Mammographic sensitivity

Discussion in 'Question Zone' started by samuel, Dec 23, 2014.

  1. samuel

    samuel New Member

    Mammographic sensitivity for breast cancer declines significantly with increasing breast density, and the risk of breast cancer is higher in women with dense breasts. Hormonal status has no significant effect on the effectiveness of screening independent of breast density.

    Although mammography is an effective screening tool, data suggest that it is often less sensitive in detecting cancer in mammographically dense breast tissue. Kolb et al and Buchberger et al found that when performed carefully, ultrasonography may be useful in detecting occult breast cancer in dense breasts

    usually if the doctor feels a lump and the mammogram shows dense breast tissue, the ultrasound may be able to find the lump within the dense breast tissue. Ultrasound also is a good tool for getting more information about the characteristics of a lump, such as whether it is a fluid-filled cyst or solid.
    Before ultrasound, physicians used to diagnose the characteristics of a palpable mass by sticking a needle in it to see whether it contained fluid. This did not always work well, since it is hard for a small needle to get fluid out of a cyst that has thick walls or that contains very thick fluid. If a lump was thought to be solid, it then had to be biopsied with a bigger needle or be removed.

    An ultrasound can also be extremely useful in helping the radiologist interpret a mammogram. On mammography, both fluid (a cyst) and solid tissue (a tumor) appear the same (white). Using ultrasound, the radiologist can look more closely at the white area and determine if it is a cyst or solid tissue.

    Ultrasound may also be a good tool for diagnosing young women who have breast cancer symptoms. A study published in April 2003 in the American Journal of Roentgenology found that ultrasound was better than mammography at detecting breast cancer in young women who had symptoms of the disease.

    to compare the two screening methods, Australian researchers enrolled 240 women who had been diagnosed with breast cancer. All of the women were given both mammography and ultrasound. For older women, there was no statistically significant difference between the ability of the two tests to detect breast cancer. But ultrasound did do better at finding the cancers in women who were 45 or younger, with ultrasound detecting 84.9 percent of the cancers and mammography detecting 71.7 percent of the cancer

    US is useful in the evaluation of palpable masses that are mammographically occult, in the evaluation of clinically suspected breast lesions in women younger than 30 years of age, and in the evaluation of many abnormalities seen on mammograms. Some breast imagers believe that US is the primary modality for the evaluation of palpable masses in women 30 years of age and older and that mammography plays an adjunctive technique. US is also useful in the guidance of biopsies and therapeutic procedures; research is currently under way to evaluate its role in cancer screening.

    Ultrasonography does not expose a patient to ionizing radiation — a factor that is particularly important for pregnant patients and young patients. It is believed that in these patients, the breast is more sensitive to radiation; this would mean that in comparison with US, mammography would be associated with a slight increase in the small risk of acquiring radiation-induced neoplasm. Furthermore, young women's breasts tend to appear dense on mammograms — a factor that reduces the diagnostic sensitivity of mammography in this group. In addition, breast US is superior to mammography in the evaluation of breast abscesses

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