Mammography (MRTG) – indications, preparations, course, price. At what age should I go for the examination? WE EXPLAIN

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Mammography is an x-ray examination of the breasts that can find cancer. Anesthesia is not administered during a mammogram. Currently used digital cameras can show even millimeter changes, which allows early detection of cancer. Should a woman with breast implants undergo a mammogram? How often should my breasts be examined?

Mammography is a low-dose x-ray that allows you to examine the breasts and detect any changes in them.

In recent years, two new MRTG methods have appeared that ensure even greater accuracy of the study: cyfrowa mammography (FFDM) oraz CAD mammography (ang. computer-aideddetection). We do not need anesthesia to perform it, and the devices available on the market detect even millimeter changes.

Mammography is a screening test to detect early cancer changes in women who do not report any disturbing breast symptoms.

It is also used in the diagnosis of breast diseases in people who have felt a lump in them, or have noticed breast pain or leakage of discharge from the nipple.

Find out what you should know about breast cancer

Screening mammography

Mammography plays a key role in recognizing early breast cancer. It is able to detect changes up to 2 years before they are found in self-examination or breast examination performed by a gynecologist.

According to the recommendations of the Polish Cancer Society, this test is recommended for women:

  1. 1 from 40 to 50 years of age – once every 2 years;
  2. after the age of 50 – once a year;
  3. between the ages of 50 and 69 – all women who have not developed breast cancer.

In addition, after 12 months, women in whose family:

• there is a BRCA 1 or BRCA 2 gene mutation;

• one of the immediate family members has or is suspected of having breast cancer.

Screening mammography considerations:

  1. Mammography should be performed within the first 10 days of the menstrual cycle;
  2. Under the National Health Fund program, women aged 50-69 who have not had an examination in the last 2 years are entitled to free mammography;
  3. Early detection of a neoplastic lesion enables quick treatment implementation, which increases the effectiveness of the therapy;
  4. Women with a family history of breast cancer or patients who are at increased risk of breast cancer for other reasons should have breast cancer screening more frequently. They are usually recommended to undergo the test annually, starting at the age of 40.

Diagnostic mammography – what can it detect?

Mammography is the basic test used to clear up disturbing symptoms, such as lumps, during self-examination or during a breast examination by your doctor.

  1. Talk to your doctor (gynecologist) before having a mammogram if you notice any changes in your breasts. It is also worth informing him if he has had surgery, is taking medication or if someone in the family has had breast cancer;
  2. Mammography should not be performed approximately one week before your expected period; The breasts are swollen and tender during this period. MRTG is best performed during the first 7 days after the first day of menstruation. Be sure to tell your doctor or radiological technician performing the examination if there is any chance that you are pregnant;
  3. On the day of the mammogram, it is not recommended to use deodorants, talcum powder or lotions in the armpits and breast skin. The chemicals they contain may crystallize and give an image of microcalcification in the test;
  4. If you experience any other discomforts on the day you are having your mammogram, such as breast pain, please inform the tester. She will handle the painful breast all the more carefully;
  5. If MRTG has been performed previously, take the last result with you. It will be useful to the doctor describing the test (for comparison);
  6. It is worth asking when and where the test result will be collected. Don’t assume that the lack of information about a bad result is a good sign;
  7. It is best to come to the examination in a comfortable two-piece clothing. This will make it easier to undress to the waist.

Before having a mammogram, your doctor may ask about:

  1. age;
  2. date of the last menstruation;
  3. pregnancy;
  4. breast-feeding;
  5. hormonal medications taken (e.g. birth control pills, hormone replacement therapy);
  6. breast surgery;
  7. if a family history of breast or ovarian cancer
  8. whether you have had breast tests before – if so, have the results with you.

Mammography and the risk of developing breast cancer

Women at increased risk of developing breast cancer are:

• have never given birth – pregnancy and breast-feeding have a protective effect on the breast;

• have had a child after the age of 35;

• started menstruating early (before the age of 11) and menstruating late (after the age of 54) – long-acting estrogens can stimulate the development of breast cancer;

• have had a mastectomy (surgery to remove the breast) for breast cancer – it has been shown that women who have had breast cancer are at an increased risk of developing this cancer in the other breast;

• XNUMXst degree relatives (mother, grandmother or sister) have / have had breast cancer or ovarian cancer – in the case of such a family burden, the risk of developing the disease is several times higher.

Check if pregnancy after the age of 35 is at high risk

Mammogram consists of a cubic box with a tube emitting X-ray rays. The device is specially adapted for breast X-ray and is only for this purpose. Two plates are attached to the box – the breast is placed on one of them, and the other one gradually squeezes it during the examination.

Mammography and X-rays

X-rays are a type of radiation similar in some respects to light or radio waves. When a beam of rays is directed at a given object (e.g. chest, breast), it passes through it, registering the image of the overexposed part of the body. During this process, the rays are absorbed by the tissues to varying degrees.

Dense bones or calcifications absorb most of the rays, which is visible in the photo as white. Soft tissues, adipose tissue and muscles absorb radiation to a much lesser extent, which is shown in the picture as gray (dark).

The air in the photo appears as black.

Until now, all MRTG results have been stored in the form of a photographic film. Currently, more and more often mammography is performed in digital quality, and the results are archived on CDs.

Mammography can be done in a clinic or hospital. In the latter case, however, it does not require hospitalization. During the examination, the radiological technician or the doctor places the breast in the appropriate position on the equipment plate. The gland is then compressed by a second plate (usually a plastic one). The technician will gradually increase pressure on the breast during the test.

A little squeezing of the breasts is necessary:

  1. in order to even out any lumps in the breast – so that all the breast tissue is clearly visible;
  2. that the density of the tissues can be evenly distributed and the small regularities are not obscured by the overgrown layers of the surrounding tissues;
  3. to keep the breast in one position so that the result of the slight shake does not blur the image.

Mammography can be performed in two positions – usually standing up (from top to bottom) and in an oblique-lateral position. During the examination, the woman may be asked to change position. After taking the appropriate position, stay in it. It is sometimes necessary to hold your breath for a few seconds during the test to eliminate image blur.

Information

Mammography is performed separately for each breast and lasts no more than a quarter of an hour. After completing the test, ask when the results can be collected.

While you are having a mammogram, you may feel a little pressure on the breast you are examining. It will gradually be pressed against the plastic plate of the mammograph. For this reason, it is best to do a mammogram when the breasts are not swollen and tender. If you experience sudden soreness while increasing pressure, be sure to inform the examiner.

Find out how to interpret mammography tests

Mammography – Benefits and Risks

1. Benefits:

  1. MRTG enables the detection of small nodules. Usually, if the neoplastic lesion is small, the prognosis for its recovery is better;
  2. Mammography is used as a screening test to detect breast cancer and other tissue abnormalities such as calcifications. It enables the detection of changes in the ducts of the mammary glands (the so-called ductal carcinoma in situ – DCIS). MRTG is the only effective method of detecting these changes;
  3. After the test is completed, the rays do not remain in the body.

2. Risk:

  1. In the case of mammography, the risks associated with overexposure to X-rays. Therefore, it is recommended to perform further examinations at appropriate intervals;
  2. In about 15% of cases it happens that the result of mammography is false positive. This means that the MRTG shows a lesion that is actually part of normal breast tissue. For this reason, in order to verify the result, an ultrasound examination of the breast is additionally performed, and if the doubts are still not dispelled – a breast biopsy under ultrasound guidance.
  1. In many cases, mammography does not allow to determine whether the revealed lesion is benign or malignant. Then it is necessary to conduct more detailed research;
  2. Breast implants can make breast imaging difficult because silicone is not fully X-ray permeable and may obscure the tissues behind it, especially if the implant is placed in front of, not underneath, the pectoral muscle. Experienced technicians and doctors know how to compress the breast with the implant during the examination to improve the image without damaging the implant itself;
  3. If you have implants, you should make sure that the facility has the appropriate equipment when registering for an MRTG examination, and the x-ray technician and physician have experience in MRTG in women with implants.

A patient with a poor mammography test result is referred for further tests: additional ultrasound, supplementary mammography or fine-needle biopsy – a cytological test used in the diagnosis of cancer not only of the breast, but also of the thyroid gland or lymph nodes.

Mammography and breast ultrasound are complementary examinations. Both are safe, but mammography is more often performed in mature women because their breasts are dominated by fatty tissue, which will appear black in the photo. In turn, any changes will only be shaded. In younger women, glandular structure predominates, so a better solution is to conduct an ultrasound of the breastwhich is also safer for pregnant women.

Attention

The main contraindication to mammography is pregnancy.

3D mammography with tomosynthesis is a much more precise examination than classic digital mammography. It allows you to take 400 photos from different angles, which are then superimposed on each other. As a result, the image can be viewed like a movie, checking each fiber of the gland in turn, while zooming out and zooming in on selected parts. 3D mammography is suitable for assessing neoplastic changes, their structure and boundaries.

The first mammogram should be performed after the age of 40. Both breasts should be taken every two years. After the age of 50, mammography should be performed every year.

You need a referral from your doctor to take a digital photo of your breast.

In the case of mammography, it is impossible not to mention breast self-examination, which should be a habit of every woman (regardless of age). The glands are best observed in the shower or while standing in front of a mirror. First, raise both hands up and check that the nipples and around the nipples have not changed color. In addition, we check whether the skin is properly taut on the breasts. The same observations should be made with the hands on the hips.

The next step is to squeeze the nipples lightly to see if there is any fluid leaking from them. A disturbing symptom that makes us go for a mammogram is dark nipple discharge. Then place your left hand behind your head, and your right hand in a gentle circle around the gland up and down. The same operation should be repeated on the left breast.

Breast self-examination should be performed once a month.

Computer mammography can be performed in a selected facility. It can be performed under the National Health Fund or for a fee. Special campaigns are also carried out throughout Poland to encourage women to perform free mammography in a special mammogram equipped with all the most important equipment for a detailed examination.

The cost of the MRTG examination is about PLN 80-100 for both breasts. You can also perform a mammography of one gland, which is valued at about PLN 50. 3D mammography with tomosynthesis is relatively more expensive. It costs about PLN 150-200. Mammographic examination under the National Health Fund can be performed upon presentation of a referral from a specialist.

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