The second most common type of breast cancer in Finland is usually poorly visible in a mammogram, i.e. an X-ray examination of the breasts.
In ordinary ones breast cancer examinations may miss one type of breast cancer.
The second most common type of breast cancer in Finland, lobular or glandular breast cancer, is usually poorly visible in mammography, i.e. breast X-ray examination.
“In that case, a mammogram alone is not enough, but an ultrasound examination of the breast is also needed. Sometimes, rarely, breast cancer does not show up in either test. No matter how it is done correctly, imaging studies are not always perfect,” says Terveystalo's chief physician, oncology specialist and docent Peter Bono.
However, magnetic resonance imaging is not always taken.
However, if the patient has clear symptoms, according to Bono, the next step after the mammography and ultrasound examination is an MRI of the breast.
“Some lobular breast cancers can be seen extremely poorly without an MRI. It is unfortunate.”
HS has told problems of diagnosis, among other things Maiju from Helenius in a telling story. Her breasts eventually had to be removed.
If the breast if something abnormal is seen in the ultrasound examination, mammography or magnetic resonance imaging, a needle sample is taken.
“If the radiologist detects a suspicious change in the breast in the imaging studies, a thick-needle sample is taken from it, from which the pathologist can make a cancer diagnosis. The radiologist makes a decision about the needle biopsy based on the images,” says Pihlajalinna's medical director, oncology specialist Sari Riihijärvi.
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Suspicion of breast cancer usually arises when a person finds a lump in their breast.
But if no changes are found in any of the imaging studies, it is difficult to take a needle sample, according to Bono.
“You have to find a target for the needle sample. If there is, for example, a two-centimeter change in the breast without it being visible in the pictures, the needle sample must not be aimed at the right place,” he says.
“Only if the change or pain point is close to the surface of the skin, a needle sample can be taken without ultrasound guidance. Another option is that the area can be removed.”
Suspected breast cancer usually wakes up in such a way that a person finds a lump in their breast, Sari Riihijärvi states.
“In this case, you should see a doctor immediately.”
Riihijärvi reminds that there can also be benign causes behind the lump, for example a cyst or mastopathy. Mastopathy means that the breast tissue is uneven.
Terveystalon's Bono states that imaging tests usually provide certainty as to whether a person has breast cancer or not.
“It is rare that both the mammography and the ultrasound examination are clean if there is cancer in the breast.”
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