By Denise Mann

When a Mammogram is Inconclusive:New Miraluma Test offers a closer look

  |  Women's Health  

When it comes to her health and well-being, Alsuna Roland, a 49-year-old Staten Island-based nutritionist, doesn’t like to take chances. A two-time breast cancer survivor, she gladly sings the praises of a new, non-painful and highly accurate breast imaging technique called Miraluma. In fact, this test may very well have saved her life. While not designed to take the place of screening mammography or breast X-ray to detect cancer, Miraluma, a nuclear imaging test, is a useful adjunct for women whose mammograms are inconclusive, for those with dense breast tissue, as well as in women with prior breast reconstruction or breast implants. Dense tissue appears solid white on film; tumors appear black, so the dense white often hides the cancerous tissue.

Roland’s Story In 1996, Roland went for a routine mammogram; at the time, her doctors said everything looked normal. But she had a gut feeling — one based on a strong family history of breast cancer — that all was not right. She insisted on having a sonogram, which uses sound waves to create a picture of the breast. Ultrasound is usually the next step after mammography, but some doctors go right to biopsies (removing cells or fluid, so that a piece of the lump can be examined under the microscope). Unfortunately, Roland was right to be skeptical of the false-negative mammogram result. She later had a cancerous tumor removed from her right breast. It was around that time that she first heard about a new test called Miraluma, a nuclear imaging technique that allows the visualization of small tumors within the breast. To perform the 45-minute test, a woman lies face down on an imaging table that bears an opening for the breast to hang downward. For better visualization, a technician will inject a small amount of radioactive material and tracer into the foot. The amount of radiation exposure is comparable to that of a CAT (CT) scan. “I decided that I would like to continue to follow myself with Miraluma,” Roland explains. “It’s less invasive than a mammogram, where your breast gets pressed … and I am very skeptical about mammograms because of the false negative I got in 1996.” While mammography is arguably the best breast cancer screening tool that is currently available, it is not perfect. Mammography may not effectively catch cancerous tumors in as many as two-thirds of women with dense tissue in their breasts. One new study of 11,130 women at a Manhattan radiology clinic found that ultrasound exams could detect a significant number of cancers that were missed by mammography in women with dense breasts. The study, which appears in the October issue of the journal Radiology, found that sonograms will find 33 additional cancers in roughly 5,000 women with dense breasts who had normal mammograms and breast exams. In 1999, when Roland again felt a lump — this time in her left breast — she underwent the Miraluma test immediately. The cancer had returned; she later had a mastectomy of her left breast. In the future, she says, Miraluma would be her first choice to determine if the cancer has recurred. “I’m feeling fine now,” she adds.

The Uses of Miraluma “This test is meant for patients who have a mammogram which is abnormal, but they cannot tell you for sure if it is a cancer,” says Hemalatha Rao, M.D., chairman of nuclear medicine at Coney Island Hospital, in Brooklyn. “These are the patients who will benefit the most.” “It also is useful for patients with breast implants that are hard to compress on a mammogram, and it shows beautifully if there is a recurrence in same or different spots in patients who have had prior chemotherapy, radiation and/or a mastectomy. In these cases, it can be used as a primary screening tool if the radiologists and breast surgeons feel comfortable with the test.” Results are available the same day, Dr. Rao says. “And patients love this test because there is no compression,” says Dr. Rao, who has performed the test on more than 2,000 patients. Many women complain that mammograms are painful because in order to perform a mammogram, the breast is compressed to flatten and spread the tissue. The test costs $400-$600, and in some cases is covered by insurance. You may have to go to a nuclear medicine or radiology department at your local hospital, or to a freestanding clinic for the test. Call 800-343-7851 or visit to find out where the technology is available near you.