Mammography results are ready immediately. Mammography results of the mammary glands, interpretation of the norm in women

Contents of the article:

Mammography is one of the methods for diagnosing pathological neoplasms in the mammary gland.

Breast mammography is included in the standards of preventive measures for the early diagnosis of breast cancer; upon reaching the age of 40, every woman is required to undergo this type of examination. If mammograms do not reveal evidence of pathology, then the next examination of the mammary glands must be done after 2 years.

It is possible to perform mammography at an earlier age, but there must be compelling reasons for this, for example, suspicion of a tumor process in the breast.

Digital mammography is a very effective and reliable way to diagnose diseases of the mammary glands; tumors up to 5-6 mm in size and pathologically changed lymph nodes are clearly visualized in the images, which allows for a timely correct diagnosis and initiation of treatment. For many women, this diagnostic method has saved their health and even their lives.

Before undergoing a mammography examination, the patient must take with her previous statements and results, if any.

Interpretation of mammogram results: norm and pathology

In order to make a final diagnosis, the radiologist must take into account the clinical manifestations and data obtained as a result of a conversation with the patient. The structure of the breast tissue, visible formations, vessels, ducts and lymph nodes are assessed.

If a woman is healthy, then there are no darkening or compactions, the structure of the organ is homogeneous. Vessels and ducts are clear, intertwined in a network. Regional lymph nodes are not enlarged.
Sometimes lesions are visible during mammography. The doctor must describe their number, shape, structure, location.

Depending on the age of the woman, the density of the mammary glands is different. Thus, in girls, tissue density is increased, and in older women in menopause or postmenopause, the tissue structure is hypoechoic.

Fibroadenoma and cyst on a mammogram look like neoplasms with clear, even contours; one of the signs of a malignant neoplasm is blurred boundaries.
Sometimes calcifications are revealed on x-rays. These salt accumulations can exist on their own, but can accompany breast cancer or any benign neoplasm.

Women always ask the same question: “At what day of the menstrual cycle do they do a mammogram?” It is better to take an X-ray examination of the mammary glands from 4 to 7 days from the start of menstruation, but the examination can be performed up to 10 days from the start of the cycle. For menopausal women, mammography screening can be done any day.

Mammologists and radiologists have a special standard for interpreting mammography results, with a total of six categories.

0 - Incomplete rating. This is usually how they describe mammograms that for some reason did not work out. It is necessary to undergo re-diagnosis.
1 - No pathological formations were found in the tissues of the mammary glands, i.e., this is a variant of the norm.
2 - Benign neoplasm, no signs of malignancy.

3 - The neoplasm is benign, but requires monitoring over time. In such cases, a repeat mammogram is prescribed after 6 months.
4 - The tumor formation is suspicious in its parameters. To exclude breast cancer, ultrasound-guided biopsy is justified. The possibility of malignancy exists, but it is small.
5 - A tumor is visualized that looks like cancer. To verify the diagnosis, a biopsy of the tumor and further diagnostic methods are performed. The likelihood that a “bad” diagnosis will be confirmed is high.
6 - Malignant neoplasm of the breast, already confirmed. In this case, mammography allows you to evaluate the effect of the treatment and the dynamics of the pathological process.

False positive and false negative results during mammography: what is it?

Sometimes, for some reason (human factor, malfunction of equipment, gluing of some material to the chest during the examination, for example, a piece of dry deodorant, rhinestones, etc.) a formation suspicious for a tumor is visualized on the mammogram. In these cases, additional diagnostics are carried out, which refutes the diagnosis, the patient is healthy, the mammography result is false positive.

With a false negative result, nothing pathological is found in the images, but after a short period of time a diagnosis of breast cancer is established.

Young women under 40 years of age often find themselves in this situation, this is explained by the fact that the breast tissue of this category of representatives of the fair sex is denser due to hormonal characteristics, and it is not always (20% of cases) possible to establish a diagnosis of breast cancer using only one mammographic examination . The worst thing in this situation is that the patient considers herself healthy and does not go to the doctor when the signs of breast cancer become obvious. If you approach the situation wisely, then even if the pictures are in order and there are clinical manifestations, it is unacceptable to postpone a visit to the doctor!

What breast diseases can be diagnosed using mammography?

In addition to breast cancer, there are a number of pathological conditions:

Mastopathy

A group of pathologies of fibrocystic origin, similar in clinical manifestations and symptoms. The diagnosis is made in approximately 50% of women. What causes the development of mastopathy is still debatable. Predisposing factors include hormonal imbalance and hereditary predisposition.

Fibroadenoma
A benign neoplasm arising from healthy breast tissue. If the results of dynamic observation determine the growth of fibroadenoma, then surgical treatment is indicated.

Calcifications
Accumulation of salt clots, mainly calcium salts, in the tissues of the mammary gland. It is impossible to palpate them, but on mammograms calcifications are clearly visible in the form of a shadow of increased density.

Breast cysts
A cyst is, relatively speaking, a “ball” filled with fluid. Mammograms differentiate well; in case of doubt, pneumocystography is performed. Breast cysts are a pathology that occurs mainly in young girls and women. The cyst can be single, but there are also several pathological neoplasms in one or two mammary glands at the same time.

There are fatty cysts, they do not pose a danger to a woman’s health, but with increased growth they can provoke pain, and if they become inflamed, they can cause suppuration.

What types of mammograms are there?

X-ray mammography: film, projection and digital.

Plain radiography is an X-ray examination of the mammary glands and nearby lymph nodes in the clavicle and axillary region. The study is carried out in direct and oblique projection.

Digital mammography- a more modern method, digital mammograms are distinguished by higher accuracy. This type is a screening method and is suitable for examining a large number of women for early detection of tumor pathology of the mammary glands. Pictures are taken in 2 or more projections. This requires a special machine - a mammograph, using X-rays. The data is sent to the computer and the analysis is carried out automatically. Images can be viewed from any angle using a special program. At the request of the diagnostician, you can change the contrast of the images. This is the main difference between digital mammography and film mammography. In addition, the data obtained in digital form can be sent by e-mail to any specialist in any medical center.

Let us note that in terms of radiation exposure with digital mammography, it is 20% less than with conventional mammography, and the detection of oncopathology is just as much higher.

Magnetic resonance mammography- the best diagnostic method, absolutely non-invasive, eliminates exposure to x-rays. Diagnostic accuracy is ensured by contrast, which in 95% of cases detects pathology at the earliest stages.
The disadvantages are that the equipment is not available in all medical centers, and the cost of the procedure is quite high.

Microwave mammography (radiothermometry)

Diagnosis is based on measuring temperature in various parts of the breast. It is believed that in cancer the temperature response increases. Using radiothermography, pathological foci can be detected earlier than using other methods.

Diagnostic accuracy is close to 98%.

In addition to breast cancer, it is suitable for diagnosing mastopathy and fibroadenomas.

Electrical impedance mammography suitable for diagnosing breast pathology in pregnant and lactating women.

This type of examination is also effective for identifying any breast tumors, as well as monitoring the effect of the therapy.

The disadvantages include the sensitivity of the technique - it is no more than 75%.

How is mammography performed?

No special preparation for the study is required; general hygiene procedures are sufficient. In the office you will be asked to undress from the waist up, remove gold jewelry, piercings, in a word, everything that can give a shadow on a mammogram.

The mammary gland is placed between special holders and compressed, which achieves better visualization due to a decrease in tissue thickness. A series of images are taken.

If the examination is performed from the 4th to the 7th day of the menstrual cycle, then there is no engorgement of the mammary glands, which makes the procedure almost painless.

Where can I get a mammogram?

The examination can be done at a clinic at your place of residence or at any private clinic that has the necessary equipment.

In this article we will look at how breast mammography is interpreted.

This is an x-ray examination. The doctor takes pictures in two projections, which is necessary for a better examination. When the mammography results are ready, the specialist processes them and sometimes compares them with previous studies. From them we can draw a conclusion about the presence or presence of any pathology.

So, what can deciphering the results of mammography of the mammary glands reveal?

Possible pathologies

This diagnostic study is necessary for the purpose of premature detection of pathologies that are benign or malignant. Among them:

Calcifications. They are an accumulation of calcium salts in the tissues of the mammary glands. Most often, this neoplasm indicates a developing cancer disease. Ordinary palpation does not detect calcifications, so there is a need for mammography.
Cysts. They are a fairly common type of neoplasm filled with fluid. If you discover a cyst in the mammary gland, you should not panic, since such a pathology is not a sign of cancer development.
Fibroadenoma. It is a benign formation, prone to rapid development. Fibroadenomas must be removed surgically.
Oncology is a malignant neoplasm characterized by uncontrolled growth. Cancer cells have the ability to invade nearby cells and organs. The cancerous tumor should be removed immediately.

After the patient undergoes an examination, the specialist obtains X-ray images of the mammary glands. Based on them, he determines whether there are any changes in the tissues.

Important factors to consider

In the process of deciphering the results of mammography of the mammary glands and ultrasound, the doctor takes into account the following important factors:

The presence of thickenings in the skin, calcifications.
The presence of various pathologies.
Asymmetry (when only one of the mammary glands has lumps).

It should be noted that it is impossible to diagnose cancer based solely on the results of a mammographic examination. To determine the final diagnosis, the doctor recommends additional examinations. However, the test results can tell a specialist a lot.

Interpretation of breast mammography

Using an X-ray of the mammary glands, the doctor examines the condition of the lymph nodes, ducts, vessels, and tissue texture. If there are no compactions, the tissue structure in the breast is uniform, then we can judge the absence of pathological changes.

Ducts and capillaries should be clearly visible on the images. If there are disturbances in the structure of the breast tissue or enlarged lymph nodes, the presence of pathology is diagnosed.

With the help of deciphering mammography of the mammary glands, it is not difficult for a specialist to determine the foci of development of a neoplasm, its quality, shape, and size.

False negative and false positive results

If the outcome of the examination shows the likelihood of cancer in the mammary gland, the doctor recommends additional testing. It should be borne in mind that mammography does not always give unambiguous and correct results.

If a specialist has even the slightest suspicion of cancer, he sends the patient for additional studies. In cases where the mammologist’s diagnosis is not confirmed, we are talking about a false-positive mammography result. In this case, the woman is considered healthy.

What does this mean?

It is worth noting that such results negatively affect the physical and mental state of the patient. Most often, a woman, upon learning about the likelihood of a tumor, immediately begins to feel worse. In addition, a false positive result implies further examination and, as a result, financial costs.

It is important to find out in advance what mammography of the mammary glands shows.

There are situations when the images reflect the normal state of the mammary glands, and after some time a woman is diagnosed with cancer in an advanced form. In this case, the results of mammography are false negative.

Statistics show that cancer is not detected precisely for this reason in approximately 20% of patients. As a rule, this situation occurs with young women. The structure of their mammary glands is denser than that of older patients.

Factors influencing the result

A false negative breast mammogram result can be due to several factors:

The neoplasm is small in size.
The doctor who performed the examination is inexperienced or incompetent.
An increased level of sex hormones is observed in a woman’s body.
A malignant neoplasm grows dynamically.

This result is dangerous because a woman may postpone a visit to a mammologist even if she has obvious symptoms of cancer. This approach to one’s health often leads to death. It is important to remember that breast mammography cannot be used to judge cancer. If undesirable symptoms are present, the woman should immediately consult a doctor for advice.

Signs of oncology

Symptoms that occur with breast cancer depend on the stage of development and can be expressed by the occurrence of general weakness, sudden causeless fluctuations in weight, changes in the shape of the breast, and discharge from the nipple. A decrease in the size of the areola, deformation of the nipple, its retraction, and enlargement of regional lymph nodes may also be observed.

Conclusion about the condition of the mammary glands

After the mammogram, the mammologist will also have to assess the density of the patient’s breast glands. In accordance with the generally accepted classification, 4 groups are distinguished:

Predominance of adipose tissue. The structure of the mammary gland contains a certain amount of glandular and fibrous tissue. The likelihood of developing a neoplasm is minimal.
Scattered areas of fibrous and glandular tissue are present.
They have different densities. Detecting changes is difficult.
Breast tissue is highly dense. Getting clear results with mammography is difficult. Oncological formations can mix with areas of normal tissue.

We looked at how breast mammography is interpreted.

WHAT IS MAMMOGRAPHY?

Mammography is an x-ray method for examining the mammary glands, based on the ability of different types of living tissue to transmit x-rays to varying degrees. In this case, normal and pathologically altered breast tissue give a different image on an x-ray (in our case it is called a mammogram), which allows the doctor to detect various diseases.

Mammographic examination is performed using a special device - a mammograph. The patient places the mammary gland on a special table under the X-ray tube. After this, the laboratory assistant gives a current, the tube generates X-rays that pass through the tissue and illuminate the X-ray film, or affect digital detectors in more modern devices. The image is then either digitized and displayed on a computer screen, or printed in “analog” form on film. These images are subsequently analyzed by a radiologist and a conclusion is issued based on them.

The figure shows a diagram of the passage of X-rays through the mammary gland (marked in light brown). The letter T marks the X-ray tube, P – the areas of the film exposed to radiation. Thus, volumetric formations (conventionally marked with circles of red, blue and green colors) do not transmit (or transmit to a much lesser extent than fat) radiation, creating a shadow effect on an x-ray.

WHAT DOES MAMMOGRAPHY SHOW?

The mammary gland is heterogeneous in structure, dense connective tissue, fluid and fatty tissue, as well as inclusions of calcium and metals. Fat tissue blocks X-rays to a much lesser extent than connective tissue, and liquid (water) is even more impenetrable to X-rays. Calcifications are almost 100% impenetrable to x-rays. Thus, on mammograms you can see cysts, tumors, calcifications in the structure of the mammary gland - in scientific terms, evaluate its architectonics.

Example of a mammogram. The red arrow marks an irregularly shaped shadow (in the form of an “egg”, with smooth edges, clear contours, having a uniform structure, dense. It can be assumed that this shadow is caused by some kind of fluid formation - a cyst. However, something else cannot be completely excluded (soft tissue, solid) education.

For comparison. The images show a CT scan of the mammary glands. See how the images differ from those of classic mammograms.

WHEN SHOULD YOU DO A MAMMOGRAPHY?

Mammography can be diagnostic and performed to confirm an already established diagnosis to assess, for example, the size of a tumor node, its growth rate in comparison with previously taken images, as well as preventive screening. Preventive examinations are carried out for all women over 40 years of age, thanks to which early detection of cancer is possible.

Diagnostic mammography can be recommended by an ultrasound doctor, gynecologist, surgeon, oncologist, mammologist - in order to clarify the nature of the changes identified by him during manual examination, or using ultrasound. Mammograms for diagnostic purposes are performed on women and men (!), regardless of age, the main thing is the presence of objective indications, for example, a palpable mass in the mammary gland.

Preventive mammography is necessary for all women starting from the age of 40, since during this period changes in hormonal balance begin, associated with involutive processes in the ovaries. In addition, after 40 years, the information content of X-ray images of the mammary glands is much higher, since fibroglandular tissue in older women is less developed, space-occupying formations are not masked by connective tissue, as a result of which they are better visible on X-ray images.

On the left is a mammogram after 60 years, on the right is a young woman. Compare the images of the mammary glands on x-rays. If adipose tissue predominates on the left, and the gland is “transparent” to X-rays, multiple dense inclusions - calcifications - are clearly visible, then on the left, due to the predominance of fibroglandular tissue, practically nothing is visible - there is a high risk of missing a tumor.

HOW OFTEN SHOULD I HAVE A MAMMOGRAPHY?

Mammography for preventive purposes is performed once a year. If any mass formation in the mammary gland is identified, there is a need to assess changes in the size and structure of this formation over a certain period of time - usually after 3, 4 or 6 months. In this case, the radiologist may recommend a repeat image after the period indicated above - in order to make sure that the formation does not change its size, structure and shape. If changes are present, a malignant tumor may be suspected.

For mammography performed for diagnostic purposes, there is no frequency of examinations. You can take as many pictures as necessary in order to come to any unambiguous opinion - a consensus between the radiologist and the mammologist-clinician. In practice, this means that 4 photographs are taken in standard projections, and also, if necessary, photographs in additional projections (sighting).

WHAT DAY IS A MAMMOGRAPHY DONE?

An important question is on what day after menstruation to do a mammogram. According to the recommendations of the International Society of Mammology, this study is best performed at the beginning of the menstrual cycle before ovulation - on days 5-15 of the cycle. At this time, better conditions are created for visualizing changes (the glands are not so dense, and all volumetric formations are visualized better).

HOW IS MAMMOGRAPHY DONE?

Mammographic examination is performed in two projections for each gland. First, photographs are taken in a direct craniocaudal projection. In this case, the mammary gland is placed on the machine table and pressed from above with a special device. The degree of pressure can be high - this is the reason for multiple complaints from patients about a painful examination. Usually this requires standing, but special seats are provided for weakened women - they are needed to ensure that the patient does not get injured if she suddenly loses consciousness during the examination.

Then the laboratory technician takes an x-ray of one or both glands and begins the study in the second standard - mediolateral oblique projection. In this case, the patient’s arm must be bent at the elbow and raised upward, clasping the neck. This is necessary so that the soft tissues of the limb do not create additional shadows in the image.

Sometimes a radiologist prescribes images in additional projections if he sees questionable changes in the images obtained. In some cases, palpation examination of the gland and axillary region is necessary - in order to localize the formation identified in the image, assess the degree of enlargement and structure of the lymph nodes in the axillary region.

HOW TO PREPARE FOR A MAMMOGRAPHY?

Mammography does not require special preparation. You must arrive at the x-ray room at the appointed time and have a change of shoes, directions, towel or sheet with you. After being invited to the office, you must provide your passport details to the laboratory assistant to be entered into the database. Then you need to take off your outer clothing, exposing the mammary glands, go to the mammograph and follow all the instructions of the laboratory assistant. Of course, you need to follow the rules of hygiene and come to the examination after washing yourself - respect the X-ray room staff.

IS MAMMOGRAPHY HARMFUL?

Mammography is a study involving irradiation of the mammary glands. Since the volume of tissue exposed to radiation is small, the overall effect on the body is minimal. On average, the dose received during one mammography examination is 0.03-0.1 mSv, which is similar to the radiation exposure during fluorography. The dose depends on the following points: the type of device (film devices have a higher dose, modern digital devices have a lower dose), the volume of irradiated tissue (the larger the volume, the higher the dose). In general, mammography refers to studies that are accompanied by low radiation exposure - unlike CT and some other x-ray diagnostic methods. Therefore, there can be only one answer to the question of how many times a mammogram can be done - as many times as needed for an accurate diagnosis. In this case, the doctor prescribing the study should, if possible, strive to avoid additional radiation exposure and, in the case of similar information content, prefer other, non-ionizing diagnostic methods (ultrasound, MRI of the mammary glands).

DESCRIPTION OF MAMMOGRAPHY AND Bi-RADS SCALE

Today, when assessing the mammary glands, a classification is used - the Bi-RADS scale. What does Bi-RADS mean? According to this scale, the radiologist, when describing radiographs, sets a certain category of changes.

If no pathological changes are detected, the radiologist writes in the conclusion: Bi-RADS 1. This means normal.

Changes that are not the absolute norm, but acceptable, can also be identified, for example, large single calcifications, calcification of the walls of blood vessels, widespread fibrosis, local areas of fibrosis, age-related involution of the glands and the predominance of adipose tissue in the structure of the gland. In this case, the radiologist can write Bi-RADS 2. This means there is nothing to worry about here either.

This is what the normal mammary glands of an elderly woman look like. The image shows the mediolateral oblique projection, one of the standard ones. Yellow arrows mark the shadows of the pectoral muscles. Please note that the predominant tissue is adipose; multiple inclusions of connective tissue in the form of “strands” are also visible. The glandular tissue is practically invisible. This is a normal option for women over 45 years of age who are in menopause and not taking hormonal medications.

If any suspicious changes are detected that the doctor cannot consider completely benign, the doctor will make a conclusion about the Bi-RADS 3 category and recommend an ultrasound, consultation with another specialist (mammologist, oncologist, surgeon) or a repeat mammogram in 3-6 months. For example, it is possible to distinguish a simple cyst from a fibroadenoma or from a cancerous tumor, but sometimes it is difficult. In this case, the result of mammography is considered doubtful.

Fibroadenoma on mammography, requiring follow-up. A large formation in the mammary gland is visible, having a heterogeneous structure due to the inclusion of calcium (milky white). Organized fibroadenomas usually look like this, and the radiologist is very tempted to make a confident conclusion about benign changes. However, this is wrong. When identifying such formations, it is necessary to set a categoryBi-RADS 3 and prescribe additional ultrasound or monitoring after 6 months. This will help distinguish fibroadenoma from cancer.

If the radiologist is inclined to believe that the changes he has detected are most likely caused by cancer, he sets the Bi-RADS category 4. This means that, most likely, we are talking about a malignant tumor - to make sure of its nature, the doctor must order a biopsy and histological examination.

If the conclusion says Bi-RADS 5, this is an unfavorable result - the doctor has no doubt that the formation he identified is truly a malignant tumor. After the study, it is necessary to decide on the verification of the tumor and treatment methods.

Mammograms revealed a malignant neoplasm in the left breast. It is large in size - at least 2 cm in diameter, irregular in shape, with “radiant” edges due to tumor lymphangitis. In addition to the formation marked with a red arrow, there is another important sign of malignancy - nipple retraction (blue arrow). In this case, the patient needs a biopsy to verify the tumor, a chest CT scan to detect metastases in the lungs and tumor growth into the chest wall, and in their absence, surgical treatment (mastectomy) followed by chemotherapy and radiation therapy.

If the conclusion says Bi-RADS 0, this means that there is not enough data to make a conclusion. You must provide an archive of images or perform the study again.

The Bi-RADS standard is currently the main one in the world. In Russia, an increasing number of mammologists are also switching to the Bi-RADS classification.

If you were given a mammography report without specifying a Bi-RADS category, you can always get a Second Opinion on the images and receive a qualified description according to modern standards.

WHEN SHOULD I EXPECT THE CONCLUSION?

The result can be obtained a few minutes after the study, or maybe after a few days. It all depends on the doctor’s workload. At the same time, the following trend can be observed: in private clinics the results are prepared faster.

At the same time, you need to understand that the more time the doctor has to prepare the result, the more thorough analysis of mammograms he can conduct. Accordingly, the risk of making a mistake becomes less.

SECOND OPINION ON MAMMOGRAPHY

Today, consultations using the Second Opinion system are increasingly used - review of mammography results in specialized centers. This interpretation of mammography is expert, because the radiologist conducting it has extensive experience in diagnosing breast cancer. This can be useful when study results are questionable or contradictory. There are cases when the patient himself doubts the doctor’s conclusions and wants to double-check the conclusion.

Breast diseases are the most common pathology faced by middle-aged and older women. Almost 15% of them are cancer. This means that effective preventive screening of the population is necessary to detect the disease at an early stage of development. The main one is mammography.

Breast mammography is an X-ray examination method that has a high sensitivity and specificity. This examination is available to all segments of the female population, is organized en masse in medical institutions and is the “gold standard” for detecting tumors.

Mammography is performed on all older women at certain intervals.

Also, an extraordinary study is prescribed if there are certain indications, such as:

palpable hard or soft formation in one of the glands;
visual deformation of the nipple or any other area;
the appearance of blood when pressing on the nipple;
local pain, signs of swelling, change in skin color, violation of symmetry on both sides.

Women of the young age category are referred for mammography under the following conditions:

risk group for breast cancer (close relatives have been diagnosed with a malignant neoplasm);
cancer of the uterus or ovaries;
inability to get pregnant;
diseases of the endocrine system;
surgical interventions on mammary organs in the past.

What does breast mammography show?

Mammographic imaging of the mammary glands may show cysts, mass formations (tumors), and calcifications. The general type of structure of the organ is also assessed (glandular, fibro-fatty, mixed with a predominance of one of the components). Attention is paid to the milk ducts, their structure and diameter.

Some mammographs are equipped with equipment for a needle biopsy, which is performed immediately to confirm or exclude the malignant nature of the process.

When to do a mammogram of the mammary glands?

Mammography is performed as a preventative measure for all women over 40 years of age once every 2 years. At the discretion of local institutions for the female population over 50 years of age - once a year.

In addition, there are unscheduled indications for this type of examination.

Carrying out a mammogram while breastfeeding is completely acceptable.

During pregnancy at any stage, it is preferable to use the ultrasound method due to the absence of side effects, primarily radiation exposure to the body of the mother and fetus. Carrying out a mammogram during breastfeeding is quite acceptable, but it is not very informative for a doctor. It is recommended to use other auxiliary studies.

It is considered most correct to undergo a mammological examination on days 5-13 of the menstrual cycle, i.e. in the first phase. In the second phase, the breast tissue undergoes some hormonal changes: the ducts expand, the structure of the glandular component changes, and swelling of the soft tissues may appear. In this case, the result may be unreliable, and the examination will be endured with a feeling of discomfort and pain.

During menopause, mammary organs can be examined at any time.

How often can I do it?

According to basic recommendations, mammography should be performed no more than once a year. But in urgent cases, up to 2-3 times are allowed. If more frequent examinations are necessary, it is reasonable to use auxiliary methods - ultrasound (ultrasound), magnetic resonance imaging (MRI).

How to prepare?

No special measures are required before the manipulation. The results of mammography are not affected by food or liquid intake. The only recommendation is to avoid using cosmetics for the skin of the axillary area on the day of the study.

Before the procedure, you should remove all neck jewelry, raise your hair, and completely free your chest from clothing.

The radiologist or laboratory assistant warns the woman about all possible side effects, asks the day of the menstrual cycle, and asks about pregnancy at the time of the mammary gland examination.

To correctly interpret changes in the mammary organs, you need to have with you the protocols of previous studies (mammography, ultrasound, MRI).

How is a breast mammogram done?

Mammography is carried out in the X-ray room, where the mammography machine is located. The woman is shown how to position herself next to him. The position depends on the type of equipment (standing or sitting). Next, a protective apron made of lead material is placed on the waist area, covering the lower abdomen. The mammary glands are placed on a plate intended for this purpose, and the chest is pressed on top with a similar plate. Next, the x-ray technician leaves the room and turns on the machine remotely. Exactly the same actions are repeated on the other side. The whole procedure takes no more than 5-10 minutes.

If a pathology is detected, the woman may additionally undergo radiography in a different projection - lateral and/or oblique. At the discretion of the doctor, a targeted mammography is possible, when the affected area of the gland is directly imaged on an enlarged scale.

A photo with a description can be received on the same day. Some clinics are equipped with digital equipment that provides more detail in the resulting image. All information can be saved on electronic media and used at any time.

On the first day, a woman may complain that her breasts hurt after a mammogram. This is due to the mechanical pressure of the plates, does not last long and eventually goes away on its own.

Other X-ray examinations should be rescheduled on this day so as not to exceed the permissible radiation dose.

Mammography or ultrasound of the mammary glands - which is better?

Both methods, mammography and ultrasound, are highly accurate and specific for the presence of breast tumors. Ultrasound is preferable if visualization of areas located near the chest from different angles is necessary. These areas are difficult to reach for x-rays.

In addition, the ultrasound method more accurately differentiates the cystic and solid components of the tumor, reveals small pathology, and shows the presence of blood flow. It is also more informative in young females due to the increased density of organ tissue at this age. Ultrasound can be used at any stage of pregnancy.

Ultrasound allows you to analyze the size and shape of lymph nodes - an important marker for differential diagnosis between benign and malignant formations.

However, mammography makes it possible to detect single or multiple small calcifications, extensive tissue restructuring, and precise identification of the type of cyst, which is impossible with ultrasound.

Thus, both studies are complementary to each other. Combining them together significantly increases the accuracy of diagnosis and should be used when identifying pathology.

Decoding the results

The results of mammography are assessed by a radiologist. The conclusion is issued on the same day. The research protocol describes the types of tissues that make up the mammary gland (fibrous, glandular, fatty), their relationship with each other, homogeneity or heterogeneity of the structure.

The shape of the organ is analyzed: round, oval, lobed or irregular. The size of the ducts is indicated (normally up to 0.4 cm in women of childbearing age, up to 0.2 in menopause), whether they are straight or convoluted, contain homogeneous or inhomogeneous contents, in which area they are better developed.

The age of the patient must be taken into account. In women over 40 years of age, involution processes begin (the glandular component is gradually replaced by fibro-fatty component). Mammography for fibrocystic mastopathy shows that during this period the glandular component predominates.

Dilated ducts and cysts are also clearly visible on x-rays. The doctor describes in detail their location (using a watch dial for convenience), diameter, contours, and internal contents. Types of cysts are presented as simple and complicated (festering).

The space-occupying formation stands out quite well on the mammogram, as it is accompanied by a darkening symptom on the X-ray film. Its presence is confirmed in two projections. If visualization occurs in only one projection, then they speak of a focus of compaction in the mammary gland.

Tumors are described qualitatively by analogy with cysts, only the contours (smooth, uneven, presence of a capsule), density (low, mixed, high, asymmetrical), the presence and main characteristics of calcifications are analyzed in more detail.

It is now customary to assess the condition of the mammary organs according to the international system for describing and processing data BI-RADS (Breast Imaging Reporting and Data System), which is used in most countries.

The resulting changes are expressed as points. This algorithm accurately indicates to the attending physician further tactics for managing the patient and the necessary therapeutic measures. BI-RADS creates continuity between all treatment and diagnostic links that a woman goes through.

The scale includes 7 categories: 0 and 3 – cases subject to auxiliary research, re-monitoring after six months, 1 and 2 – sent to the treating gynecologist, 4 and higher – consultation with an oncologist, fine-needle biopsy is recommended.

The quality of the examination also depends on the experience and training of the specialist. In addition, there is a small percentage of false-positive diagnoses, which once again confirms the need for an integrated approach to the examination.

Signs of a benign tumor on a mammogram

Mammography can differentiate or suspect the nature of the formation. The main disadvantage is the difficulties encountered in women under 35 years of age due to the increased density of the organ parenchyma.

Among the benign focal changes in the mammary gland there are lipoma, fibrolipoma, leaf-shaped fibroadenoma, fibroadenolipoma, etc. They are characterized by the following signs:

clearly defined, smooth boundaries;
shape in the form of a circle, oval or lobes;
homogeneous structure;
absence of small calcifications;
low density.

Signs of a malignant tumor on a mammogram

Breast cancer appears on mammography with certain properties:

irregular or lobed shape;
fuzzy (blurry), uneven contours;
asymmetrical density;
germination into healthy tissues;
violation of architectonics;
the presence of a local accumulation of small (up to 1-2 mm) calcifications in the structure or duct;
enlargement and pathological changes in lymph nodes;
thickening, swelling of the skin and subcutaneous fat layer above the tumor.

Other distinctive signs of malignant pathology in the mammary glands are the lack of compressibility and mobility of the formation, the vertical orientation of germination into the organ.

Mammography is an examination of the mammary glands using a mammograph (X-ray machine). This procedure is the most common method of breast examination. Its information content is more than 90%. Mammography can detect breast cancer at an early stage. Early diagnosis of the disease will help to completely get rid of or minimize the damage from the oncological process.

The quality of the examination depends on the equipment and the qualifications of the radiologist. The image clearly shows the structure of the mammary gland - connecting vessels and ducts. When abnormal foci are found, their size, location, shape, and structure are recorded.

What are the indications for the procedure? Is X-ray radiation harmful? How often should you have a mammogram? Similar questions interest women who are concerned about their health.

What is mammography

Mammography is an x-ray examination with a low dose of radiation. The procedure is a screening method for diagnosing mammary glands. It is often prescribed to detect breast diseases.

Mammography - what is it? A photo of the procedure is evidence that this is a non-invasive examination method. That is, during its implementation there is no invasion of the human body with the help of needles or other medical instruments.

Mammography can detect tumors, lumps, or other changes in a woman’s breast area.

Who should have a mammogram?

An annual mammogram can detect cancer at an early stage. Therefore, doctors advise regularly undergoing this medical examination. This procedure is especially relevant for women over 40 years old. At this age, hormonal changes begin that can lead to abnormalities in the breast tissue. You should definitely undergo the procedure if:

there is discharge from the nipples;
lumps and chest pain appeared;
deformation of the shape of the breast or nipples has occurred.

Mammography is a diagnostic procedure that is necessary to assess the patient’s condition. After 35 years, it is mandatory for all women. It is enough to undergo the procedure once every 2 years to identify tumors. After age 50, mammograms are performed annually.

If there is a genetic predisposition (there have been cases of breast disease in the family), you should undergo mammography from the age of 30.

If malignant tumors are detected, the procedure must be done once a month. It will allow you to trace the dynamics of the development of formations.

What does the procedure reveal?

Mammography can detect benign and malignant neoplasms. The procedure allows you to analyze changes in the mammary gland, their size and distribution.

Cyst. This fluid cavity is a common occurrence in the mammary glands. It is not a cancerous disease. But mammography, unfortunately, does not allow distinguishing a cyst from a malignant tumor - further examinations are needed.

Fibroadenoma. Tumor-like formations that are subject to growth. More common in young women. They are not malignant.

Calcifications. Small, numerous accumulations of calcium salts in tissues can be the first sign of the initial stage of cancer. Large lesions are most often not associated with cancer. However, the presence of calcifications in the mammary gland may be due to the presence of an oncological process.

Even if there is a lump on only one side, both mammary glands are examined. This is done for comparison pictures and to identify changes in the other breast. If you have pictures of past procedures, you need to show them to the radiologist.

Contraindications to the procedure

Breast mammography is an X-ray with a small dose of radiation. Therefore, doctors do not recommend it:

pregnant women;
nursing mothers.

How to prepare for a mammogram

Before the procedure, worried women often ask: “Does mammography hurt or not? How will I feel? Mammography is an absolutely painless procedure. It lasts about 10-30 minutes. Before the procedure, the doctor will tell patients on what day the mammogram is done. However, for urgent diagnosis, the day of the cycle is not important.

Some women may experience discomfort during the examination if they have chest pain. Therefore, on the recommendation of a doctor, they may be prescribed painkillers.

Jewelry should be removed during the procedure. The individual characteristics of patients will be fundamental for calculating on what day a mammogram is done. Usually this is 6-12 days from the start of the cycle.

If you have breast implants, you should tell your doctor. On the day of the procedure, you cannot use deodorant or cream. The armpit and chest area must be clean so that darkening does not appear on the film.

How does the procedure work?

Before the procedure, patients ask: “Is mammography an ultrasound? How is the examination going?” Both methods do not require special training from women. X-ray examination differs from ultrasound examination.

Ultrasound allows you to monitor the condition of soft tissues. And visualization of dense ones is better diagnosed on mammography. Therefore, if the patient’s condition is of concern, then both examinations are prescribed.

They pass through the human body, capturing the image on a special film. Mammography is a procedure that is performed on an outpatient basis. The radiologist places the patient's breast on the platform and fixes it. Several pictures are taken (top to bottom and side), during which the patient changes position.

For a clear image, the woman should freeze and hold her breath. The principle of the procedure is reminiscent of fluorography. But, unlike her, the radiologist takes pictures of each breast separately. During the procedure, the breast is slightly compressed by the device. Why is this being done?

To even out the thickness and unevenness of the breast.
To get a clearer image.
To distribute the soft tissue, visualizing compactions and possible formations.
To reduce the radiation dose - the smaller the tissue layer, the less dose it requires for a full image.

After receiving the images, the radiologist analyzes them and provides documentation to the attending physician. In some cases, mammography descriptions are received in person. Based on the results of the procedure, the attending physician may prescribe additional examinations to clarify the details of the diagnosis.

Types of mammography

There are 2 types of X-ray mammography according to the research method:

Film.
Digital.

Film mammography (from the Greek mamma - “mother” and grapho - “to draw”) has been used since the 60s of the last century. The image in this method is recorded on film.

In recent years, digital mammography has become increasingly popular. It allows a more detailed examination of a woman’s mammary glands and reduces radiation exposure to the body.

Depending on the purpose, there are 2 types of mammography:

Preventive (prescribed by the attending physician when the patient reaches a certain age).
Diagnostic (prescribed if a neoplasm is suspected).

Features of digital mammography

In digital and film mammography - for a better image - the breast is sandwiched between two plates. Studies have shown that in 20% of cases, film examination does not detect the presence of breast cancer.

Another thing is digital mammography. We have already discussed what this is. What is its advantage? In the digital examination method, X-ray film is replaced by detectors (similar to them are found in digital cameras). They are the ones who convert X-rays into electrical impulses. Such signals can be printed, saved in a computer, or made copies.

Digital mammography is the best option for:

patients with dense breasts;
women under 50 years of age;
patients before menopause (or if menopause lasts less than 1 year).

As for women after menopause (or after 50 years), they can be examined in any way: both film and digital methods will be equally effective. This is due to the fact that breast density decreases with age, which allows for high-quality images in both cases.

Is the procedure harmful?

Some patients, due to their incompetence, claim that mammography is harmful. Supposedly it is large, so it is better to do an ultrasound. Doctors assure that if the standards for conducting x-ray examinations are followed, the damage to health will be minimal.

Firstly, there are standards for undergoing x-ray procedures throughout the year.

Secondly, the dose for radioactive exposure is too small (less, by the way, than with fluorography).

Ultrasound and x-ray examination complement each other. Therefore, doctors often prescribe both diagnostic methods.

Pros of mammography

The examination reveals abnormal glands. Mammography allows cancer to be diagnosed at an early stage. And this, in turn, will help fight cancer. There are many methods for treating early stage cancer.

Disadvantages of mammography

It is possible to obtain incorrect data, so it is better to combine several methods of breast examination. In case of an incorrect positive result, additional mammography and ultrasound are prescribed. Rechecked results most often turn out to be normal. In the case of examining women under 30 years of age, the procedure may be ineffective (breast density makes a qualitative study difficult).

Additional methods of breast examination

Mammography with tomosynthesis is a three-dimensional image of the breast in the form of thin (1 mm) sections. This is a new method that has not undergone enough clinical trials.

MRI is a more gentle method that does not use harmful radiation. But it is not able to display some anomalies.

Optical mammography is a method using projection and tomography devices. Not applicable for diagnostic type of research. Optical fluorescence mammography involves introducing phosphors into the tissue. This helps to see the growth of the tumor.

Ultrasound is an ultrasound examination that allows you to get a clear picture from different angles. It is used during pregnancy and lactation, as it is less harmful than the x-ray method.

A biopsy is the removal of tissue samples for further examination. It is this method that allows you to verify the presence or absence of breast cancer.

Why is it needed?

Mammography is used to diagnose changes in the mammary glands. Low doses of radiation will not harm the patient's health. Minor discomfort during the procedure makes it optimal for detecting cancer at an early stage.

Finally, we list the unfavorable factors that contribute to the development of cancer at an early age:

abortions;
early menstruation (up to 11 years);
hormonal changes (taking oral contraceptives, thyroid disease, being overweight or underweight);
late menopause (after 55 years);
first birth at a late age (after 30 years);
gynecological diseases;
genetic predisposition;
regular stressful conditions.

Early diagnosis will allow you to cure the cancer completely or perform surgery with minimal damage (for example, remove only the tumor, do without chemotherapy). Regular examination will help maintain health for many years.