Gynecology

Mammography: Everything that interests you about the study

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Mammography is one of the methods for diagnosing pathological neoplasms in the breast.

Mammography of the mammary glands is included in the standards of preventive measures for the early detection of breast cancer; upon reaching 40 years of age, every woman must undergo this type of research. If mammogram data for pathology does not appear, then the next breast examination should be completed in 2 years.

It is possible to perform mammography at an earlier age, but there must be good reasons for this, such as a suspected tumor process in the breast.

Digital mammography is a very effective and reliable way to diagnose diseases of the mammary glands, the pictures clearly visualize tumors up to 5-6 mm in size and pathologically changed lymph nodes, which allows making a correct diagnosis in time and starting treatment. For many women, this diagnostic method has preserved health and even life.

Before undergoing a mammographic examination, the patient should take previous extracts and results, if any, with her.

Decoding mammogram results: norm and pathology

In order to make a final diagnosis, the radiologist necessarily takes into account the clinical manifestations and the data obtained as a result of the conversation with the patient. An assessment is made of the structure of the breast tissue, visible structures, vessels, ducts and lymph nodes.

If a woman is healthy, then there are no obscurations, no seals, the structure of the body is homogeneous. Vessels and ducts are clear, intertwined in the network. Regional lymph nodes are not enlarged.
Sometimes when performing a mammographic examination, foci are visible. The doctor must describe their number, shape, structure, localization.

Depending on the age of the woman, the density of the mammary glands is different. Thus, in girls, tissue density is increased, and in age-related women in menopause or in postmenopausal tissue structure is hypoechoic.

Fibroadenoma and cyst on a mammogram look like neoplasms with clear even contours, one of the signs of a malignant neoplasm is blurring of the boundaries.
Sometimes on the X-ray, calcified calcium is detected. These accumulations of salt can exist by themselves, but can accompany breast cancer or any benign neoplasm.

Women always ask the same question: "At what bottom of the menstrual cycle do mammograms be made?" X-ray examination of the mammary glands is better to take place from 4 to 7 days from the start of menstruation, but it is allowed to perform the test up to 10 days from the beginning of the cycle. For menopausal women, a mammographic examination can be performed on any given day.

Mammologists and radiologists have a special standard for deciphering the results of mammography, a total of six categories.

• 0 - Incomplete assessment. This is usually described by mamma gammas, which for some reason did not work out. It is necessary to undergo a second diagnosis.
• 1 - No pathological lesions were found in the mammary gland tissues, that is, this is a variant of the norm.
• 2 - Benign neoplasm, there are no signs of malignancy.

• 3 - The neoplasm is benign, but requires observation in dynamics. In such cases, after 6 months, repeat mammography is prescribed.
• 4 - Tumor formation is suspicious in its parameters. To exclude breast cancer, it is reasonable to conduct a biopsy under the control of ultrasound. The probability of malignancy exists, but it is small.
• 5 - A tumor that is similar to a cancer is visualized. A neoplasm biopsy and further diagnostic methods are performed to verify the diagnosis. The likelihood that a "bad" diagnosis is confirmed is high.
• 6 - Malignant neoplasm of the breast, already confirmed. In this case, mammography allows to evaluate the effect of the treatment and the dynamics of the pathological process.

False positive and false negative for mammography: what is it

Sometimes, for any reason (human factor, equipment malfunction, gluing of any material on the chest during the study, for example, a piece of dry deodorant, rhinestones, etc.), a tumor suspicious of the tumor is visualized on the mammogram. In these cases, an additional diagnosis is carried out, which refutes the diagnosis, the patient is healthy, the result of mammography is false positive.

With a false-negative result, nothing pathological was found on the images, but after a short period of time a diagnosis of breast cancer is established.

Young women under 40 are more likely to get into this situation, because the breast tissue in this category of the fair sex is denser due to hormonal features, and it is not always (20% of cases) that a diagnosis of breast cancer can be established only by one mammographic examination . The worst thing about this situation is that the patient considers herself healthy and does not go to the doctor when the signs of breast cancer become apparent. If you approach the situation wisely, then even if the pictures are in order, and there are clinical manifestations, it is unacceptable to postpone a visit to the doctor!

What diseases of the breast can be diagnosed by mammography screening?

In addition to breast cancer, there are a number of pathological conditions:

The group of pathologies of fibrocystic genesis, similar in clinical manifestations and symptomatology. The diagnosis is set in approximately 50% of women. What is the cause of the development of mastopathy is still controversial. Predisposing factors include hormonal imbalance and hereditary predisposition.

• Fibroadenoma
Benign neoplasm originating from healthy breast tissue. If the results of dynamic observation determine the growth of fibroadenoma, then the performance of surgical treatment is shown.

• Calcinates
The accumulation of salt clots, mainly calcium salts, in the tissues of the breast. Palpation is impossible to probe them, but on mammograms, calcinates are clearly visible as a shadow of increased density.

• Breast cysts
A cyst is, relatively speaking, a “ball” filled with fluid. On mammograms differentiated well, in case of doubt, pneumocystography is performed. Breast cysts - a pathology that occurs mainly in young girls and women. The cyst can be single, but there are several pathological neoplasms in one or two mammary glands at the same time.

There are fatty cysts, they do not pose a danger to the health of a woman, but with an increase in height they can provoke pain, and with inflammation - suppuration.

What types of mammograms exist

X-ray mammography: film, projection and digital.

Survey X-ray is an x-ray examination of the mammary glands and nearby lymph nodes in the clavicle and axillary region. The study is conducted in a direct and oblique projection.

Digital mammography - A more modern method, digital mammograms are distinguished by higher accuracy. This type is a screening method and is suitable for examining a large number of women for the early detection of a breast tumor pathology. Pictures are taken in 2 or more projections. For carrying out the special device is necessary - a mammographer, X-rays are used. Data arrives on the computer, the analysis passes automatically. Images can be viewed from any angle with the help of a special program. At the request of the diagnostician, you can change the contrast of images. This is the main difference between digital mammography and film mammography. In addition, the obtained data in digital form can be forwarded by e-mail to any specialist in any medical center.

It should be noted that in terms of exposure, with digital mammography, it is 20% less than with normal mammography, and as much as the detection rate of oncopathology is higher.

Magnetic resonance mammography - The best way to diagnose, absolutely non-invasive, eliminates the effects of X-rays. Accuracy of diagnostics provides contrasting, which in 95% of cases determines pathology at the earliest stages.
Among the shortcomings, not all medical centers have equipment, and the cost of the procedure is quite high.

Microwave mammography (radio thermometry)

Diagnostics is based on measuring temperature in different parts of the breast. It is believed that in cancer, the temperature response increases. Using radiothermography, pathological foci can be detected earlier than using other techniques.

The accuracy of diagnosis is close to 98%.

In addition to breast cancer, suitable for the diagnosis of mastopathy, fibroadenomas.

Electrical impedance mammography suitable for the diagnosis of breast pathology in pregnant and lactating women.


This type of examination is also effective for detecting any neoplasms of the mammary gland, as well as controlling the effects of therapy.

The disadvantages include the sensitivity of the technique - it is not more than 75%.

How is mammography done

Some special preparation for the study is not required, it is quite enough to conduct general hygiene procedures. In the office you will be asked to undress above the belt, remove the gold jewelry, piercing, in a word, everything that can give a shadow on the mammogram.

The mammary gland is placed between special holders and is compressed, which results in better visualization due to a decrease in the thickness of the tissue. A series of shots are taken.

If the examination is performed from the 4th to the 7th day of the menstrual cycle, then there is no breast engorgement, which makes the procedure virtually painless.

General rules and some features of mammography

There are several basic methods for diagnosing pathological changes in the mammary glands:

  1. X-ray mammography or simply mammography.
  2. Computed tomography (CT).
  3. Digital mammography.
  4. Ultrasound examination (ultrasound).
  5. Magnetic resonance tomography.
  6. Electrical impedance tomography.

Mammography is the main, fairly simple and affordable X-ray objective method of assessing the state of the mammary glands without the use of contrast agents. It allows you to diagnose or suspect the presence of pathological changes in 75-95% of cases.

From what age do mammography?

It is recommended for all women from the age of 40, and for diagnostic purposes, depending on need.

The study is carried out by means of film mammography apparatus. The patient is given a certain position, and the chest is pressed with a special compression plate in order to eliminate the effect on the image quality of excessive shadow overlays and ray scattering, which reduces the sharpness of the resulting image.

Special preparation for breast mammography is not required. The main requirements for the woman being examined are the absence of residues of powder, perfume, talcum powder, ointment, cream, lotion, and deodorant on the skin of the mammary glands and underarms. In addition, it is necessary to warn the radiologist about the presence of implants or performing in the past any operations on the mammary glands.

What is the day of the cycle to do a mammogram?

It is carried out from the 5th to the 10th-10th day of the menstrual cycle, counting from the first day of menstruation, when the glandular tissue is almost not swollen and painless. In the absence of menstruation, the study can be carried out on any day.

Compliance with these simple conditions is necessary for the possibility of excluding artifacts (defects) in radiographic images that can be regarded when they are deciphered as pathological changes. For example, the swelling of tissues reduces the clarity of the picture, and the dotted shadows on it from cosmetics can be regarded as small calcinates, which sometimes appear at an early stage of cancer and are one of its main features.

When mammography is prescribed

The indications for the surveys are grouped into two groups depending on the timing, frequency and purpose of their conduct:

Pictures for prophylactic purposes, as a rule, are produced by viewing: in the cranio-caudal (straight) and oblique projections. In most medical institutions, direct and medio-lateral (lateral) are used more often, which is less informative as compared with oblique. The latter allows you to cover not only the gland itself, but also the axillary region. Preventive examinations have the following goals:

  1. Primary detection of pathological changes.
  2. Detection of an unidentified primary cancer focus in case of identified metastatic tumors of unknown origin, especially in the lymph nodes nearest to the mammary glands, in the lungs or in the bones.
  3. To relieve obsessive states of patients suffering from the fear that they may have a malignant tumor (carcinophobia).

Diagnostic examination may be a review, but more often it is aimed, that is, aimed at a limited area or specifically at the most pathological formation. For this purpose, special tubes with a slight inclination, additional projections, an enlarged image, etc., are used. There are no contraindications for it, since it is carried out in the following cases:

  1. Mastodynia (feeling of pain, swelling, engorgement).
  2. The presence of nodules, discharge from the nipple.
  3. Mastopathy - to determine its type (diffuse, nodular, mixed) and control the effectiveness of its treatment.
  4. Conducting replacement therapy.
  5. The need for a differential diagnosis of tumors.
  6. The presence of tumors, "suspicious" for a malignant tumor and in order to determine the point of puncture biopsy.
  7. Breast cancer - elucidation of the stage, periodic monitoring for the timely detection of recurrence after mastectomy for cancer.
  8. The need to differentiate between true and false types of gynecomastia.
  9. Complications after surgery endoprosthetics or other plastic surgery on the breast.

How often can x-rays of the breast?

Such a question is legitimate and has repeatedly debated in scientific circles for two main reasons:

  • the presence of summable radiation loads on the body,
  • the ratio of the risk of cancer as a result of x-ray exposure and the benefits of early detection of cancer with systematic regular preventive examinations.

As for the first, the use of sophisticated patient protection during X-ray imaging, high-sensitivity film, reinforcing high-efficiency screens in modern devices make it possible to avoid significant radiation loads that could have some kind of negative effect on the woman’s body.

The risk of cancer in the distant future as a result of such screening tests is assumed (!) At 1 year about 7.5 cases per 256,000 women who underwent mammography, with 3026 cases of cancer detected (data from studies conducted in Moscow). Other epidemiological studies have even lower values ​​for cancer risk. Moreover, many conclusions generally express the opinion of its absence.

Based on a long-term study of the effect of an x-ray examination of the mammary glands and the frequency of cancer detection, recommendations have been developed regarding the age at which chest x-rays are taken and with which frequency:

preventive examinations for women after 40 years are recommended to be held 1 time in 2 years, and after 50 years - annually.

The frequency of diagnostic studies depends on their need. The radiation dose for them is even smaller, since the pictures are taken precisely in a limited area.

At the same time, X-ray mammography during pregnancy and breastfeeding is contraindicated.

Evaluation of results

The roentgenogram of each patient is characterized by its individual features, and its interpretation is not devoid of a significant proportion of subjectivity. Therefore, the correctness of the conclusion depends largely on the experience of the radiologist and some other conditions.

Special attention in evaluating both survey and target images is given to the interpretation of the obtained data in terms of detecting changes corresponding to the main (primary) and indirect (secondary) signs of a malignant tumor.

Primary signs are particularly clearly defined against the background of involutive changes in the mammary gland in women of older age groups. These signs on the x-ray film are defined as the shadow of a tumor and dense small shadow clusters, which are calcinates. The shadow of the formation of a "suspicious" on a cancer, as a rule, is characteristic:

  1. Irregularity (inhomogeneous).
  2. Fuzzy, "blurred" contours of irregular stellate or amoeboid shape.
  3. The characteristic seals on its background are shadow-strands in the form of radial rays.
  4. Connection with the nipple "track" (usually).

The most reliable manifestation of cancer, sometimes the only thing is calcinates with a size of 1 mm or less, resembling dust particles, and they are the smaller, the larger they are. Calcinates are often found in normal conditions or with mastopathy, but they have the appearance of a lump and a much larger diameter exceeding 3-5 mm.

Indirect symptoms include thickening and sometimes retraction of the skin over the tumor, retraction of the nipple, an increased number of vessels, and others.

CT scan

CT, or computed mammography is also based on the use of X-rays, and the criteria for its evaluation are the same. However, it is only of secondary importance in the diagnosis of primary tumors. The quality of CT images is largely inferior to those of the previous method:

  • contrast, visibility and subtlety of the image,
  • lack of the possibility of detailing the structural units in the picture,
  • the difficulty of detecting clusters of microcalcifications, atypical fibrous tissue changes, especially in cases of fibrocystic type mastopathy, as well as growths in the ducts of the gland,
  • low information content with a significant compaction of tissues and the presence of formations that are not detected by palpation (palpation).

But in some cases it can serve as the main diagnostic method:

  1. In the case of localization of the node, determined by palpation, in those areas that are inaccessible for mammography, for example, near the sternum,
  2. With common forms of cancer (edematous-infiltrative) that are not available for ultrasound because of its fragmentary imaging or excessively high density of tumor tissue.
  3. In order to clarify the degree of local prevalence of a sedentary tumor process on adjacent muscles, ribs, sternum, lymph nodes.
  4. If necessary, identify signs of metastasis to the skeletal bones, chest or abdominal cavity.

In other cases, images obtained even with the help of high-class modern CT devices are unable to detect preclinical forms of cancer and are characterized as poor quality.

Digital mammography

Regular (analog) mammography can be considered as a compromise between the quality of the image obtained and the dose of radiation exposure, in order to reduce which image-enhancing screens are used. The thicker they are, the more they reduce the patient's dose of radiation, but the more they reduce the clarity of the image on the film.

Modern full-format digital systems in clinical use have appeared relatively recently and are promising in terms of diagnostic and screening studies of breast cancer.

They are based on the principle of converting X-ray radiation into a digital signal and allow obtaining images simultaneously in several projections, changing the contrast and brightness, applying aiming magnification, etc., with subsequent automated analysis.

Compared to analog, digital mammography has the following advantages:

  • high-quality images (with a low dose of radiation), due to their clarity, contrast and latitude of the range,
  • the ability to obtain in one image an image of the smallest pathological changes, as well as almost all tissues with different densities, this is available without the use of additional exposures, but only through the subsequent processing of the image
  • the possibility of eliminating exposure errors, thereby minimizing the need for repetition of images, which also prevents additional radiation doses to patients, reduces the examination time and the throughput of the room,
  • no need for film, reagents and storage room,
  • the possibility of electronic archiving of digital examination materials, their processing and transmission to any medical diagnostic institutions.

Thus, digital mammography allows for a more detailed and more accurate diagnosis of diseases of the mammary glands and is a clinically very beneficial method. A cabinet that is equipped with digital equipment, if there are two laboratory assistants at the same time, can replace three cabinets with analog mammography equipment. However, its use is limited by the high cost of digital equipment and can be cost-effective only for mass screening of women.

Ultrasound procedure

Despite the high efficiency of using mammography, its results are unreliable in young women, in whom breast tissue usually has a high density, with severe diffuse mastopathy, in the presence of multiple fibroadenomas, implants or post-inflammatory (after mastitis) changes, as well as other changes violating the structural background. In these cases, resort to the help of ultrasound.

The main echographic criteria for cancer are the predominance of the anterior-posterior dimensions of the gland, fuzzy contours and irregularity of the neoplasm form, heterogeneous and reduced echogenicity of the structure, acoustic shadows and increased echogenicity of various inclusions of different sizes.

The advantages of ultrasound are:

  1. Use as an additional method of diagnosis of obscure changes detected as a result of mammography.
  2. Ease of use, safety and the possibility of repeated repetitions, due to the absence of harm to the patient. In this regard, ultrasound is the main method of diagnosing pathological changes in the mammary glands in girls and women under 40 years of age, in pregnant and lactating mothers. In addition, it is also the main way to dynamically monitor the effectiveness of the treatment.
  3. Visualization of tumors in women with a high density of breast tissue, as well as formations located close to the bones of the chest.
  4. An opportunity in 100% of cases to distinguish dense education from cavitary of any sizes (cysts).
  5. Availability of examination of the mammary glands in acute inflammatory process and in case of injury.
  6. The possibility of examining the axillary, supra- and subclavian lymph nodes, as well as conducting targeted puncture biopsy of the lymph node or formation in the gland.
  7. Control studies after the introduction of implants or reconstructive operations.

Despite all these advantages of ultrasound, most doctors prefer to focus on the data of mammography research when it comes to choosing the tactics of treatment. This is explained by the fact that the interpretation of the results of ultrasound diagnostics is largely subjective due to the constant changes in the structure of tissues, which depends on the menstrual cycle and its disorders, the patient's age and life span, body weight and other associated pathological conditions.

In addition, uniform criteria for the echographic evaluation of minor deviations from the normal state of breast tissue, but not being pathological, have not yet been developed. Therefore, different transcripts of one ultrasound are often found by different doctors.

What is better, mammography or breast ultrasound?

The above statistics figures show the relevance of modern research methods. They do not replace each other, but complement each other. Their widespread use and improvement is necessary in order to identify and treat any benign diseases, as well as early diagnosis of the initial stages of cancer.

MRI or mammography?

Often, mammography and CT do not allow an unequivocal conclusion and treatment strategy to be chosen. Ultrasound can provide significant assistance, but it is not always sufficiently effective. In these cases, you can resort to using magnetic resonance imaging.

The meaning of the method is to place the investigated mammary gland in a "coil" with an electromagnetic field. It changes and amplifies the vibrations of the nuclei of atoms (protons), at which radio waves of varying intensity are emitted. The latter are captured by special sensors and subjected to computer analysis. As a result, a layer-by-layer, clear image of fabrics is obtained.

This safe method of research is highly sensitive to changes associated with malignant tumors of the mammary gland, and can be used to determine their early forms. The best timeframe for MRI is the mid-menstrual period.

The use of MRI is justified in cases of:

  • obtaining by the previous methods of distinct changes, the clinical significance of which is not completely clear, or insufficiently distinct because of the high density of tissue images,
  • detecting on X-rays of one or several sites with groups of calcinates located against the background of fibrocystic mastopathy or fibrous-fat involutive changes,
  • the need for a differential diagnosis between multicentric forms of cancer and nodular forms of mastitis,
  • search for a primary tumor in the presence of metastases,
  • the need to clarify the prevalence of (local and regional) malignant tumors,
  • the need to control the status of implants, identify on their background nodal changes of tissues with the definition of their nature.

The use of MRI is limited by the insufficient number of special modern devices, as well as the high cost of them and the examination itself. Its implementation is advisable only as an additional argument in favor of the chosen radical treatment in case of suspicion of the presence of a malignant tumor.

Electrical impedance tomography

The electrical conductivity of pathological tissues, that is, the degree of their resistance (impedance), is significantly different from that of healthy tissues, with the result that a potential difference is formed. Electrical impedance mammography (more commonly used name) is a method based on registering the difference of these potentials when electrodes are placed on the mammary gland and passing through it a weak electric current that creates a volume distribution of potentials. The scan duration takes about 30-40 seconds, and the whole procedure, including patient interviewing, takes no more than 15 minutes.

The data is obtained in a color image, it is possible to graphically process them based on age, phases of the menstrual cycle, associated diseases, medication, the number of pregnancies and deliveries, etc.

Electrical impedance mammography is a simple, cost-effective way to study the breast, not accompanied by radiation loads. He has no contraindications and restrictions on the multiplicity of studies. It is very important for the examination of pregnant and lactating mothers, dynamic observation and control when using oral contraceptives or treatment with hormone replacement drugs. In addition, the study can be carried out regardless of the phases of the menstrual cycle and in general from its presence.

The main drawbacks of the electrical impedance technique are low sensitivity (less than 75%) and the lack of a sufficient number of doctors who are able to decipher and evaluate the results of the study qualitatively. Therefore, it can only be used for the time being to identify “suspicious” areas of pathology and recommend more accurate methods of research and subsequent follow-up to a woman.

What is a mammography for?

X-ray examination of the mammary gland is performed in the presence of seals of obscure nature, to clarify the form of mastopathy and monitor its course, in breast cancer to establish the diagnosis and stage of the process. Due to the fact that mammography reveals hidden forms of breast cancer, it is of great importance in preventive examinations of women over 40, especially from risk groups.

What is a mammography?

In the most common meaning and understanding of most specialists, mammography is an X-ray of the mammary gland using a special apparatus: the mammograph.

A broader understanding of this term is an image of the breast, obtained in the course of the following studies:

  • computed tomography (CT),
  • magnetic resonance imaging (MRI),
  • ultrasound (ultrasound),
  • tomosynthesis,
  • electrical impedance mammography.

In this article, the term "mammography" refers to the X-ray examination of the mammary gland at the mammogram.

Who is recommended breast mammography?

As a preventive screening examination in Russia, mammography is recommended for all women from 40 years and older, and for hereditary predispositions - from 35 years of age. It is also made at any age if there is a suspicion of a malignant tumor.

In most Western European countries, such a survey is shown to women who have crossed the 45-year-old milestone. In this case, the effectiveness of early detection of cancer is more than 90%.

Although mammography is prescribed mainly for women, it is also recommended for men in the following situations:

  • suspected breast tumors,
  • gynecomastia,
  • hyperprolactinemia syndrome,
  • breast cancer.

At what age can a mammogram be performed?

It makes sense to carry out a planned preventive mammography after 40 years. Mammography up to 40 years is possible, but must have a clear indication.

Currently, there are 2 types of mammography:

Classic. The X-ray beam passes through the mammary gland and produces an image on a special film, after the manifestation of which a standard X-ray image is obtained. According to WHO recommendations, to obtain a high-quality image, it is necessary that the image resolution per 1 mm should be not less than 20 pairs of lines.

Digital. In this situation, the X-ray beam after passing through the breast tissue falls on a special screen with detectors that record the received pulse and translate it into an image that can be viewed in detail on the monitor screen. In recent years, digital mammography is increasingly replacing the classical mammography, because it allows you to record the results of research on electronic media and continue to work with images, forming an electronic database of them. To obtain a high-quality image, WHO recommends a resolution of at least 20 pixels per 1 mm 2.

What is ductography?

Ductography - a type of mammography with X-ray contrast ducts of the mammary gland. In this study, a contrast agent is injected into the ducts of the mammary gland, which makes it possible to clearly see on the mammogram the structure and location of the ducts. As a rule, ductography is used to clarify the diagnosis of “intraductal papillomatosis”.

General rules and some features of the

As a rule, mammography is an outpatient examination. It is made with the help of a special device - a mammogram, which is a device equipped with a tube that synthesizes X-rays, and special devices for the proper placement and compression of the mammary gland.

Before starting the study, the health worker places the breast on the apparatus stand and gently squeezes it with a transparent plate on top. This is necessary in order to:

  • level the thickness of all areas of the breast,
  • clearly visualize all tissues and structures
  • to ensure good visibility even of minor surroundings,
  • use lower doses without losing image quality.

After that, a special lead apron is worn on the examined woman to protect her reproductive organs from radiation, and then a series of shots are taken. In a typical situation, a snapshot is first taken in a direct projection (the x-ray beam is directed from top to bottom), and then to the side. Then examine the second mammary gland.

General rules for mammography:

  1. While taking pictures, one should maintain maximum immobility, holding the breath for a few seconds at the command of the health worker.
  2. In conducting the study, the medical staff exits the X-ray room to minimize the radiation they receive.
  3. After the pictures are taken, it takes some time to process the results.

As a rule, 1 mammography session takes about half an hour.

  • Before you do a mammogram for the first time, it is advisable to first visit the mammologist,
  • if the result of standard mammography is questionable, then special methods of breast laying are used — targeted radiography with local compression, oblique radiography, etc.

During the test, for breast compression, the plate can be discomfort or mild soreness. However, if the pain is strong, you need to inform the health care provider, conducting a mammogram, and then it will somewhat reduce the pressure plate on the breast.

Features of the mammography after breast reconstruction with implants:

  1. In most cases, mammography in the case of the presence of implants is not used. This is due to the fact that it can burst during compression by a plate (although this happens very rarely). And if they do, then with non-standard breast styling.
  2. Наличие имплантатов «загораживает» существенный процент ткани железы, что снижает диагностическую ценность стандартной маммографии на 10-25%.

Когда делать маммографию

Mammography needs to be done in the period when the mammary glands have a minimum density and are not particularly sensitive. This is usually the 5-12th day of the menstrual cycle. Elderly women with no monthly mammography can be done on any given day.

Compliance with these terms allows to exclude possible artifacts that can be regarded as pathological changes.

What diseases does a mammogram reveal?

Mammography allows you to identify any tumor formation and is shown primarily in case of suspected breast cancer. In addition, she is appointed for:

  • mastopathy to determine the type and evaluate the effectiveness of treatment,
  • painful engorgement and swelling of the mammary glands (mastodynia),
  • identifying tumors of unknown origin,
  • breast cancer to determine the stage of the disease,
  • gynecomastia in order to clarify the diagnosis.

In fact, at the initial stages, mammography can detect benign and malignant tumors, the type and nature of mastopathy, gynecomastia and other diseases, as well as evaluate the dynamics of changes in the mammary gland after surgery.

How often do mammography?

As a preventive examination, mammography is recommended to be done 1 time in 2 years, and after 50 years - every year. In case of the presence of precancerous diseases, as well as of the operated breast cancer, it is prescribed with a frequency of 1 every 6-12 months.

Repeated mammography can also be carried out several weeks or days after the first examination, if you need to determine the location of the targeted biopsy for suspected cancer.

How to prepare for mammography

  1. If mammography is not done for the first time, be sure to show your doctor the results of previous studies so that he can evaluate the picture in dynamics and reveal "fresh" pathological changes.
  2. A few days before the mammography, stop drinking coffee, energy drinks, which can increase the tenderness of the milky gland.
  3. If it is necessary to take hormones, also consult with a breast specialist. It may be necessary to interrupt the administration of drugs or to delay with mammography.
  4. On the day of the examination, wear comfortable clothes that can be easily removed in the office. The best option - a blouse with a skirt or pants.
  5. Do not wear jewelry that will need to be removed during the procedure. In the case of piercing - remove all jewelry from the breast area.
  6. On the day of the procedure, do not use fatty creams in the armpits and mammary glands. Breasts should be clean and lean.

Who is undergoing mammography?

For diagnostic purposes, mammography is shown to all those for whom the following changes were first identified in the breast:

  • seals (determined by palpation or detected by ultrasound),
  • discharge from the nipple,
  • changes in the shape of individual sections (bulging or depression),
  • soreness, swelling.

In order to prevent healthy women undergo this examination from the age of forty, and women at risk - from 35 years. This group includes those who have the following diseases:

  • benign breast tumors,
  • mastopathy,
  • mastitis
  • diabetes, hypo-and hyperthyroidism,
  • obesity,
  • infertility.

Also at risk are women who have already undergone breast cancer.

Decoding results

Deciphering the results of mammography deals with the doctor radiologist, who received additional specialization in the field of mammography. Depending on the burden on the doctor, the results are handed out to the patient after 30 minutes or several days.

It is important to know that the resulting digital image or X-rays can be shown to another radiologist: this increases the efficiency of the detection of tumors.

When analyzing the images obtained, all radiologists use the international system for evaluating the results of Bi-RADS. It includes the description:

  • type of structure of the breast,
  • the presence / absence of bulk formations, calcifications,
  • possible asymmetry,
  • architectonically disturbed
  • related formations.

The described pathological changes and other features of the mammary glands are also described in detail.

In accordance with this evaluation system, the following recommendations can be obtained:

  • Bi-RADS 0 - the results of previous mammograms are needed, or a re-examination, malignancy is not determined.
  • Bi-RADS 1 - no changes detected.
  • Bi-RADS 2 - changes of benign character.
  • Bi-RADS 3 - probable benign changes, repeated mammography is shown with an interval of up to 6 months.
  • Bi-RADS 4 - suspicious changes, it is necessary to perform targeted biopsy and histological analysis of the material.
  • Bi-RADS 5 - almost reliable result of the presence of a malignant tumor, biopsy and histological examination is shown.
  • Bi-RADS 6 - a malignant tumor was histologically confirmed, surgery is needed.

Mammography or ultrasound?

If earlier mammography was the only mass method for detecting cancer and other diseases of the mammary glands, in recent years ultrasound has become very popular. Currently, ultrasound and mammography are often used together, which significantly increases the effectiveness of early detection of cancer and other diseases of the breast.

Ultrasonography reveals breast cysts better than mammography, and since it does not carry radiation exposure at all, it can be done to girls and young women, including breastfeeding periods and pregnancy. And with the help of mammography, tumor processes are more successfully diagnosed and breast cancer is detected (especially in women from the age of forty).

How much does a mammography cost

This is a relatively inexpensive survey, the price depends on:

  • view - digital will be more expensive
  • the status of the clinic - public, private,
  • region - for example, prices in the capital will differ from those in the cities on the periphery.

On average, the cost of 1 procedure is 1.5-2 thousand rubles.

What is mammography

This is a whole section of medical diagnostics dedicated to x-ray examination of the mammary glands in order to identify pathological processes at different stages. In this way, tumor neoplasms of a benign or malignant nature can be identified, speeding up the final diagnosis. Additionally, to clarify the clinical picture, the doctor prescribes an ultrasound of the mammary glands, both non-invasive procedures are completely painless, do not require prior hospitalization and a rehabilitation period.

In a photograph of a mammographer, connective and glandular tissues, vessels and ducts are clearly visualized. If they contain foci of pathology, their size, location, shape, and structural features can be reliably determined. Such a non-invasive method of examination has a mass of significant advantages, including:

  • speed, high efficiency,
  • the reliability of the results,
  • no contraindications and side effects
  • no need for hospitalization, subsequent rehabilitation,
  • minimum dose of ionizing radiation.

Indications for study

Mammography is carried out for the purpose of further treatment and for prevention. In the latter case, women from 40 years and older once a year should undergo clinical examination. This is due to the increased risk of oncological processes on the background of age-related changes in the breast tissue, a genetic predisposition to oncology. Such a safe method of diagnosis for the purpose of further therapy is recommended in the following clinical pictures strictly for medical reasons:

  • acute chest pains of unknown etiology,
  • nipple discharge unrelated to lactation,
  • seals, bumps and inflamed nodes in the chest, palpable palpable,
  • deformity, asymmetry of one or both mammary glands,
  • breast engorgement, hormonal disorders,
  • pathological enlargement of the lymph nodes located near the mammary glands,
  • preoperative examination,
  • progressive carcinophobia
  • during hormone therapy,
  • during the rehabilitation period to control the positive dynamics.

If we talk about specific diagnoses in the female body, a mammogram is prescribed for suspected:

When prescribing such a clinical examination, the doctor takes into account the patient's age, for example, the first mammography can be done at 40 years of age, and until this point, breast ultrasound can be performed regularly (1–2 times a year) to identify tumors of different origin and other foci of pathology. If you suspect a progressive oncology, an additional biopsy is prescribed, other laboratory tests.

What mammary mammography shows

The special apparatus with which this clinical examination is carried out is officially called a mammograph. In this way, benign and malignant tumors can be visualized on the screen, and other abnormal changes in the structure of the mammary glands can be detected. It is possible the identification of other pathological processes, including:

  • calcinates in milk-rich tissues (a clear sign of oncology),
  • fibroadenoma (benign tumor prone to rapid growth),
  • cysts (cavitary masses containing a certain substance),
  • the need to clarify the results of ultrasound.

In the presence of purulent contents and other prerequisites of oncology, it is mandatory for the patient to take biological material for a biopsy. In addition, to clarify a specific disease, the attending physician directs to undergo CT, MRI, laboratory tests of blood and urine, visual examination with the help of the method of palpation of a presumptive focus of pathology.

Mammography is an informative diagnostic method that is used to identify pathological changes in the mammary glands, and is carried out in a hospital. In modern medicine, there are several variations of an extensive mammographic examination:

  1. Traditional X-ray diagnostics. Conducted with the participation of film technology, is a "morally obsolete" technique. Provides a high risk of error, therefore, is extremely rare. Among the advantages are an affordable price, a large selection of specialists.
  2. Digital. This is a modern technique for studying the structure of the mammary glands with a minimal effect of radiation on the female body. It is considered the main tool for screening studies of the population. To clarify the diagnosis, computer technologies are additionally used to detect structural changes in milk-ferrous tissues. Disadvantages - high cost of the procedure, not all medical centers.
  3. Magnetic resonance. X-ray irradiation is completely absent, and the diagnosis is carried out with high accuracy and information with the participation of a contrast medium or without it. The main drawback of such a survey is the high price of the procedure, the lack of competent specialists.
  4. Electrical impedance. This is the most advanced method of clinical examination, which is based on the difference in current conduction between oncological and healthy tissues. Conducted in the hospital. Among the main advantages - security and information, the disadvantage - the high price.
  5. Sightseeing. In order to detect tumors of various genesis, mastopathy, cyst and other pathologies of a malignant nature, X-rays are actively used in the diagnosis. Performed pictures of the chest in two projections, while visualizing the region of the mammary glands, collarbone, axillary hollows.
  6. Ultrasound. A diagnostic session is conducted with the participation of an ultrasound scanner, and is conducted in conjunction with an x-ray examination to clarify the prevailing clinical picture. Mammography is safe; it is prescribed even to women under 40 years old. Among the disadvantages are the high cost of the session, the lack of competent specialists. Advantages - the ability to use during pregnancy and lactation.
  7. Optical. The diagnosis is based on red laser radiation, and the images are taken in two projections. Such a survey is allowed to conduct, since 30 years old, helps to identify benign and malignant neoplasms. Necessary for dynamic monitoring of the tumor and its pathogenic growth. Such a diagnosis is carried out infrequently, has a high cost.
  8. Radiothermometry. Based on sudden temperature changes, which can be monitored and controlled using a special apparatus. An increase in temperature indicates the presence of cancer cells and the oncological process. Cells with a lower temperature are considered healthy. Thus, the foci of pathology are visualized, their shape, size, and structural features can be determined. The disadvantage of the method is its high cost.

The final choice depends on the medical indications and the age of the particular patient. It is important to consider the cost of the procedure, since the prices are different and not available to all patients. If a woman is older than 40 years old, she is at the clinic with a gynecologist with fibrocystic mastopathy, for example, then she regularly receives referrals for this medical examination at a specialized medical center.

Who is a mammogram

Annual mammography allows you to detect cancer at an early stage. Therefore, doctors advise to regularly undergo this medical examination. This procedure is especially relevant for women older than 40 years. At this age hormonal changes begin, which can lead to abnormalities in the tissues of the mammary glands. Be sure to go through the procedure if:

  • there is nipple discharge,
  • there were seals, chest pains,
  • there was a deformation of the shape of the breast or nipples.

Mammography is a diagnostic procedure that is necessary to assess the patient's condition. After 35 years, its passage is mandatory for all women. It is enough to go through the procedure 1 time in 2 years to detect tumors. After 50 years, mammography is done annually.

If there is a genetic predisposition (there have been cases of breast disease in the family), you should undergo a mammogram from the age of 30.

If malignant tumors are detected, the procedure should be done 1 time per month. It will allow to trace the dynamics of the development of formations.

What does the procedure reveal?

With the help of mammography, you can identify benign and malignant neoplasms. The procedure allows you to analyze the changes in the mammary gland, their size and prevalence.

- Cyst. This cavity with fluid is a frequent occurrence in the mammary glands. It is not a cancer. But mammography, unfortunately, does not allow to distinguish a cyst from a malignant tumor - further examinations are needed.

- Fibroadenoma. Tumor formations that are prone to growth. More common in young women. Not malignant.

- Calcinates. Small numerous accumulations of calcium salts in the tissues may be the first sign of the initial stage of cancer. Large education sizes most often are not associated with cancer. However, the presence of calcinates in the mammary gland may be due to the presence of an oncological process.

Even if there is a seal on one side only, both mammary glands are examined. This is done for comparative shots and to identify changes in the other breast. If there are pictures of past procedures, you must show them to the radiologist.

How to prepare for mammography

Before the procedure, anxious women are often interested in: “Mammography - is it painful or not? What will I feel? ” Mammography - the procedure is absolutely painless. It lasts about 10-30 minutes. Patients before the procedure, the doctor will tell you what day they do a mammogram. However, for urgent diagnosis, the day of the cycle is not important.

Some women may experience discomfort during the study if they have chest pains. Therefore, on the recommendation of a doctor, they may be prescribed painkillers.

During the procedure should be removed jewelry. The individual characteristics of the patients will be fundamental for calculating the day on which the mammogram is done. This is usually 6-12 days from the start of the cycle.

In the presence of breast implants, a physician should be warned about this. On the day of the procedure can not use deodorant, cream. The axilla and the chest should be clean so that there is no darkening on the film.

How is the procedure

Patients before the procedure are interested in: “Is mammography an ultrasound scan? How is the examination? ” Both methods do not require special training from women. X-ray examination differs from ultrasound.

Ultrasound allows you to track the state of soft tissue. And dense imaging is better diagnosed on mammography. Therefore, if the patient's condition causes concern, then both examinations are prescribed.

X-rays pass through the human body, fixing the image on a special film. Mammography is an outpatient procedure. Врач-радиолог размещает грудь пациентки на платформе и фиксирует ее. Делается несколько снимков (сверху вниз и боковые), во время которых пациентка меняет положение.

For a clear image of a woman should stand still and hold her breath. The principle of the procedure resembles fluorography. But, unlike her, the radiologist takes pictures of each breast separately. During the procedure, the chest is slightly compressed by the apparatus. What is it done for?

  • To even out the thickness and unevenness of the breast.
  • To get a clearer image.
  • To distribute soft tissue, visualizing seals and possible formations.
  • To reduce the radiation dose - the smaller the tissue layer, the lower the dose it requires for a full image.

After receiving the pictures, the radiologist analyzes them and provides the documentation to the attending physician. In some cases, the description of the mammography get on your hands. According to the results of the procedure, the attending physician may prescribe additional examinations to clarify the details of the diagnosis.

Types of mammography

There are 2 types of X-ray mammography by the method of research:

Film mammography (from the Greek mamma - "mother" and grapho - "draw") has been used since the 60s of the last century. The image in this method is recorded on film.

In recent years, digital mammography has become the most popular. It allows a more detailed study of the mammary glands of women, reduces the radiation load on the body.

By type of appointment, there are 2 types of mammography:

  1. Prophylactic (appointed by the attending physician when the patient reaches a certain age).
  2. Diagnostic (appointed when suspected neoplasm).

Digital mammography features

In digital and film mammography - for a better image - the breast is clamped between two plates. Studies have shown that in 20% of cases film screening does not reveal the presence of breast cancer.

Another thing is digital mammography. What is this, we have already discussed. And what is its advantage? In the digital survey method, the X-ray film is replaced by detectors (they are similar in digital cameras). They transform x-rays into electrical impulses. Such signals can be printed, saved in the computer, make copies.

Digital mammography is the best option for:

  • thick-breasted patients
  • women under 50,
  • patients before menopause (or in the event that menopause lasts less than 1 year).

As for women after menopause (or after 50 years), they can be examined in any way: the film and digital methods will be equally effective. This is due to the fact that the density of the breast decreases with age, which allows to obtain high-quality images in both cases.

Is the procedure harmful?

Some patients, because of their incompetence, argue that mammography is harmful. Allegedly, the radiation dose is high, so it is better to do an ultrasound. Doctors claim that with the observance of the standards of the X-ray examination, damage to health will be minimal.

First, there are standards for the passage of x-ray procedures during the year.

Secondly, the dose for radiation exposure is too small (less, by the way, than with fluorography).

Ultrasound and X-ray examination complement each other. Therefore, doctors often prescribe the one and the other diagnostic method.

Mammography pros

Examination reveals abnormal formations in the mammary gland. Mammography allows you to diagnose cancer at an early stage. And this, in turn, will help to overcome cancer. There are many methods for treating cancer in the initial stage.

Cons of mammography

It is possible to obtain incorrect data, so it is better to combine several methods of examining the breast. In case of an incorrect positive result, additional mammography and ultrasound are prescribed. Rechecked results are most often normal. In the case of examination of women under 30 years of age, the procedure may be ineffective (breast density makes it difficult to do qualitative research).

Additional Breast Examination Methods

Mammography with tomosynthesis is a three-dimensional image of the breast in the form of thin (1 mm) sections. This is a new method that has not passed a sufficient number of clinical trials.

MRI is a more benign method that does not use harmful radiation. But he is not able to display some anomalies.

Optical mammography is a method using projection and tomographic apparatus. For the diagnostic type of research is not applicable. Optical luminescent mammography involves the introduction of phosphors into the tissue. It helps to see the growth of the tumor.

Ultrasound is an ultrasound examination that allows you to get a clear picture from different angles. It is used during pregnancy and lactation, as it is less harmful than the X-ray method.

A biopsy is a collection of tissue samples for further investigation. This method allows to verify the presence or absence of breast cancer.

Why is it needed?

With the help of mammography is the diagnosis of changes in the mammary glands. Low doses of radiation will not harm the patient's health. Minor discomfort during the procedure makes it optimal for detecting cancer at the initial stage.

Finally, we list the adverse factors that contribute to the development of cancer at an early age:

  • abortions,
  • early menstruation (up to 11 years),
  • hormonal changes (taking oral contraceptives, thyroid disease, overweight or underweight),
  • late menopause (after 55 years),
  • first birth at a later age (after 30 years),
  • gynecological diseases
  • genetic predisposition
  • regular stressful states.

Early diagnosis will completely cure cancer or carry out surgery with minimal damage (for example, remove only the tumor, do without chemotherapy). Regular examination will help maintain health for many years.

Contraindications

Most often, medical tricks for mammography are:

  • period of carrying a child,
  • lactation,
  • not reaching the patient thirty-five years of age,
  • a period of less than six months, which has passed after the abortion,
  • the presence of breast implants
  • the presence of any skin lesions in the area of ​​the breast,
  • nipple injuries, etc.

In the case of significant obesity women mammography can be ineffective. In addition, it may not give the desired results in the development of severe mastopathy or in the event of irreversible changes after its late treatment.

In those situations when there are certain doubts about the condition of the regional lymph nodes, this diagnostic method also provides quite a bit of information.

He has little to say to a specialist in the development of any pathologies in the blood vessels of the breast in a woman.

On which day of the cycle do breast mammography

Most often, the study is carried out for a short period, starting from the sixth to the twelfth day of the menstrual cycle.

After the end of the menstrual period, the hormonal background of the woman changes and the mammary glands do not experience an increased effect. Therefore, the breast becomes more relaxed and soft, allowing you to easily conduct research.

Shortly before the onset of menstruation, the effect of estrogens provokes a pronounced swelling and an increase in the density of tissues, as well as the appearance of certain painful sensations.

Therefore, in short, it is possible to describe in a similar way the changes that occur during the menstrual cycle in the mammary gland of a woman.

  • From the fifth to the thirteenth day, the phase of ripening of the follicles in the ovaries occurs. The woman is experiencing the greatest impact of sex hormones. The number of endocrine glands and connective tissue formations increases in her chest.
  • From the fourteenth to the sixteenth day of the menstrual cycle, the ovulatory phase begins, characterized by the fact that the mature egg, leaving the ovary, enters the female genital tract. During this period, the representative of the weaker sex is fully ready to perform fertilization. The hormone levels at such times are very high. In the mammary gland, the number of internal secretion ducts increases significantly, and it is precisely at such times that they sometimes coalesce into a common whole, provoking the appearance of cysts. With these processes, there is some pain in the chest area in women.
  • From the seventeenth day to the twenty-eighth day, the luteal phase occurs. At this time, the corpus luteum appears, giving impetus to the large production of progesterone. The hormone is responsible for the full carrying. It causes a very active blood flow to the breast tissue, due to which it significantly increases in size.

Therefore, the onset of each new phase of the menstrual cycle, including the menstruation itself, significantly affects the general condition of the woman's mammary glands. Such changes may affect the conduct of the study.

Immediately after the completion of menstruation, the breast does not experience an increased effect of hormones and is most suitable for various diagnostic examinations of its general condition. Especially important is the degree of permeability of its tissues for the passage of x-rays and the possibility of a certain compression of the mammary gland between the panels of the device for mammography.

In cases where the procedure is carried out urgently and the woman is influenced by various hormones released during different phases of the menstrual cycle, the specialist should calculate the position of her breast in the device so that the degree of accuracy of the results is maximum. Therefore, in some cases, the doctor is able to change the timing of the study.

In cases where the diagnosis of the mammary glands must be carried out urgently, they do it, not paying any attention to the period that has passed since the beginning of the menstrual period.

When menopause occurs, the time for performing mammography also loses any meaning. Therefore, women over the age of forty should undergo this procedure every two years. After the suppression of the fifty-year age limit, the study should be conducted every twelve months.

How do mammography?

The procedure takes place in a special room, specially prepared for radiography. It is completely harmless, safe and painless.

The equipment for breast examination is a specially connected flaps, located horizontally. The mammary gland during the mammography is placed between them. This method allows you to take several photos of its tissues in various projections.

The sequence of stages of the procedure is as follows:

  • the patient completely removes herself all clothes, including underwear, and exposes the upper part of the body,
  • she removes all her jewelry
  • it is better to raise the hair in advance in a high hairstyle,
  • the patient is approaching the device,
  • lays the mammary gland into the apparatus,
  • its lower torso is covered with a lead overlay to protect against ionizing radiation,
  • the doctor lowers the top plate and fixes it in the required way,
  • the patient takes a breath
  • the device turns on,
  • after a few seconds, it turns off and the doctor releases the mammary gland.

The patient may experience some discomfort with some slight squeezing of her chest between the instrument panels. But such an action is very important, as it allows you to fully explore its structure over the entire length.

Various mammography machines allow a woman to sit or stand while she is undergoing the procedure.

First, the state of one breast is studied, and after - the other. In the implementation of differential diagnostics, the focus of the device is additionally raised not only to the straight line, but also to the side and oblique projection.

Before making a diagnosis, a specialist should be warned about the use of contraceptives, hormonal preparations or certain pharmacological substances.

Do not use perfumes, lotions or deodorants. The body should not be different chains, piercings or pendants.

The total duration of the passage of mammography with a full study of the structure of the breast does not exceed twenty minutes.

If all the necessary requirements are met, a response to the conducted study with the interpretation of the results is usually ready within a week after the procedure.

In some cases, the doctor will give you the results of the examination shortly afterwards.

How often can you do a mammogram

As already mentioned, after forty years of study, it is required that a representative of the weaker sex be required for everyone at least once every two years, regardless of general well-being.

When a cancer tumor is detected or during treatment for cancer of the areas adjacent to the mammary gland, mammography is desirable to be performed at least once every thirty days.

Within six months, this study should be done in women who have previously been diagnosed with benign tumors in the tissues of the mammary glands.

If the patient has close relatives with cancer of the breast and adjacent anatomical structures, the procedure should be annually performed after crossing the thirty-five year age mark.

If there is an urgent need, it is recommended to do a single mammography even for persons under that age.

Despite the fact that the radiation from the apparatus is very low, it still exists, especially with instruments manufactured for a long time. The more modern the diagnostic equipment, the smaller the percentage of radiation received by the patient and the higher the degree of its protection from possible negative influences.

If it is necessary to carry out research in various projections, then naturally the effect of the rays becomes higher. But, according to experts, even a sufficiently large percentage of radiation cannot lead to any tangible consequences even for those women who have previously been diagnosed with malignant neoplasms.

It must be remembered that the Ministry of Health of the Russian Federation and the World Health Organization have established certain standards and requirements for the passage of this diagnostic procedure. They directly indicate the need for a study in the coming year. You should know that the apparatus of fluorography is no less burden on the body.

Therefore, you should not go through two such types of diagnostics in a row. It is necessary to warn the specialist that one species preceded the other. The minimum period between them should not be less than two weeks. Radiologists recommend increasing it to three to six months.

In addition, to improve the safety of the patient's body after performing radiation diagnosis, more milk or red wine, vegetables, fruits, bread and cereals should be consumed. The use of activated carbon can be of great benefit.

What is better, mammography or breast ultrasound

What research should be carried out by the patient, only a specialist is able to decide. The woman herself can not assess the degree of influence of various diagnostic technologies on the detection of the disease and the appointment of appropriate treatment.

Many people are more aware of the features of ultrasound scanning, therefore they consider this method preferential. But the ultrasound machine is not so accurate to evaluate the overall picture of the functioning of the female breast. He is not able to identify the smallest neoplasms and microchanges in the tissues of the breast.

Therefore, for early diagnosis, mammography is more important. It is more suitable for routine surveys. If necessary, clarify the details of the course of the disease using ultrasound.

In those situations when monitoring of the treatment being carried out or diagnostics in the dynamics of the disease, it is better to carry out ultrasound. As a rule, equipment for it is modern and meets all standards of safety for the body.

This study is also recommended to choose when it comes to the diagnosis of breast diseases in the representatives of the weaker sex during gestation and infant feeding.

However, in the primary diagnosis of breast diseases, it is recommended to give preference to mammography. It is a high-precision method for the detection of various pathologies, which makes it possible to start treatment at the earliest stages and making it possible to achieve an absolute recovery.

Therefore, in situations where the doctor advises to undergo the procedure many times, you should not think about the possible consequences. In the absence of timely treatment, the development of cancer may result in the death of the patient.

Without a doubt, mammography is by far the most informative method for the early detection of breast diseases in women. Она дает возможность проанализировать характер различных изменений в ее тканях на самых ранних этапах, что позволяет немедленно начать лечение.

If the changes in the breast tissue of a woman are functional or benign, mammography helps keep them under control, apply the necessary therapy, and also relieve the patient from painful fears. In this case, further monitoring of the treatment is carried out on other equipment, if a decision is made by the attending physician.

Features and possibilities of the mammography method

Mammography is called an x-ray of the mammary glands. It is carried out in order to study the state of the breast tissue and detect seals, cysts, the presence of calcinates. For each disease of the mammary glands are characterized by special features, such as the shape and localization of tumors, changes in the density of various tissues, especially the development of the vascular network.

The results can be used to diagnose diseases such as mastopathy (proliferation of breast tissue with the formation of nodes and cysts), tumors. To establish the nature of the tumors after their detection, a biopsy and laboratory examination of the contents are carried out. If large calcinates are visible in the image, this indicates that the process is benign. For malignant diseases characterized by the appearance of multiple small deposits of calcium in the tissues of the breast.

With the help of mammography, both mammary glands are examined, even if signs of trouble are visible only in one of them. This allows you to quickly detect pathology by comparison, to establish the stage of its development.

Indications for mammography

Distinguish between diagnostic mammography and prophylactic. Most often, this method is used in the examination of women older than 40 years. At this age, the risk of breast cancer pathologies increases. In addition, the picture is more distinct, because as a result of the age-related involution of the mammary glands, the amount of adipose tissue increases due to glandular.

Note: Up to 35 years old, it is practically useless to do a mammogram, because in the dense and elastic tissue it is very difficult to notice the nodules, the probability of obtaining a false-positive result is high. During the examination, although weak but harmful X-rays are used. Exposing the body once again to the risk of radiation does not make sense.

Diagnostic mammography

It is performed when the following signs of pathology are found during an external examination and breast palpation:

  • one or more seals
  • changing the shape and size of one or both mammary glands,
  • appearance of nipple discharge
  • breast asymmetry,
  • the appearance of pain and swelling in the chest,
  • change in skin color and structure.

Mammography, in addition, is prescribed before surgery or in order to monitor the state of the breast after the removal of the tumor, hormonal, radiation or chemotherapy. Diagnosis may be primary (conducted on the basis of complaints from the patient) or secondary, when the seals are detected by ultrasound, it is required to clarify the nature of the disease.

Prophylactic mammography

Conducted to prevent the development of breast cancer, the detection of its early signs. At the age of 40-50 years, women are recommended to undergo a mammogram once every 2 years. After 50 years - once a year.

Comment: If there are assumptions about the presence of breast cancer in a woman, then the examination is carried out as many times as necessary to control the course of treatment, since there is a real threat to the patient's life, the danger is not comparable with the consequences of mammography.

At risk of breast disease are women who have a genetic predisposition to breast cancer or endocrine disorders are detected. They should be screened annually. This also applies to obese women with genital tumors.

The mammography procedure for women of reproductive age is done on days 5-12 of the cycle. During this period, the hormonal background is most stable, the milk ducts are not enlarged, there are no painful sensations. This is of great importance, since the breast is compressed in the device.

If you need an emergency examination, mammography is done on any given day.

Traditional mammography

It is carried out on a conventional apparatus, in which the chest is clamped between two plates (flattened out). This allows it to fix, reduce the thickness and bring the seal to the surface. As a result of glandular x-ray examination, an x-ray is obtained on a special film. In the tissues you can see the dark and light areas, characteristic of tumors of various types.

Computed Tomomamography

The so-called tomosynthesis. This is an examination of the mammary gland using a special device, reminiscent of the principle of the tomograph.

In the CT method, in order to achieve the accuracy of the result and obtain a three-dimensional computer image, it is required to make several dozen x-rays of the gland “in section” (in different planes). There are a total of 11 such images taken in a tomomamograph. The mammary gland is not clamped, and the camera moves around it. This simplifies the procedure and speeds up the result.

Other methods of breast examination

In recent years, technologies have been developed for examining mammary glands, in which harmful x-rays are not used.

Optical mammography. Instead of X-rays, different types of light radiation are used (infrared, laser). The following varieties of this method are developed:

  1. Projection On the screen are fixed projections of tissues in different planes.
  2. Tomographic. With the help of a tomograph, a three-dimensional image is obtained that is made up of individual “slices”.
  3. Luminescent. Into the patient's body are injected drugs containing phosphors. They are able to accumulate in the tissues of tumors, which allows them to be considered, as well as to establish the presence of metastases.

Electrical impedance mammography. Instead of x-ray exposure, an electric current is used. Defects are detected by measuring the electrical conductivity of the tissues of the gland. This method is safer than traditional X-ray mammography. Such an examination can be carried out repeatedly during the treatment period. It is permissible to apply it during pregnancy.

Comparison of ultrasound and mammography

Ultrasound and mammography are the main methods used for the diagnosis of diseases or prophylactic examination of the mammary glands. In terms of safety, ultrasound has an advantage, since harmful radiation is not used here. Ultrasound examination is permissible to use for examination of women of any age, as well as pregnant and lactating women. The advantage of this method is the fact that with its help inspect the chest of small size.

There are downsides. Ultrasound examination shows only the condition of soft tissues, so the tumors on the screen are not clearly visible.

The advantage of mammography is that with its help you can get a more accurate picture of changes occurring in the state of the mammary glands, the probability of getting false results here is about 3 times lower than with ultrasound diagnostics. Mammography is the most effective method for diagnosing breast cancer at the earliest stages, when it is still impossible to detect compaction using ultrasound.

The disadvantage of x-ray mammography is that it can only be performed by women over 40 years of age. Advanced optical techniques extend its scope.

Preparation for the survey, assessment of results

On the day of the examination, the woman should not use any cosmetic skin care products, deodorants, perfumes, creams. Need to remove jewelry. Dark areas appear on the image, which may affect the accuracy of the result.

If a woman is particularly sensitive to the discomfort that occurs during the examination, she is recommended to take a sedative and anesthetic. The examination is conducted in the clinic, lasts from 10 to 30 minutes.

The mammary glands are translucent. The chest is pressed against a special platform and fixed between the plates. Several pictures are taken in a different projection. Compression of the breast, reducing the thickness of the translucent layer of tissue reduces the radiation dose received by the patient.

As a result of the survey, the following results can be obtained:

  1. There are no tumors in the mammary glands.
  2. Neoplasms of benign character are found. The result on oncology is negative.
  3. The nature of the detected neoplasm is likely to be benign, but clarification is required by repeated mammography examination after 6 months.
  4. A suspicious tumor was detected. A high probability that it has a benign character. A biopsy is required.
  5. The nature of the tumor is in doubt. Most likely, it will be malignant. Biopsy is required.
  6. A cancerous tumor was found. The character is confirmed using a biopsy.

The assumption of the presence of pathology in the mammary gland is based on the fact that the structure of the tissues viewed in the picture is heterogeneous, there are changes in the state of the milky ducts and blood vessels. The nature of tumors is judged by their form, the presence of clear boundaries. For example, fibroadenoma has a rounded shape and clear outlines. When cancer on the mammogram visible blurred bright spot, which has no contours.

During the decoding of the image, the state of the lymph nodes is assessed. When the diagnosis is also taken into account the nature of the symptoms that occur in the patient.

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