Mamografia este cea mai buna modalitate de depistare a cancerului de san
in stadiile cele mai tratabile - in medie cu cca. 1,7 ani inainte
ca femeia sa simta vreun nodul. De asemenea, mamografia localizeaza cancerele
care sunt prea mici pentru a fi evidentiate in cursul examenului clinic
al sanului. f4n17ny
Mamografia este examinarea radiologica a sanului. Mamografia diagnostica
se foloseste la diagnosticarea bolilor glandei mamare la femeile care au simptome.
Mamografia de screening se foloseste pentru a depista boli ale sanului
la femeile asimptomatice, adica la cele care nu par sa aiba probleme.
Desi radiografia ca metoda diagnostica se efectueaza de peste 70 de ani, mamografia
moderna exista doar din 1969. Acesta a fost primul an in care in
occident au aparut unitati de radiologie dedicate exclusiv examenului sanului.
In unitatile moderne de mamografie echipamentul este conceput in
asa fel incat sa se foloseasca doze foarte scazute de radiatii,
de obicei 0,1 - 0,2 razi per mamografie. Reglementarile in vigoare sunt
foarte stricte, in sensul ca aceste unitati nu sunt avizate decat
in conditiile in care echipamentul este sigur si dozele de radiatii
folosite sunt minime.
Many people are concerned about the exposure to x-rays, and rightly so, but
the level of radiation in up-to-date mammograms does not significantly increase
the risk for breast cancer. To put dose into perspective, a woman who receives
radiation as a treatment for breast cancer will receive several thousand rads.
If a woman had yearly mammograms beginning at age 40 and continuing until 90,
she will have received 10 rads.
In order to perform a mammogram, the breast is compressed to flatten and spread
the tissue. Although this may be temporarily uncomfortable, it is necessary
in order to produce a good mammogram. The compression only lasts a few seconds,
and the entire procedure for screening mammography takes about 20 minutes. This
procedure produces a black and white image of the breast tissue on a large sheet
of film that is "read," or interpreted, by a radiologist. The physician
reading the films will look for several types of changes. Screening mammography
usually involves two views (x-ray pictures) of each breast. For some patients,
such as women with breast implants, additional pictures may be needed to include
as much breast tissue as possible. Women who are breast-feeding can still get
mammograms. They can express their breast milk before the mammogram.
The x-ray machine for mammography
Calcifications are tiny mineral deposits within the breast tissue which appears
as small white spots on the films. Calcifications are divided into two categories,
macrocalcifications and microcalcifications. Macrocalcifications are coarse
(larger) calcium deposits that most likely represent degenerative changes in
the breasts, such as aging of the breast arteries, old injuries, or inflammations.
These deposits are associated with benign (noncancerous) conditions and do not
require a biopsy. Macrocalcifications are found in about 50 % of women over
the age of 50, and in about 10 % of women under the age of 50.
Microcalcifications are tiny (less than 1/50 of an inch) specks of calcium in
the breast. An area of microcalcification that is seen on a mammogram does not
always mean that cancer is present. They may appear singly or in clusters. The
shape and arrangement of microcalcifications help the radiologist judge the
likelihood of cancer being present. In some cases, the microcalcifications do
not even indicate a need for a biopsy. Instead, a doctor may advise a follow-up
mammogram within 3 to 6 months. In other cases, the microcalcifications are
more suspicious and a biopsy is recommended.
Another important change that can be seen on a mammogram is a mass, which may
occur with or without calcifications. Masses can be due to many things, including
cysts and fibroadenomas, but may be cancer and usually should be biopsied if
they are not fluid-filled cysts. A cyst, which is a benign collection of fluid
in the breast, cannot be diagnosed by physical exam alone, nor can it be diagnosed
by mammography alone. Either breast ultrasound, or removal of the fluid with
a needle (aspiration), is used to confirm that a mass is a cyst. If a mass is
not a cyst, then further imaging may be obtained. As with calcifications, a
mass can be caused by benign breast conditions, or by breast cancer. Some masses
can be monitored with periodic mammograms, while others may require immediate
or delayed biopsy.
A mammogram, while suggestive, cannot prove that an abnormal area is cancer.
To confirm whether cancer is present, a small amount of tissue must be removed
and examined under a microscope. This procedure is called a biopsy.
For more information on imaging examinations for early detection and diagnosis
of breast diseases, refer to the American Cancer Society document "Mammography
and Other Breast Imaging Procedures."
Kate Connelly discovered a lump while doing a breast self-exam. When examined
by her doctor, he felt a pea-size lump under the nipple of her right breast
and recommended she have a mammogram.
What is a mammogram?
A mammogram is a low-energy X-ray image of the breast. It can detect a cancerous
or precancerous tumor in the breast even before the tumor is large enough to
When is it ordered?
If any of the following signs are noticed, a mammogram is recommended: a breast
lump, unusual breast pain, nipple discharge, a change in the shape of the breast,
or a lump or skin thickening of the breast that does not disappear after your
next menstrual period.
Women younger than age 40 with no family history of breast cancer or other symptoms
should have a mammogram every 2 years, or as recommended by their doctor. Beginning
at age 40, a mammogram is recommended every year because of age-related increased
breast cancer risk. If you have a family history of breast cancer, ask your
doctor when you should start having regular mammograms.
What does the mammogram find?
The radiologist looks for abnormalities in the breast tissue. On the mammogram,
small calcium deposits, which may indicate a tumor, appear as white spots In
addition, soft-tissue nodules or distortion of the normal fibrous and fatty
breast tissue may be detected.
How do you prepare for a mammogram?
Schedule the mammogram for the week after your next menstrual period, when the
breasts are less tender.
Do not use any talcum powder, lotion, or deodorant before the mammogram, because
these products produce abnormal spots that may mimic calcium deposits.
What happens during a mammogram?
The procedure takes about half an hour. You will be asked to remove your clothing
above the waist and to put on an examining gown. The technician positions your
breast on an X-ray plate on the mammography machine. You may experience mild
discomfort as another plate on the machine is lowered to compress the breast
tissue. A beam of radiation is quickly passed through the breast, forming an
image of the breast on X-ray film. Each breast is imaged in two different directions.
Inform the technician if you have had a mammogram done previously; it is helpful
to compare mammograms to detect subtle changes in the breast tissue.
Kate’s mammogram shows a dense mass among the fatty tissue in her right
breast. The doctor recommends a breast biopsy to determine whether the lump
is benign or malignant.