Molecular Breast Imaging-guided Percutaneous Biopsy of Breast Lesions: A New Frontier on Breast Intervention

Beatriz E Adrada, MD, Tanya Moseley, MD, S Cheenu Kappadath, PhD, Gary J Whitman, MD, Gaiane M Rauch, MD, PhD

Abstract: Molecular breast imaging (MBI) is an increasingly recognized nuclear medicine imaging modality to detect breast lesions suspicious for malignancy. Recent advances have allowed the development of tissue sampling of MBI-detected lesions using a single-headed camera (breast-specific gamma imaging system) or a dual-headed camera system (MBI system). In this article, we will review current indications of MBI, differences of the two single- and dual-headed camera systems, the appropriate selection of biopsy equipment, billing considerations, and radiation safety. It will also include practical considerations and guidance on how to integrate MBI and MBI-guided biopsy in the current breast imaging workflow.

Full Article in Journal of Breast Imaging, Volume 2, Issue 5, September/October 2020, Pages 484–491

Supplemental screening in the dense breast: does molecular breast imaging have a role?

Deborah J. Rhodes, MD

With the passage of a 2019 US federal law directing FDA to ensure that mammography facilities provide a summary to patients categorizing their breast density and explaining how it can influence mammography accuracy, providers will increasingly be called on to discuss the options for supplemental screening. Numerous studies have elucidated the extent of masking that occurs with mammography screening in dense breasts when mammography is compared with other supplemental screening modalities. Despite this evidence, there is currently no consensus among experts or imaging societies as to whether or with what supplemental screening should be performed, leaving providers to counsel patients regarding the balance of benefits and harms.

Full Article in Menopause: January 2020 – Volume 27 – Issue 1 – p 110-112

Comparative Benefit-to–Radiation Risk Ratio of Molecular Breast Imaging, Two-Dimensional Full-Field Digital Mammography with and without Tomosynthesis, and Synthetic Mammography with Tomosynthesis

Matthew Brown, Matthew F. Covington

Purpose: To apply previously published benefit-to-risk ratio methods for mammography and molecular breast imaging (MBI) risk estimates to an expanded range of mammographic screening techniques, compressed breast thicknesses, and screening views.

Full Article in Radiology: Imaging Cancer (

Hruska CB. Molecular Breast Imaging for Screening in Dense Breasts: State of the Art and Future Directions. American Journal of Roentgenology. 2017. 1-9. 10.2214/AJR.16.17131

OBJECTIVE. The purposes of this review are to discuss the motivation for supplemental screening, to address molecular breast imaging (MBI) radiation dose concerns, and to provide an updated guide to current MBI technology, clinical protocols, and screening performance. Future directions of MBI are also discussed.

Full Article in American Journal of Roentgenology

Shermis RB, Wilson KD, Doyle MT, Martin TS, Merryman D, Kudrolli H, Brenner RJ. Supplemental Breast Cancer Screening with Molecular Breast Imaging for Women with Dense Breast Tissue. American Journal of Roentgenology. 2016;207: 1-8. doi:10.2214/AJR15.15924.

OBJECTIVE. Molecular breast imaging was implemented in routine clinical practice at a large community-based breast imaging center. The aim of this study was to retrospectively assess the clinical performance of molecular breast imaging as a supplementary screening tool for women with dense breast tissue.

Full Article in American Journal of Roentgenology

Hruska CB, Conners AL, Jones KN, et al. Diagnostic Workup and Costs of a Single Supplemental Molecular Breast Imaging Screen of Mammographically Dense Breasts. American Journal of Roentgenology. 2015;204(6):1345-1353. doi:10.2214/AJR.14.13306.

OBJECTIVE. The purpose of this study was to examine additional diagnostic workup and costs generated by addition of a single molecular breast imaging (MBI) examination to screening mammography for women with dense breasts.

Full Article in American Journal of Roentgenology