Mammography

The mammography does not prevent cancer but can save lives by the timely discovery of the cancer.

In the past, the breast cancer was diagnosed in advanced stage when the tumor was already palpable. Nowadays, due to the imaging investigation methods, the cancer can be diagnosed in early stage when its dimensions are much smaller and it is not spread to the lymph nodes, the current studies showing that the mammography can reveal breast lesions two years before they can be clinically detected. Furthermore, the early diagnostic, when the tumor has small dimensions, removes the need of the mastectomy (breast removal), the excision of the tumor being enough in order to mitigate cancer risks.

The ignorance, fear of diagnostic and the lack of health education are the factors due to which the disease is diagnosed in an advanced state.

The mammography procedure takes about 20 minutes and the patient’s discomfort is minimal in most of the cases. Both breasts are mandatorily exposed, in two incidents each. The technician will position the breast on the platform of the device and will easily compress the breast with a special scraper (made of transparent Plexiglas), in order to reduce breast thickness for a better visualization of the anatomical structures. This compression will take a few seconds and may create a slight feeling of breast pressure which disappears when the breast is decompressed. If you underwent other mammography examinations in the past, you should bring the results with you in order to get a compared result.

The mammography must be performed in the first term of the menstrual cycle, being most indicated between the 7th -14th day of the cycle, when the breast is less dense.

The mammography is not indicated during pregnancy.

Some women are concerned about the radiation exposure during the mammography procedure, but the irradiation is minimal with the modern device (is lower than the cosmic irradiation that an intercontinental flight passenger or a ski runner at over 3000m height are exposed to)

It enables the view of several structural details of the dense breast and involves lower irradiation and compression than in case of the standard mammography.

The scope of the mammography is to discover the tumors and to make the difference between benign and malignant tumors. In case of some patients, after the mammography is performed, several additional investigations may be recommended: breast ultrasound, breast MRI or breast puncture biopsy.

• as a screening method in case of healthy women in order to discover cancer in early stage. Currently, the American College of Radiology and the American Cancer Society recommend an annual mammography for women over 40 years old. If you have a family history of breast or ovarian cancer or if you underwent a chest X-ray in the past, the annual examination may be started earlier. The breast screening increases the rate of cancer detection in early stage. The mammography is the only method proven effective in detecting “in situ” breast carcinoma, a stage in which the healing rate is of 100%;
•  In case of symptomatic women who experience pain, nipple discharge, skin or nipple retractions, palpable nodules;
•  In order to monitor an abnormality found on a previous mammography;

The American College of Radiology developed an evaluation code of the mammographic images (Birads), which is used in order to translate the result of a mammography:

• 1. normal aspect;
• 2. benign lesion;
• 3. most likely benign lesion that needs to be monitored;
• 4. suspected cancer lesion, the biopsy is recommended;
• 5. most likely malignant lesions, the biopsy and the surgery are needed;

The mammography is the most important breast diagnostic imaging method. However, it is not always conclusive, further investigations, such as breast ultrasound or breast MRI being needed.

Other breast investigations methods made available by Neuromed Diagnostic Imaging Center are the following:

• breast ultrasound
• breast elastography
• ultrasound-guided breast puncture biopsy
• breast MRI
• breast MRI spectroscopy