Imaging Techniques Used in Breast Diseases

It is an examination method, where it is used

• It is used for cancer screening in women without complaints,

  It is used for diagnostic purposes in patients with complaints.

• Taking biopsy from non-palpable masses and so that it can be found accurately

It is the most important test used in breast cancer screening. The sensitivity of digital mammography is higher than normal mammography.

In mammography, two films are taken and examined in the CC and MLO directions. At the end of the report written after the examination, a rating called BIRADS is used.

BIRADS reporting system is like a common language, all physicians dealing with breast diseases can clearly understand what is intended to be stated when they see the report.

BIRADS (Breast Imaging Reporting and Data System) classification:

• BIRADS 0: It is not possible to comment on the patient with the examination performed, other examinations are required.

• BIRADS 1: No pathology was detected in the examination, it means everything is normal.

• BIRADS 2: The findings found in the examination are definitely benign lesions. p>

• BIRADS 3: The lesions found are most likely benign (98%), but there is a 2% risk of cancer. Patients in this group should be closely monitored at 6-month intervals for 2 years.

• BIRADS 4: It means that suspicious findings for cancer have been detected, a biopsy is required, an MRI examination may be required before biopsy. p>

  • BIRADS 4a: The risk of cancer is 2-9%

  • BIRADS 4b: The risk of cancer is 10-49%

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  • BIRADS 4c: The risk of cancer is 50-94%.

• BIRADS 5: The findings are high It means that it probably indicates cancer (>95%), a biopsy is required. Before the biopsy, an MRI should be requested and examined to see if there are other foci.

• BIRADS 6: It indicates that the patient has previously been diagnosed with cancer through biopsy.


 

Mammography How is the scan performed?

In mammography, the breast tissue is thinned by being compressed between 2 plates. There may be some pain during this time. It is recommended to have it scanned preferably one week after the end of menstruation to reduce the pain. The patient should not use deodorant and powder when going for the shooting, otherwise misleading findings will appear in the imaging.

In digital mammography, the radiation dose is 30% lower and the imaging quality is higher, and the images taken can be processed on the computer to make them better. There is no need to take additional shots.


 

Tomosynthesis

It is a shooting technique similar to mammography, in which mammography takes two-way shots. In tomosynthesis, 10 sections are taken, these are processed on the computer and a 3D image is obtained. It is 25% more successful in making a diagnosis than mammography. It is preferred in dense breast structure, but its use is not common because it is not available in every radiology center.

 

Breast Ultrasonography

As it is known, it works with sound waves, it is used to obtain more information about a detected lesion, for example, when a lesion is detected in mammography, we determine with ultrasound whether there is fluid inside that lesion, and also a lesion that is not seen in mammography can be seen in ultrasonography. It also provides guidance in procedures such as taking needle biopsy. If a non-palpable mass is seen on ultrasonography, a wire is marked before the surgery, which guides the surgeon to find the location of the mass.



 

Breast MRI.

 

Imaging is performed by administering contrast material intravenously, 

• It is of great importance in showing lesions that cannot be seen on mammography, 

• It is used for cancer screening along with mammography in high-risk patients.

• To check whether there is another mass other than the one detected in patients with suspected breast cancer. It is done for research. To plan before surgery or needle biopsy.

• For examination purposes in women who have had breast surgery before

• Breast prosthesis surgery It is performed for examination purposes in women who have been diagnosed with breast cancer.

• If chemotherapy was applied before surgery in patients diagnosed with breast cancer, it is performed to see the effectiveness of the treatment.

The reason why it is not used alone in routine cancer screening is that it cannot show small calcifications and precancerous lesions, which are cancer markers.


 

Metastasis of breast cancer (other organs and Imaging techniques that examine whether or not it spreads to tissues

• Lung radiography

• Computed tomography (CT scan), abdominal and is taken for the lung

• MRI (magnetic resonance imaging)

• Ultrasound

• PET scan examines the whole body for metastasis

• Bone scan is like PET, it examines whether there is metastasis to the bones


 

Other techniques in development

• Molecular Breast Imaging  MBI  alias   (Breast-Specific Gamma Imaging   BSGI)

• Positron Emission Mammography  PEM

• Contrast Enhanced Mammography CEM

• Optical Imaging Test

• Electrical Impedance Imaging EIT

• Elastography



 

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