mammogram

In one of our previous articles, we wrote that mammography (MMG) is a screening diagnostic method for breast cancer. Today, we would like to expand on this topic and have invited a specialized specialist to share information about MMG and the current mammogram screening guidelines being used. This article was written by Y. Timovskaya, Ph.D., doctor oncologist of the highest category, Member of ESMO with the help of A Galishyna, head of the diagnostic department of the Specialized Breast Center, a doctor of radiation diagnostics, member of ESR, EUSOBI. This article was last modified on 10 August 2021. It has been proven that regular examinations increase the rate of early detection of breast cancer. 👉 But are all examination methods (examination, mammography, ultrasound) equally effective for the early detection of breast cancer?👉 And how often should they be applied: annually, every six months, or are there other options? Today we will deal with these issues. Early Diagnosis of Breast Cancer For early detection of breast cancer, especially preclinical forms, the effectiveness of mammography (MMG) and magnetic resonance imaging (MRI) of the mammary glands with contrast enhancement has been proven. Ultrasound examination of the mammary glands is a useful addition to them. When choosing a diagnostic method, there is no universal approach that would suit everyone. The results of breast cancer treatment directly depend on the stage at which the treatment of this disease is started. The smaller the stage, the shorter, cheaper, and more effective the treatment. Therefore, the whole world is fighting to identify the early, if possible, preclinical stages of breast cancer (we wrote about what clinical breast cancer is in a separate article). IN THIS ARTICLE 1 Early Diagnosis of Breast Cancer 2 Ultrasound breast screening and Mammogram: definition 3 How to Choose Diagnostic Methods 4 Mammogram vs Ultrasound 5 Mammogram screening guidelines 6 What you need to tell the doctor to determine the research method At the same time, it is necessary to take into account the patient’s age, complaints, anamnesis, clinical examination data, and the results of previous medical tests. Ultrasound Breast Screening and Mammogram: definition ✔ Mammography (MMG) is an X-ray method for breast examination, which is the gold standard for diagnosing breast cancer. It perfectly detects microcalcifications, one of the early signs of breast cancer. The most important thing when using MMG is the fact that even standard views allow you to visually assess the full volume of an organ. ✔ Ultrasound – ultrasound examination of breast tissue, an additional diagnostic method. Suitable for patients with increased density of breast tissue (women under 35-40 years old). Therefore, it may be more appropriate for patients under 35-40 years of age to have an ultrasound scan rather than mammography (MMG). It is also the best method for fragmentary assessment of breast tissue. It is also used for the differential diagnosis of some formations. These, for example, include formations with a clear outline, identified on mammography. Each of these methods has advantages and disadvantages. There are no absolute contraindications to their implementation. How to Choose Diagnostic Methods As we wrote above, each clinical case requires an individual approach in the selection and examination sequence. So, for example, if a patient has complaints, her examination is diagnostic in nature. In this case, the doctor’s task is to choose the most appropriate diagnostic method. The aim will be to find out the reason for the complaints, the nature of the process, and the extent to which it has spread. It’s worth saying that a multimodal approach is often used. In such cases, a combination of several methods is used (MMG + ultrasound, MMG + MRI, using interventional techniques). It is also important to note that doctors sometimes need to apply special techniques within the same research method. For example, in the case of MMG, these are spot view, magnification view(s), Cleopatra’s view, etc. But in any case, the doctor is responsible to choose the appropriate diagnostic methods and techniques. Therefore, it is very important to contact specialists who can use the entire arsenal of diagnostic methods. Is it possible to avoid examinations if there are no complaints from the breast? The American Society of Breast Surgeons says that all women over the age of 25 must have a formal breast cancer risk assessment. You can do it yourself, or go through the risk assessment according to the NCCN guidelines in Healsens (below there will be links to download the app). After such an assessment is made, categories of patients without complaints should undergo screening. If a woman is not at risk, then such examinations can be started from the age of 40+. But we’ll talk more about mammogram screening guidelines below. If the risk of breast cancer is above average, then annual screening mammograms should be started at an earlier age, and in addition to mammography, additional examinations may be required. Mammogram vs Ultrasound It is worth pointing out what the limitations are for each diagnostic method. Thus, it will become more obvious what is decisive when choosing a diagnostic method. So, for ultrasound, the following limits are distinguished: Since ultrasound assesses the gland tissue fragmentarily, section by section, for patients with large breast sizes, this method is also not very suitable. This is due to the fact that there is a high risk of missing small formations. Mammography is not recommended without direct indications (suspected cancer) during pregnancy and lactation. In addition, in young patients, the diagnostic value of MMG decreases. This is due to the fact that young women have a higher density of breast tissue. And finally, we add that MMG is also ineffective in the presence of inflammatory diseases of the mammary glands. Mammogram screening guidelines At the moment, medical guidelines aim for an individualized approach, taking into account personal risks. Generally, the higher the risk of breast cancer, the earlier and more often screenings are recommended. So, for example, the American Cancer Society divides women into risk groups. For Women at Increased Risk of Breast