Mammography In Bangalore
What is mammography?
- Mammography is a sophisticated imaging technique which plays a crucial role in breast health assessment.
- It is a specialized X-ray imaging method which is a powerful tool utilized to examine the breast tissue for early detection of cancer and other breast diseases.
How mammography works?
Guidelines for Early Detection of Breast Cancer:
- Increased Risk Considerations: Women with an increased risk of breast cancer, such as a family history, genetic predisposition, or a history of breast cancer, should engage in an informed discussion with their healthcare providers. This conversation should encompass the benefits and limitations of starting mammography screening earlier, considering additional tests like breast ultrasound or MRI, or opting for more frequent exams.
- Personalized Risk Assessment: Each woman’s breast cancer risk is unique, and it is crucial to talk with your healthcare provider about your personal risk factors. This personalized evaluation will help determine the appropriate age to initiate mammograms and the recommended screening frequency tailored to your individual needs.
- Updated USPSTF Recommendations: In May 2023, the U.S. Preventive Services Task Force (USPSTF) updated its recommendations, advising women to begin breast cancer screening with mammograms at age 40. Regular screening mammograms can play a significant role in early detection and improved treatment outcomes.
What are the reasons to get mammography?
1. Screening mammography
- Breast Cancer Screening: For women aged 40 years and above, mammography is recommended as a routine breast cancer screening tool. Regular mammograms help in the early detection of breast abnormalities, even in the absence of symptoms, leading to better treatment outcomes.
- Breast Pain Evaluation: Women with dense, “lumpy,” or very large breasts may undergo mammography for breast cancer screening. Physical examination can be challenging in such cases, making mammography an essential tool to detect any abnormalities.
- Dense or Large Breasts: Women with dense, “lumpy,” or very large breasts may undergo mammography for breast cancer screening. Physical examination can be challenging in such cases, making mammography an essential tool to detect any abnormalities.
- High-Risk and Breast Cancer History: Women with a high risk of breast cancer due to family history, genetic predisposition, or a personal history of breast cancer may undergo routine mammography for proactive surveillance and early detection.
2. Diagnostic mammography
- Breast Lump or Axillary Mass: The presence of a palpable lump in the breast or underarm (axillary mass) may prompt a diagnostic mammogram to investigate its nature and potential cause.
- Thickening or Swelling: If you notice thickening or swelling in a specific area of the breast, a diagnostic mammogram can help in determining its origin and whether further evaluation is necessary.
- Dimpling of Breast Skin: Any changes in the appearance of breast skin, such as dimpling or puckering, warrant a diagnostic mammogram to investigate possible underlying causes.
- Changes in Breast Size or Shape: If you observe a change in the size or shape of your breast, a diagnostic mammogram can provide detailed imaging to assess the area of concern.
- Heaviness in One Breast: A sense of heaviness or persistent discomfort in one breast may prompt your healthcare provider to recommend a diagnostic mammogram for further evaluation.
- Nipple Retraction: The pulling inward of a nipple (nipple retraction) may be indicative of breast health issues, and a diagnostic mammogram can help assess the condition.
- Nipple Discharge: Unexplained nipple discharge can be evaluated through diagnostic mammography to determine its cause and significance.
- Breast Pain: Persistent breast pain that raises concerns may lead to a diagnostic mammogram to assess the breast tissue.
- Redness, Scaling, Rash, or Irritation: Any skin changes, such as redness, scaling, rash, or irritation of the breast or nipples, may prompt the need for a diagnostic mammogram.
- Itchy Breasts: Persistent itching in the breast area may be further investigated through a diagnostic mammogram to identify potential underlying issues.
How to prepare for mammogram?
- Menstrual Cycle Scheduling: If your breasts tend to be tender during the week before or during your menstrual period, it’s best to avoid scheduling your mammogram during this time. Instead, try to schedule the exam one to two weeks after your period starts for more comfort and accurate results.
- Personal Hygiene: On the day of your mammogram, refrain from using any deodorant, powder, lotion, or perfume on your breasts or underarms. These products may interfere with the mammography results.
- Clothing and Jewellery: During the mammogram, you will need to remove your clothing from the waist up and change into a patient gown. A secure locker will be provided for your personal belongings. To ensure clear images and prevent interference, remove all piercings and leave all jewelry and valuables at home.
- Breast Implants: If you have breast implants, please inform the medical office when scheduling your mammogram. Special considerations may be required for women with breast implants during the imaging process.
Advantages of mammography over Ultrasound and MRI:
- Detection of Microcalcifications: Mammography is highly sensitive in detecting microcalcifications, which are tiny calcium deposits that can be early signs of breast cancer. These microcalcifications may not be as visible on ultrasound or MRI.
- Screening for Early-Stage Cancer: Mammography is a widely used screening tool for breast cancer, especially for women over the age of 40. It can detect small tumors at an early stage, allowing for early intervention and improved treatment outcomes.
- Cost-Effectiveness: Mammography is generally more cost-effective compared to MRI, making it a practical choice for large-scale breast cancer screening programs.
- Availability and Accessibility: Mammography machines are more readily available in most healthcare facilities, making it a convenient option for routine screening and diagnosis.
Limits of Mammography:
- Breast Tissue Density Variation: Breast tissue density can vary significantly among women. Denser breasts pose challenges in imaging and accurately assessing tumour diagnosis. As a result, the sensitivity of mammography in detecting cancer can vary widely.
- Difficult Cases: In some instances, mammography alone may not be sufficiently sensitive or accurate in detecting breast cancer, especially in cases with dense breast tissue. Additional imaging technologies, such as ultrasound or magnetic resonance imaging (MRI), are used to enhance the sensitivity of the examination.
Complementary Imaging Technologies
- Ultrasound and MRI: These imaging methods are valuable complementary imaging methods to mammography. Ultrasound is often used to further evaluate suspicious findings on a mammogram and assess breast abnormalities in women with dense breasts. MRI is particularly useful for high-risk patients or when the mammogram and ultrasound results are inconclusive.
- Molecular Breast Imaging (MBI): MBI is a promising nuclear medicine technique that has shown effectiveness as a less expensive alternative to MRI in clarifying test results, especially for patients with dense breasts. During MBI, patients receive an injection of radioactive molecules that target cancer cells. Special cameras detect radioactivity, allowing for the identification of cancer cells in breast tissue. Molecular breast imaging can improve sensitivity in detecting breast cancer, especially in cases where mammography and other imaging modalities may not be as effective. It has the potential to provide valuable insights and aid in early cancer detection.
Ultrasound over mammography:
- Evaluating cystic breast lumps: Ultrasound can help determine if the lump is a fluid-filled cyst (benign) or a solid mass (which may require further investigation).
- Dense Breast Tissue: For women with dense breast tissue, mammograms may be less effective due to overlapping tissues. In such cases, ultrasound can provide additional information and be used as a complementary screening tool.
- Younger Women: In younger women (under age 40), whose breast tissue is denser, ultrasound can be preferred as an initial imaging method for breast evaluation.
- Pregnant / lactating Women: Ultra-sonomammography is safe in pregnant and Lactating women, because it does not use radiation.
Risks in mammography:
Common medical terms in mammography reports:
- Clustered Breast Calcifications or Microcalcifications: These are tiny white spots on a mammogram that represent small calcium deposits in the breast tissue. The significance of calcifications can vary, and further evaluation may be needed to determine their nature.
- Spiculated Mass: A spiculated mass refers to a lump with spikey borders resembling the shape of a starfish. This finding may raise concern for potential malignancy and usually requires additional investigation.
- Asymmetrical Density of Breast Tissue: Asymmetrical density refers to areas of breast tissue that appear different from the surrounding tissue. This may prompt further evaluation to determine the cause of the asymmetry.
- Skin Thickening: Thickening of the skin over the breast may be noted in the mammography results. Skin thickening could be a sign of an underlying condition that requires further assessment.
- Retraction: Retraction refers to areas of the skin or nipple pulling inward. This finding may warrant additional investigations to identify its cause.
- Focal Distortion: Focal distortion indicates that something is pressing on the breast tissue, leading to a distortion in the mammogram image. Further evaluation may be necessary to understand the cause of the distortion.
- Breast Tissue Density: The mammogram report may include a description of the density of your breast tissue. Breast tissue density can vary from person to person and may impact the interpretation of mammogram results.
BIRADS Classification in Mammography Reports:
- Incomplete Assessment – The mammogram report is incomplete, and further evaluations, additional views, or comparison with previous films are needed before an impression can be given.
- Negative – The mammogram shows no abnormal findings, indicating a normal and healthy breast appearance.
- Benign Findings – The mammogram reveals benign changes, such as benign calcifications or a benign fibroadenoma. These findings are non-cancerous and do not raise concerns.
- Probably Benign – The mammogram shows findings that are likely benign, with a 98% chance of not being cancer. Although likely non-cancerous, closer follow-up, such as another mammogram in six months, is recommended.
- Suspicious Abnormality – The mammogram indicates a suspicious abnormality that may require further investigation. This category can be divided into 4A, 4B, and 4C, with 4A having a lower chance of being cancer and 4C indicating a higher likelihood of the disease.
- Highly Suggestive of Malignancy – The mammogram shows findings highly suggestive of breast cancer, with a 95% or higher chance that the abnormalities are cancerous. In this case, a biopsy is typically recommended for definitive diagnosis.
Remember, early detection through screening mammograms can significantly impact treatment outcomes, and regular breast health screenings, despite age, is a proactive step towards maintaining your well-being.