Mammary diagnostics
Mammasonographie
Galaktographie
Kernspintomographie
Why should women have their breasts examined on a regular basis?
Breast cancer is the most frequent type of malignant tumour in women. Every 10. woman gets breast cancer; this yields approx. 53,000 women in Germany annually. Preventive measures against breast cancer do not exist yet.
But:
Early detection and treatment increase the chances of recovery to up to 98%.
The disease does not have the same frequency of occurrence at each age. Women from the age of 40 should have themselves examined on a regular basis, e.g. every 2 years.
The goal of mammary diagnostics is to detect small tumours before they are perceptible or palpable.
Mammography
The basis of mammary diagnostics is the mammography.
Method
Using an X-ray device specifically designed for this examination, the breast is inserted between two plexiglass plates and slightly compressed to obtain a layer as thin as possible with few superimpositions. The imaging only takes a split second and is pain-free. Each breast is X-rayed on two different levels.
Time of examination
Especially in case of young women, the most favourable time for the examination is 7 to 14 days after the beginning of the menstruation, as the fluid content of the breast is the smallest at this time. The breast is now less sensitive to pressure and the image is more transparent.
Are X-rays dangerous?
The statistical probability of initiating breast cancer by a mammography is as large as the probability of getting lung cancer by smoking only 3 cigarettes.
30 mammographies in the course of life increase the natural risk factor of 8-10% by the minor factor of 0.03%.
Mammary sonography (Ultrasonic examination of the breast)
The mammary sonography is a supplemental procedure. It is used particularly in case of roentgenopaque tissue or unclear focal findings of the mammography.
Palpatory findings can be specifically examined as well.
Preliminary examinations
A special ultrasonic gel is applied to the skin of the breast; then, a kind of microphone is attached via which the area is scanned manually in a meandering line. The procedure is completely harmless and can be repeated as often as necessary.
Galactography
In some extremely rare cases of sanguineous secretion from a mamilla, it may be necessary to fill a small amount of contrast medium into the lacteal duct by means of a fine probe prior to the mammography. The mammography is subsequently carried out as explained above.
Magnetic resonance examination of the breast (MR-mammography)
This is also a supplemental and technically advanced procedure. It is applied in case of e.g.
- Post-treatment after a breast-conserving therapy/surgery
- Tumour search after an implant surgery
- As optional service:
- Complete preoperative clarification of the findings (referred to as local staging)
- Search for secondary tumours/tumours on the opposite side prior to a surgery
- Tumour search in high-risk patients (first-degree tumour in a relative under the age of 40)
- Roentgenopaque tissue and uncertain results of the mammography/sonograph
Method
The patient is placed onto a special appliance (referred to as breast array coil) in a comfortable prone position and positioned in the MRI-scanner. This is an extremely strong magnet (several times that of the Earth’s magnetic field). In doing so, the numerous hydrogen nuclei (protons) contained in the human body and thus also in the female breast are aligned in the same direction and can then be specifically excited via special radio waves. The return signal is subsequently converted into cross-sectional images on various levels by an extremely powerful computer system.
Several measurements of approx. one and a half minutes each are conducted.
In doing so, a special contrast medium is once injected into the arm vein. It is well-tolerated and has no side effects.
The method works without radiation and is harmless; it can thus be repeated as many times as necessary.
Time of examination
As this method is extremely sensitive, the right time of examination is even more important as in case of the mammography.
The most favourable time is the second week of the menstrual cycle, i.e. the 7. to 14. day after the beginning of the period.
Reasons for not conducting the examination
At present, the examination is not yet suitable for patients with a cardiac pacemaker.
During pregnancy and in case of metallic foreign bodies, e.g. joint prostheses, metal splinters and clips after surgery, the physician decides in the individual case if a mammography is possible and reasonable.
Possible side effects
There is no risk of harmful effects on the body at the applied magnetic field intensity.
Preparatory measures for patients
As you are surrounded by a strong magnetic field both in the examination room and in the device, metallic objects, such as e.g. keys, coins, lighters, watches, eyeglasses, jewellery, belts or magnet-sensitive objects, such as e.g. credit or cheque cards have to be taken off prior to the examination.
Should you suffer from extreme anxiety or claustrophobia, we can give you an appropriate sedative agent prior to the examination.
Duration
The total duration of the examination is approx. 20 minutes. During the measurement period, which is accompanied by a technically unavoidable tapping noise, you should lie calmly and relaxed, as each movement causes disturbances in the image and additionally prolongs the examination period.
Post-treatment
Special post-treatment is not required.
In case you have received sedatives, you will not be fit to drive at least one to two hours after the examination and should thus not actively participate in road traffic.
If you additionally feel especially faint, you can have a rest in one of our recovery rooms.
Preliminary examinations
Especially for breast examinations, progress assessments are extremely helpful and important. If possible, you should bring along the findings of possible preliminary examinations to your appointment for examination.
Evaluation
In our institute, mammographies are always evaluated by two specialists independently from each other. They have to prove their qualifications within the framework of exams on a regular basis. The devices used are subject to regular inspections as well.
Abteilung: Radiologie
