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  • 24Sep

    How is mammography useful in breast cancer detection?

    Mammography is an imaging modality in which radiographs of breasts are taken to detect changes suggestive of cancer. It uses a low dose of x-rays for visualization of any structural changes in the architecture of breast parenchyma.

    Types of Mammography

    Mammography is basically of two types depending on the indication for which it is employed. It is classified as screening mammography and diagnostic mammography. 

    Screening mammography: Screening mammography is done in asymptomatic women for the detection of breast cancer. Screening investigations are done in a population where the disease is commonly found. This helps in the early detection of disease before it progresses to become symptomatic. A clinical study demonstrated that screening mammography resulted in a 33% reduction in mortality in women. Mammography was found to be more accurate than clinical examination for the detection of early breast cancers. In this investigation, two views of each breast are taken. One is cranio-caudal (in the vertical axis of breast) and the other is medio-lateral oblique view (along horizontal axis of breast). With these two views, a maximum amount of breast tissue can be imaged. It delivers a radiation dose of 0.1 centigray and it does not result in an increased risk of breast cancer.

    The NCCN (National Comprehensive Cancer Network) suggest that, from the age of 40 years, yearly screening mammography should be done. Studies of mammography screening confirm a 40% reduction in invasive and advanced stage (stage II, III, and IV) of breast cancer and a 30% increase in overall survival.

    Thanks to screening mammography there is 30% increase in overall survival rate.

    Thanks to screening mammography there is 30% increase in overall survival rate.

    Diagnostic mammography: This imaging modality is used for the assessment of breast in women who present with breast symptoms suspicious of cancer. They include lump, nipple discharge, nipple retraction, ulcer over breast which fails to heal, enlargement of breast and a lump in the axilla. Imaging of both breasts is done. It helps in finding out a bilateral (involving both breasts) disease. It may also show evidence of multifocality (multiple areas of cancer in a quadrant of breast) or multicentric disease (involving two or more quadrants of breast).

    It involves taking the two views as described in screening mammography; the cranio-caudal and medio-lateral oblique views. If there is a suspicious area, additional images like 90 degree lateral and spot compression views can be taken. The compression view reduces the amount of tissue between the imaging sensor and the tumor and gives a better resolution image with a lower radiation dose. Magnified views may also be obtained to see the margins of a lump or small calcifications. These views help in identification of exact location of tumor in the breast. This information can be used to guide needle localization and needle biopsy of tumor.

    Mammography in breast cancer detection

    The mammographic features which are indicative of cancer include a mass with irregular margins, asymmetric thickening of tissue inside breast and clustered deposits of micro-calcifications. The presence of micro-calcifications is associated with 50% of breast cancers in which no lump or mass is palpable. These are especially important in young patients in whom these micro-calcifications are the only findings on mammography.

    Xeromammography: This technique is similar to conventional mammography except that the image is recorded on a xerography plate (like the photographic paper) which provides a positive image. In mammography, we get a negative image.

     Digital mammography uses a digital CCD sensor to record the image. It also allows manipulation of the contrast in the image which results in better visualization of suspicious areas. It is especially useful in women with large breasts, dense breasts and young women less than 50 years of age.

    Mammography is an important breast imaging modality which uses a low dose of x-rays for early detection of breast cancer. It has a great role to play in deciding the type of treatment to be offered to these patients. It has resulted in improving the overall survival  rate of patients with breast cancer.

    Anna L.

    It’s all about health!
    I have academic background in drugs related Chemical Technology, as well as extensive professional experience in pharma and medical companies. My main area of interest is everyday life medicine. The goal of my articles is to give people informative answers to the questions that bother them, to dispel doubts and some common misbeliefs and also to inspire everyone to keep healthy lifestyle.

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