PEM: An Additional Arrow In the Breast Imaging Quiver

September 1, 2013

Many physicians and patients cast staging breast MRI as an imperfect exam. From the physician’s perspective, the exam generates thousands of difficult-to-interpret images. False-positive findings are not uncommon. The exam may be difficult for some women to tolerate, and for those with renal insufficiency or claustrophobia, it may be impossible.

Enter positron emission mammography, a focused molecular imaging technique that may provide a tolerable, and clinically superior, alternative particularly for lumpectomy candidates. Despite these positives, PEM is not without pain points.

The Center for Breast Care at Boca Raton Community Hospital in Florida. has used PEM for seven years as an alternative to breast MRI for lumpectomy candidates as well as restaging of patients with a remote history of breast cancer. Similarly, Swedish Cancer Institute in Seattle, uses PEM to evaluate lumpectomy candidates, particularly among women unable to undergo MRI, for multifocal or multicentric disease that might prompt a complete mastectomy rather than a lumpectomy, explains Carolyn L. Wang, MD.