closed tunnel.

Personalized cancer treatment

If you have been diagnosed with breast cancer, it is possible that you have heard about different therapies. One of them is neo-adjuvant chemotherapy, the main function of which is to reduce the tumor before the main treatment, usually surgery, or perhaps just to eliminate the tumor completely. This kind of therapy allows a more conservative surgery, removing only the tumor.

Follow up of this therapy is essential for the patient and also for the oncologist. It is critical for us to be aware of whether the treatment is working or not as soon as possible. Your oncologist would be able to evaluate after one course of treatment whether the tumor is responding or not to the therapy in order to introduce changes at early phases of the treatment if necessary.

Monitoring your tumor would be much more efficient with Mammi, thanks to its accurate and reliable images. Mammi identifies the amount of tracer uptake in a lesion using Standard Uptake Values (SUV), as well as the shape and size of your lesion, and these are great tools for your treatment response follow up.

Your doctor could personalize your treatment if the tumor is small enough for surgery or has disappeared, allowing the optimization of your therapy as well as a faster and improved recovery time.

Complete tumor response after neo-adjuvant chemotherapy treatment

Images courtesy of Dr. R. Valdés Olmos, NKI, Amnterdam, The Netherlands