Wednesday, October 18, 2023, 01:09
Breast cancer is a reality that affects a large number of people around the world. Although it is a much more common disease among women, it can also affect men, as Dr. Marta Huertas, radiologist at the Quirónsalud Murcia Hospital, points out.
Without a doubt, in the fight against breast cancer, Prevention is one of the fundamental pillars of early detection. For this reason, mammography has become an essential tool in this battle, although its use and effectiveness raise numerous questions that will be answered below.
What is a mammogram and what type of information does it provide us?
Mammography is the radiological test that allows the study of the breast through the use of X-rays. It is a quick technique that does not require preparation and, in general, is well tolerated, especially with current equipment.
Conventionally it is a test that is carried out in two dimensions. However, current equipment (tomosynthesis) allow a breast study in three dimensions.
What advantages does mammography with tomosynthesis offer compared to regular mammography?
Through tomosynthesis, multiple planes of the breast are obtained, reducing the overlap of structures and allowing the identification of lesions that could be hidden, so that with this technique it is possible to diagnose lesions in earlier stages.
Therefore, the need to perform additional tests or repetitions compared to conventional mammography is reduced and the assessment of dense breasts is improved.
At what age should a person start having a mammogram? How often should it be repeated?
In the case of patients asymptomatic and without risk factors of breast cancer, all screening programs agree on the recommendation to perform bilateral mammography every two years between the ages of 50-69.
According to the International Cancer Research Centre, screening in this age group results in an estimated reduction in breast cancer mortality of 40%. Hence the importance of performing breast controls in the asymptomatic population.
On the other hand, Dr. Huertas tells us that current evidence advocates the extension of this age range between 45-74 years. Something that is already being carried out in some autonomous communities in Spain following the recommendation of the European guides. On the other hand, if we pay attention to the American guidelines, they even propose lowering the starting age of screening to 40 years.
However, in the case of asymptomatic patients with risk factors of breast cancer, the performance of breast studies must be personalized. Thus, the type and degree of risk is always assessed.
However, in the presence of any breast symptoms, regardless of the patient’s age, it is recommended to consult a doctor as soon as possible.
What symptoms should alert us and lead us to schedule a mammogram?
Breast cancer is not only the most common tumor diagnosed in women, accounting for almost 30% of all cancers diagnosed in women, but it is also the most diagnosed tumor worldwide. Statistics tell us that 1 in 8 women will develop breast cancer throughout their lives.
On the other hand, we must not forget about men, since breast cancer affects men in 1% of cases.
When is it advisable to go to the doctor?
Dr. Huertas recommends consult with a doctor in view of:
– The presence of a breast or axillary lump.
– The sinking, thickening or redness of the skin.
– In case of retraction, peeling or discharge from the nipple.
– If changes occur in the size or shape of the breast.
What is a tomosynthesis-guided vacuum-assisted biopsy?
Tomosynthesis-guided vacuum-assisted biopsy is a biopsy system integrated with 3D mammography. This allows the professionals of the Quirónsalud Murcia Hospital to carry out a histological analysis of lesions that are not visible by other techniques such as the ultrasound.
One of the most important benefits it has in the diagnosis of breast cancer, according to what Dr. Huertas tells us, is that it is a outpatient procedure. Consequently, the breast radiologist performs it under local anesthesia.
Another benefit is that, as it is guided by tomosynthesis, allows you to study injuries such as distortions, which in some cases are poorly identifiable with conventional mammography. Furthermore, this implies less radiation and a lower procedure time than in two-dimensional vacuum-assisted biopsies.
What is mammography with contrast? Why is it so important for the diagnosis of breast cancer?
Breast cancer causes the formation of new vessels that supply it (neoangiogenesis) and which can be identified by introducing contrast.
Knowing this, contrast-enhanced mammography is a novel technique similar to conventional mammography, but is performed with intravenous iodinated contrast (just like CT). In this way, it allows not only the obtaining of anatomical information (like conventional mammography), but also functional information, as it detects increases in vascularization that could indicate a tumor lesion.
This is a quick, outpatient procedure. indicated in patients in whom there is a contraindication to performing magnetic resonance imagingamong others:
– Patients with claustrophobia.
– Carriers of incompatible devices, such as pacemakers.
– Patients with mobility difficulties.
Likewise, this method is used in the following situations:
– Determine the local stage of breast cancer.
– Examine patients who have undergone surgery for breast cancer in the past and in whom tumor recurrence is suspected.
– Evaluate patients with a high genetic risk for breast cancer and who have previous mammograms with dense breasts.
– Control the response to chemotherapy treatments.
– When the results of conventional imaging tests are not definitive.
In the battle against breast cancer, prevention is essential. For this reason, at the Quirónsalud Murcia Hospital they are adopting advanced approaches beyond conventional mammograms to effectively address breast lesions. These technologies and methods, such as tomosynthesis, contrast-enhanced mammography, and 3D mammography-guided biopsy, provide greater control and precision in early detection and diagnosis. In fact, they allow lesions that cannot be assessed using other techniques to be located, minimizing radiation and procedure time.
For all these reasons, the Quirónsalud Murcia Hospital is at the forefront in the fight against breast cancer.
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