My medical notes

Mammography

So October is a breast cancer awareness month. So I'm going to talk about mammography. It's for diagnosing breast cancer. So women who are above fourty years old are recommended to get mammography. Above forty five years, it's mandatory to take the test. Above fifty years it's recommended to  take the test every two years.

Also if there is any lump(swelling) in your breast, you should go to the doctor immediately. I know in other countries, people are very educated about medical stuff, but here in India, even though they know something is wrong with their body, people don't go to the doctor because it costs too much and they don't have the time. People with lower economic conditions often do this.

If there is a lump in your breast, doesn't mean it's always malignant. It could be benign too.

So coming back to mammography, it's done in the first half of the menstural cycle. It's because during periods the ovulation don't occur. After some days, the ovulation does occur, if the patient gets pregnant it's usually detected in a month, so mammography is not done in the second half of the menstural cycle to prevent any harm done to embryo.

It has two views. Mediolateral view and craniocaudal view. Mediolateral views shows the lateral outer quadrant of the breast and the axillary tail of Spence. (There are four quadrants in the breast)

1)upper inner quadrant
2)upper outer quadrant
3)lower inner quadrant
4) lower outer quadrant.

As you can see the four quadrant in here. The axillary tail of Spence is also here.

So craniocaudal view can provide better visualization for medial aspect of the breast.

The sensitivity of the mammogram increases with age since the density of the breast decreases with age.

There you can see guys how they do the test.

As you can see, lacteriferous ducts form lactiferous sinus. Which is for the breast milk production. Pectoralis major and minor are the muscles supporting the breast.

Now in case of breast cancer, there is 'architectural distortion' in the breast parenchyma(breast tissue) I'm gonna take a guess and say it means the normal breast tissue has been changed to abnormal lol. It's what it means anyways. Sorry for being unprofessional by the way.

If it's malignant breast tissue, there are tiny calcium deposits(microcalcification below 0.5mm) and the nipple is retracted inside. The skin and Cooper ligaments are thickened, the ducts in the breasts are dilated. Cluster microcalcification is the maximum risk of malignancy.

Whereas in the benign, everything is normal. There is macrocalcification in the breast there. And nipple is normal in benign tissue.

Normally for mammography, low doses of radiation (X rays is used) but for higher risk patients, 3D mammography (tomosynthesis) is done. It's done along with normal mammography. Radiation doses are doubled. There are less false positives and there is better detection.

There is a scoring system called BIRADS (breast imaging reporting and data system)

This is the BIRADS scoring.

And if a pregnant woman has symptoms of breast cancer, the best method to test her is using ultrasonogram. If it's positive, then mammography is taken as well. MRI is usually not done to confirm breast cancer in pregnant woman because 'gadolinum' in the MRI can cross placenta and cause fetal abnormalities.

These are the risk factors that can be changed. There are also some risk factors that cannot be changed.

There are detailed risk factors in the web. You can search for it if you want. If there are any doubts, please do leave a comment below. I really need to stop being lazy and read for the exams lol. Atleast by writing this I can prepare for my PG exams.

There are other methods of confirming the diagnosis for breast cancer. It's trucut biopsy.

Triple assessment for examination.

1) history taking and clinical examination
2) radiological investigation
3) histopathological examination.

Alright. This is it. Thank you for reading if anyone still reads this. :)

Have a good day everyone!!!