Division of Breast Imaging | NYU Langone Health (2024)

At NYU Langone Health’s Division of Breast Imaging, we use the most advanced imaging technologies to provide comprehensive screening, diagnostic, and interventional imaging services for breast diseases.

We perform three-dimensional (3D) mammography, ultrasound, and MRI, to provide comprehensive screening, diagnostic, and interventional biopsy services for breast disease. The division also trains medical students, residents, and fellows to practice evidence-based medicine and maintain excellence in patient care.

Under the leadership of Hildegard B. Toth, MD, chief of breast imaging, our nationally recognized team of fellowship-trained breast imaging specialists are dedicated to advancing the field through breast cancer research, education, and patient care.

Many faculty members hold leadership positions in major national radiology organizations including the American College of Radiology, the Radiological Society of North America, and the Society of Breast Imaging. Members of our division regularly publish in prestigious peer-reviewed journals, and members are invited speakers to national and international conferences.

Breast Imaging Education

Our faculty is dedicated to providing radiology training for medical students, as well as training residents and fellows in the latest breast imaging techniques.

At NYU Grossman School of Medicine, students have the option of participating in breast imaging rotations at NYC Health + Hospitals/Bellevue during the breast imaging elective and radiology selective course, as part of the MD curriculum.

Physicians who participate in our radiology residencies are integrated members of the breast imaging team at NYU Langone’s Perlmutter Cancer Center, Laura Perlmutter Center for Women’s Imaging, and Bellevue. Residents work closely with faculty to interpret breast cancer screening and diagnostic mammograms, breast ultrasound, and breast MRI studies. Trainees also perform image-guided breast procedures, including ultrasound-guided, stereotactic-guided, and MRI-guided biopsies. We also teach preoperative image-guided localizations with the SAVI SCOUT® surgical guidance system and wire placement.

Our Breast Imaging Fellowship offers radiologists subspecialty training in a variety of practice environments. Fellows work closely with faculty to become experts in all aspects of breast imaging and intervention.

Breast Imaging Research

Researchers in our division study advanced breast imaging techniques, artificial intelligence (AI), and precision medicine to advance image-based approaches to breast cancer diagnosis and treatment, including mammography, breast MRI, and breast tomosynthesis.

We have multiple National Institutes of Health (NIH)–funded research projects underway to enhance breast cancer screening procedures to detect breast diseases earlier, reduce disease recurrence, and improve survival rates.

Advanced Breast MRI Techniques

Our breast imaging specialists partner with researchers at the NYU Langone Radiology—Center for Biomedical Imaging and Center for Advanced Imaging Innovation and Research (CAI2R) to develop new advanced MRI techniques. For example, our team is investigating the role of diffusion-weighted imaging, including intravoxel incoherent motion, and compressed sensing techniques, to detect and better characterize breast cancers.

To improve cancer detection and characterization, we’ve also implemented ultrafast temporal resolution–abbreviated breast MRI in clinical cases. Our investigators are evaluating the accuracy of this novel technique with the goal of decreasing short-term imaging follow-up recommendations for patients with benign breast biopsy, and increasing the positive predictive value of MRI-guided breast biopsy.

As part of efforts to expand cancer characterization and risk assessment, our team is studying the breast tumor microenvironment and developing imaging biomarkers to evaluate tumor heterogeneity. We have pioneered a fast-spectroscopic imaging method for breast cancer to measure different types of fatty acids in the breast and investigate how these fatty acids, particularly saturated fatty acids, are associated with cancer development.

Our researchers are also designing and developing homegrown multinuclear radiofrequency (RF) coils that allow for MRI with sodium (23Na-MRI) and MR spectroscopy with phosphorus (31P-MRS) to be performed with our ultra-high-field 3-Tesla (3T) and 7T magnets. We are currently evaluating the role of 23Na-MRI to assess the response to neoadjuvant chemotherapy in women with triple-negative breast cancer.

Artificial Intelligence and Precision Medicine

We collaborate with NYU Courant Institute of Mathematical Science and NYU Center for Data Science on research that expands AI in biomedical imaging, specifically AI to detect breast cancer earlier and improve the diagnostic accuracy of a variety of breast imaging examinations.

Our researchers have developed and evaluated an image classification algorithm to improve the accuracy of screening mammograms and are currently investigating mechanisms to incorporate deep convolutional learning neural networks into clinical practice. A study of neural networks for interpretation of screening digital breast tomosynthesis is ongoing.

We also plan to develop a machine learning–based approach for continuous radial acquisitions DCE-MRI of the breast. Researchers in our division are working on advanced deep learning algorithms to close the loop between breast image reconstruction and the diagnostic interpretation of breast images by training image reconstruction and diagnostic classification together in an end-to-end fashion.

Other projects include evaluating an AI aid for characterizing lesions on breast ultrasound, with the goal of improving the specificity and positive predictive value of ultrasound for detecting breast cancer.

Our team also researches targets for precision medicine—therapies that are geared toward specific groups of patients based on genetic and molecular characteristics. As part of these efforts, we are exploring a new way to correlate image-guided breast biopsy results with serum analysis of microRNA from patients being screened for breast cancer and are using radiogenomic analysis to correlate breast MRI findings with breast cancer subtypes.

Entrustable Professional Activities Toolkit

Members of our faculty have collaborated with researchers from other institutions to develop a learning and assessment guide for breast imaging professionals called entrustable professional activities (EPAs). This toolkit allows experienced attending physicians to assess the readiness of individual residents and fellows to practice independently as breast imagers. Learn more about our EPAs toolkit for breast imagers.

Breast Imaging Clinical Services

We provide comprehensive screening, diagnostic, and interventional imaging services for breast diseases at multiple sites across NYU Langone, including the Laura Perlmutter Center for Women’s Imaging, Joan H. Tisch Center for Women’s Health, and NYU Langone Hospital—Brooklyn, as well as NYC Health + Hospitals/Bellevue and NYC Health + Hospitals/Gouverneur.

Our healthcare providers use the most advanced imaging technologies to perform breast cancer screening, including digital breast tomosynthesis, diagnostic mammograms, 3T ultrafast breast MRI, and handheld ultrasound.

Division of Breast Imaging | NYU Langone Health (2024)

FAQs

How serious is a BIRAD 4? ›

A BI-RADS 4 lesion under the breast imaging-reporting and data system refers to a suspicious abnormality. BI-RADS 4 lesions may not have the characteristic morphology of breast cancer but have a definite probability of being malignant. A biopsy is recommended for these lesions.

What is the most common imaging of breast cancer? ›

The most commonly used breast imaging tests at this time are mammograms, ultrasound, and breast MRI. Other tests, such as CT scans, bone scans, or PET scans might sometimes be done to help find out if breast cancer has spread.

What is the difference between mammogram and breast imaging? ›

First, a breast ultrasound is not a replacement screening tool for a mammogram but can be conducted in addition to an annual mammogram if a patient has abnormal results. A mammogram uses a low dose of radiation to form comprehensive breast images, whereas an ultrasound uses sound waves to create an image.

Should I worry about BIRAD 2? ›

Category 2 means the findings are benign, which is also negative for cancer. While a mass, calcification or other abnormality may have been detected, it's not cancerous. For instance, scar tissue or a change in the breast tissue from previous surgery may be found and is scored as noncancerous breast development.

What percentage of Birad 5 is malignant? ›

BI-RADS 5 lesions have the characteristic morphology of breast cancer with a ≥95% chance of being malignant1. The implication of a BI-RADS 5 finding, in contrast to BI-RADS 4, is that if the histology is benign, it should be considered discordant with imaging findings, and lesion excision is still advised.

What is a Birad score of 3? ›

BI-RADS 3 is an intermediate category in the breast imaging reporting and data system. A finding placed in this category is considered probably benign, with a risk of malignancy of > 0% and ≤ 2%4.

What type of breast cancer is easiest to treat? ›

NONINVASIVE BREAST CANCER

“Ductal” refers to the milk ducts in the breast, and “in situ” means “in its original place.” DCIS is a stage 0 cancer, which is the earliest and generally the most treatable form of breast cancer. Although DCIS is noninvasive when it's diagnosed, over time it can become invasive.

What is the most aggressive breast cancer? ›

Triple-negative breast cancers tend to grow and spread more quickly than other types of breast cancer. Because of this, triple-negative breast cancer is considered to be more aggressive than other forms of breast cancer.

What type of cancer is ductal carcinoma? ›

Invasive ductal carcinoma (IDC), also known as infiltrating ductal carcinoma, is a type of breast cancer that starts in the milk ducts of the breast and moves into nearby tissue.

Why would a doctor order an ultrasound after a mammogram? ›

A breast ultrasound is most often done to find out if a problem found by a mammogram or physical exam of the breast may be a cyst filled with fluid or a solid tumor. Breast ultrasound isn't used to screen for breast cancer.

Can I just get a breast ultrasound instead of a mammogram? ›

Ultrasound uses sound waves to image the breast. Ultrasound can be especially useful among individuals who have dense breasts, but it should not be used as a substitute for a mammogram.

How long does it take to get mammogram results if something is wrong? ›

The bottom line

You typically have the results within a week or two. Most of the time, an abnormality seen on a mammogram isn't cancer. When cancer is found with a mammogram, it's often at a very early stage, when it's most treatable.

What is highly suggestive of malignancy? ›

Highly suggestive of malignancy (BI-RADS 5)

This result is only given after a diagnostic mammogram. The term "malignancy" refers to the presence of cancerous cells. This result means the findings look like cancer and have at least a 95% chance of being cancer. The radiologist strongly recommends a breast biopsy.

What does a BIRAD score of 4 mean? ›

A category 4 result means the radiologist has found something that needs to be further evaluated and could be cancer. Other benign, non-cancerous changes can look suspicious.

Is it common to get called back for a second mammogram? ›

Getting called back after a screening mammogram is fairly common, and it doesn't mean you have breast cancer. In fact, fewer than 1 in 10 women called back for more tests are found to have cancer.

What is the next step after finding asymmetry in a mammogram? ›

Anyone who experiences developing asymmetry needs to speak with the doctor for further tests. Tests will likely include another mammogram to check both breasts thoroughly. Ultrasound testing is an additional test to check for any signs of breast cancer. A doctor may wish to follow up these tests with a biopsy.

What does "probably benign" mean on a breast ultrasound? ›

If the result of your breast imaging test is “probably benign,” it means that that the chance of that tissue being cancer is 2% or less. In other words, it's probably not cancer or very unlikely to be cancer.

What does suspicious for malignancy mean? ›

Definition. A microscopic finding indicating the presence of an atypical neoplastic cellular infiltrate with cytologic characteristics and/or architectural patterns that are not diagnostic, but raise the possibility of malignancy. [ from NCI]

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