Both authors are with The University of Texas M.D. Anderson Cancer Center in Houston, Dr. Paulus as Chief, Section of Mammography, and Professor of Radiology, and Dr. Fornage as Chief, Section of Ultrasound, and Professor of Radiology. High-resolution mammography, with either film or xerography, is the gold standard to which all other diagnostic modalities are compared for breast imaging, and it appears destined to remain so for some time. Digital mammography produces breast images of excellent quality and will probably become the breast imaging standard in the future, but it will be several years before technological improvements produce equipment that is cost-effective for widespread use.
Thermography is an unproven and ineffective modality for breast cancer detection.
In fact, screening asymptomatic women for breast cancer with thermography is thought to be virtually worthless. Diaphanography or transillumination of the breast is a c ostly, sophisticated version of an older imaging modality. It is ineffective in detecting early breast cancer. New dedicated MRI coils for the breast have increased resolution, allowing evaluation of smaller lesions. Although the cost and time required may prevent the u se of MRI for screening, MRI may become useful for breast evaluation in selected women, such as those with dense breasts or with breasts previously treated by radiotherapy.