Molecular breast imaging is a procedure that can help detect breast cancer. You might also hear it referred to as breast specific gamma imaging, scintimammography, or Miraluma.
After your doctor injects a radioactive tracer into your vein, a special nuclear medicine scanner will capture images of your breasts. Breast cancer cells usually absorb more of the tracer than healthy cells.
A routine breast cancer screening doesn’t include this test. Doctors usually reserve this test for women who have dense breasts or are at high risk of developing breast cancer. It’s also helpful when a mammogram or ultrasound indicates an abnormality. In those cases, it can help your doctor decide what steps to take.
What should I do to prepare?
Doctors don’t recommend molecular breast imaging for pregnant women. Before scheduling molecular breast imaging, be sure to tell your doctor if you’re pregnant, or may be pregnant.
If you’re breastfeeding, the radioactive tracer may be present in breast milk for 12 hours or so. You can pump and store some milk before the test. Ask your doctor when it’s safe to resume breastfeeding.
Tell your doctor about any known allergies you have. Since you’ll have to remain still for the test, let them know if you have difficulty remaining still for 10 minutes at a time.
Premenopausal women should schedule the test during the beginning of their menstrual cycle, preferably seven to 14 days after the first day of their period.
You may need to stop eating a few hours before the test. This will allow more of the tracer to travel to your breast tissue and produce clearer images. Drinking liquids like water, plain coffee, or tea won’t affect the test.
Other than that, there’s no special preparation necessary for this test.
What happens during the procedure?
Molecular breast imaging is an outpatient procedure that takes about 45 minutes to one hour.
You’ll undress from the waist up and put on a gown with an opening in the front.
Your doctor will inject the radioactive tracer into a vein in your arm. You might notice a slight metallic taste for a few minutes. You’ll be ready for imaging in about five minutes.
The breast imaging machine looks a lot like a mammogram machine. One difference is that you’ll remain seated as your breast is compressed. This may be a little uncomfortable, but it doesn’t usually cause pain.
The special gamma cameras will monitor the activity of the tracer in your breast. The breast imaging machine technician will take two images. It will take about 10 minutes to take each image. During this time you must remain still. You’ll have a chance to move around a bit between images when your breast is repositioned.
It’s possible to repeat the process for the other breast if necessary, or in other cases, like if you have very large breasts.
The technician will most likely be ask you to wait while they check the images for quality. If the images aren’t clear, you may need to repeat the procedure. Once you get the go ahead, you can leave and resume normal activity right away.
What do the results mean?
The radioactive tracer is more likely to collect in cancerous cells than healthy ones. Areas of the breast that absorb the most tracer will appear highlighted on the images.
It’s important to remember that it’s only possible to confirm cancer with a biopsy. Molecular breast imaging can’t definitively say you have breast cancer.
The radiologist will study the scans and send a report to your doctor. They’ll explain the results to you.
Molecular breast imaging can help your doctor decide if more invasive testing, such as a biopsy, is necessary.
What are the benefits?
Molecular breast imaging is a good secondary tool to follow up on mammograms or ultrasounds that have unclear results.
Other benefits include:
- The test may help you avoid an unnecessary breast biopsy.
- Breast implants don’t interfere with the quality of the images.
- When compared with mammography, the radioactive tracer used in molecular breast imaging makes it easier to find tumors in dense breast tissue.
- It’s a good alternative if you’re allergic to the contrast dye used in a breast MRI.
- It’s safe if you have a pacemaker or other cardiac implant.
- When combined with mammography, molecular breast imaging detects three times more breast cancers than a mammogram alone.
- Molecular imaging may be able to identify cancer in the early stages when it’s easier to treat.
What are the risks and side effects?
The imaging device itself doesn’t produce radiation. Your doctor injects you with a radioactive substance. You’ll pass it in your urine within a day or two. Although the radiation exposure is low, the dose is higher than that of a mammography, ultrasound, or breast MRI.
Side effects may include:
- fleeting taste of metal after receiving the injection
- temporary redness, stinging, or mild pain at the injection site
- allergic reaction to radioactive tracer
How much does it cost?
The cost of this test varies. It depends on where you live and whether your insurer negotiates a network rate. It may cost anywhere from $200 to $800.
Talk to your insurer before scheduling the test. Some may cover it for diagnostic purposes but not for screening. Your doctor’s office may have an administrator who can contact your insurer on your behalf.
If your policy won’t cover the test, ask your provider for a self-pay rate and payment schedule.
What should I do next?
Molecular breast imaging is not a primary breast cancer-screening tool.
If your doctor has suggested molecular breast imaging, ask why they believe it’s necessary and what alternatives you might have.
Inform your doctor of any potential problems like allergies or if you’re pregnant or breastfeeding.
Find out where the test is available in your area and if that facility is in your health policy network. Contact your insurer to find out if they will cover the test and what your out-of-pocket expenses will be.
Talk to your doctor about your personal risk of developing breast cancer and how you should be monitored going forward.