Breast Cancer: A Leading Cause of Death in Women

In developed nations, breast cancer is the most prevalent malignant tumor among women, both in terms of incidence and mortality. It's estimated that one in ten women will develop breast cancer in their lifetime. Traditionally, a palpable, painless lump or thickening in the breast, often self-discovered, was the typical presenting symptom. Other signs include skin irritation, changes in skin texture, nipple retraction, pain, and nipple discharge.

To diagnose this disease early, regular breast ultrasound and mammograms are crucial.

 

Mammography

What is a mammogram?

A mammogram is a quick radiographic breast examination that explores the entire breast with high sensitivity, particularly for early-stage tumors. Mammography often detects the disease even in the absence of symptoms or when the lesion is not yet palpable. This allows for early intervention, improving recovery chances and saving lives. For those concerned about ionizing radiation, modern equipment uses low X-ray doses, enabling safe repeat examinations. No preparation is needed. For women of childbearing age, it's advisable to schedule the exam during the first half of their menstrual cycle when breasts are less tender and pregnancy can be ruled out.

It's important for the radiologist to have comparative data from previous examinations. Therefore, bring all documentation from prior breast imaging studies.

 

Mammography is particularly recommended after age 40. Breasts change with age: fatty tissue increases and appears darker on mammograms, while glandular tissue decreases and appears lighter. Suspicious formations are more easily visible against a dark background. In younger women, the glandular tissue (lighter) predominates, making it harder to detect small formations. Ultrasound is generally preferred for younger women.

 

How is a mammogram performed?

Mammography uses an X-ray machine. The breast is placed on a support and compressed using a plastic plate (compressor). Typically, two views (craniocaudal and mediolateral oblique) are taken per breast, totaling four X-rays.

Additional views may be necessary. Image acquisition takes only seconds per view; the entire exam takes 10-15 minutes. No medication or contrast agent is used. No preparation or anesthesia is required. Patients can leave immediately after the exam; no observation period is needed.

 

Breast Ultrasound

What is breast ultrasound?

A breast ultrasound is a harmless ultrasound procedure that produces images of breast anatomy, the chest wall, and nearby lymph nodes. The operator follows specific protocols, instantly evaluating images to identify solid or cystic nodules and examine milk ducts. Doppler imaging can assess blood flow in nodules, which can help characterize abnormalities. The combination of ultrasound and elastography is particularly useful for nodule classification. Elastography differentiates between elastic (generally benign) and inelastic (suspicious) nodules.

 

How is breast ultrasound performed?

The operator moves the probe across the skin, examining underlying tissues. Sound pulses reflect off tissue interfaces, creating echoes. These echoes are converted into electrical pulses, digitized, and processed to generate the image. The ultrasound exam is usually complemented by a medical history and breast palpation.

 

Why is breast ultrasound different from mammography?

Breast ultrasound is a key diagnostic tool. In women under 40, it's the first choice. Suspicious lesions are further evaluated with mammography and potentially a biopsy. In women over 40, ultrasound complements mammography; combining both methods increases accuracy, especially in dense breasts. Ultrasound better detects lesions in younger breasts (higher glandular component), while mammography is better for breasts with more fatty tissue (older patients). Ultrasound is crucial in breast surgery for diagnosing and classifying many nodular conditions, and guiding procedures (biopsies, cyst removal).

It helps characterize breast thickening or swelling detected during clinical exams and clarifies abnormalities found on mammograms.

 

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