Mammography or breast ultrasound? If you are in doubt as to which of these studies will be better for you, be sure to read this text. Both tests allow the detection of suspicious changes in the breasts. However, it does not matter what we do, because each of them presents the tissues that make up the breast in a slightly different way. What are the pros and cons of these studies? When is it better to have a mammogram and when is it better to have a breast ultrasound?

In fact, bothbreast ultrasoundandmammographyare mammography, i.e. a description of the breast ( mamma- from Latin breastgrapho- from Greek I write). They differ in that ultrasound waves are used during ultrasound, and x-rays are used during mammography. In ultrasound, the image is created due to the fact that the ultrasound reflects off the tissues. The test is harmless to he alth, there are no contraindications, also in pregnancy. It should be preceded by a medical interview.

When is the ultrasound, when is the mammogram?

Young women have more glandular tissue to produce milk. Her picture is clear in the research. Fat tissue grows with age, which has a dark color on the film and on the monitor. Breast cancer, like that of other organs, is dark on ultrasound and light on the X-ray. Therefore, if you want the lesion to be distinguished from he althy tissue, light glandular (young) tissue should be examined with an ultrasound scanner, and dark fat (older) tissue - radiologically.

Things get more complicated when we use hormone replacement therapy. After two years of systematic use of hormones, the glandular tissue grows back. The breast "becomes younger". Even though we have passed a certain age threshold, the changes will be more visible on ultrasound.

But one test is not always enough also because mammography does not distinguish solid lesions, nodules, and fluid-containing lesions, e.g. cysts. On the other hand, ultrasound detects these differences very well. So if we have the advantage of glandular tissue that produces food (it is assumed that this is the case until the age of 35-40), we should do an ultrasound. If in doubt, your doctor will refer you to a mammogram. After 40, mammography is more reliable, so we start with that. But we can't stop there, especially if we're taking hormones. Both tests are obligatory before starting hormone therapy. Downmammography should always be qualified by a doctor. This is very important because the interpretation of the results depends on the interview.

What does mammography detect?

Mammography is recommended mainly for women over 35-40 years of age, who have more body fat, and the x-rays in it show any changes better. Mammography detects very small, millimeter changes, shows the shape of the tumor (regular shape suggests a benign lesion), and shows well calcifications, i.e. mineral calcium deposits. They can be large (macrocalcifications) or small (microcalcifications). The first ones are usually mild, and half of women over 50 have them. Microcalcifications are more dangerous because they can be a signal of cancer or precancerous changes.

It is worth knowing that since November 2015, the American Cancer Society argues that women with no additional risk of developing breast cancer should not start mammograms until the age of 45. All because mammography - according to scientists - is not a perfect diagnostic method and works poorly especially in the case of younger women.

A large breast is not a problem for mammography, just like the male breast (men also have this test). Also, breast augmentation surgery and implants are not a contraindication. They may obscure certain areas of the tissue, but the technician can use appropriate methods to move the implants during the examination and the image will be clear enough. Compressing the breasts during the examination, although painful, is not dangerous. Anyway, the pressure lasts less than 30 seconds.

USG distinguishes between benign and malignant

Ultrasound is an examination that uses very high frequency sounds (most people cannot hear it). Thanks to him, the image of the object is created. The advantage of ultrasound is that you can view the lesion from different angles. Ultrasound does what mammography cannot: it distinguishes a benign cyst from a mass that is malignant. But it doesn't detect calcifications. This test is recommended for younger women who have more glandular tissue in their breasts. In such tissue, ultrasounds are better "oriented", not x-rays.

  • Why do breasts hurt?
  • Breast cysts
  • fibroadenoma - benign breast tumor
  • Breast papilloma

What should you know about breast examination? Check it out!

Important

The most at risk of breast cancer are women who:

  1. did not give birth - pregnancy and breastfeeding protect the breasts
  2. start menstruating early and menstruate late,that is, they had a long period of hormonal activity - estrogens have a bad effect on the breasts
  3. have undergone mastectomy (breast removal) - they have twice as often a tumor on the other side
  4. their mother, grandmother or sister suffered from breast cancer or ovarian cancer - the risk is 3-, 4-, 5 times higher than in the case of other people
  5. their father had prostate cancer

Before breast examination, say:

  • how old are you
  • when you had your last period
  • Did you give birth
  • did you feed
  • Are you taking any hormone medications
  • Have you had breast surgeries because they leave scars obscuring the image
  • Has anyone in your family suffered from breast, ovarian or prostate cancer
  • Have you already done breast examinations; if so, you must have your results with you.

How is an ultrasound and how is a mammogram?

Ultrasound can be done at any stage of the monthly cycle. For the examination, the patient lies on her back with the arm under her head, then the breast becomes flatter, which makes it easier to obtain a good image. The doctor lubricates the breast with a special gel and then moves the head along it, observing the image of the tissues on the camera monitor. During one ultrasound examination, you can view the change from different angles, the doctor may repeatedly return the probe to the place that disturbed him. Ultrasound examination is safe and therefore the only breast examination performed on pregnant women. Immediately after the examination, the patient receives the result and description.

Although the dose of x-rays in mammography is small, it should not be done more than once a year

Mammography should be performed in the first half of the cycle. The radiologist technician places the breast on the mammography table and presses it against the device for a few seconds using a transparent plastic plate. Pressure, which can cause discomfort (but should not be painful), is essential to reduce the radiation dose and get a clear picture. When the breast is fixed in the apparatus, a small dose of radiation is passed through it. Two shots of each breast are made, in the up-down projection and in the oblique projection. The patient usually receives the test result after two weeks, as the analysis and description of the photos must be performed by a radiologist.

Where to test?

The reliability of the examination depends on the apparatus, as well as the qualifications of the doctor assessing the image. So far, ultrasound has not been recognized as an exam skill. Accordingly, anyone with a medical degree can purchase the ido research. How to distinguish a qualified specialist from an unreliable specialist? You have to ask if the doctor has a certificate of the Polish Ultrasound Society and if the laboratory is accredited by this society. It is a guarantee of the quality of equipment and sanitary conditions required to conduct medical activities. For mammography, the equipment must be standardized according to the rules of the American Radiological Society and have a developing machine that is suitable for breast imaging only.

Do not do mammography where:

  • it's dirty and nasty,
  • service is rude,
  • the doctor does not examine the patient before the mammogram,
  • they squeeze their bust like in a vice.

Preventive, free breast examinations

Every woman should do them regularly after the age of 20, and even earlier, as long as she uses hormonal contraception.

The free study under the NHF-funded population-based breast cancer early detection program is available to women aged 50-69 who have not had a mammogram in the last two years or have received a written indication for re-mammography as part of the program after 12 months due to the burden of the following risk factors: breast cancer among family members, mutation within the BRCA1 or BRCA2 genes, and no previous malignant breast cancer.

Information on test facilities and mammobus stops can be found at www.nfz.gov.pl.

Important
  • The first ultrasound scan is recommended in the age of 20. Until the age of 30, it is worth repeating them every 2 years, and then once a year, unless the doctor suggests otherwise. Ultrasound is performed more often if there is a family history of cancer or mutations in the BRCA1 and BRCA2 genes.
  • The first mammogram is recommended around 35-40 years of age, then it is repeated every 1.5-2 years. Until menopause, it is best to alternate with ultrasound.
  • American studies recommend 1 survey per year in the age range of 40-50 years and once a year testing over 50 years of age
  • European studies prefer 1-2 surveys a year in the 40-50 age group, and after the age of 50 - one survey per year.
  • The situation becomes more complicated when a woman is receiving hormone replacement therapy. Then, after two years, the glandular tissue grows (the breast becomes firmer and younger). Therefore, changes in the breasts will be more visible during ultrasound than in mammography. However, since ultrasound does not detect calcifications that may appear in old age and signal neoplastic changes, and mammography does notdistinguishes between solid and fluid-filled lesions, in such a situation it is better to perform ultrasound alternating with mammography. But be careful, the doctor decides whether and to what extent it is necessary!

Check out invasive breast examinations

  • Breast biopsy
  • Mammotonic biopsy

Breast self-examination

We watch and examine our own breasts right after menstruation; if we no longer have periods - always on the same day of the month. For life as the risk of cancer increases over time. Younger women should have a breast ultrasound every year, and every six months if they are at risk. Older women are referred to a mammogram every year and a half, and in the risk group - every year. For women taking HRT, alternating ultrasound examinations are recommended due to the growth of glandular tissue. and mammograms.

"Zdrowie" monthly

Category:

Research