Mammography
Indications
1. Scan
Mammography is the most appropriate imaging method and should be performed once a year in women over 40 years of age.
2. Diagnosis
The symptomatic patient almost always has an indication (palpable mass).
Screening with mammography reduces mortality by 30%.
It is the only method that reliably demonstrates microcalcifications.
BI-RADS (Breast lmaging Reporting and Data t m) Classification
BI-RADS 0: Additional examination required: Available mammograms and/or US are insufficient for diagnosis.
BI-RADS 1: Negative examination: Breasts are symmetrical, no mass, structural deterioration or suspicious calcification
BI-RADS 2: Benign findings: BENIGN findings such as coarse calcified fibroadenoma, sebaceous cyst, lipoma, galactocele, hamartoma, intramammary lymph node, simple cyst
BI-RADS 3: High probability benign: Most likely benign findings; however, short-term follow-up is recommended as it has a chance of being malignant (<2%). For example, uncalcified fibroadenoma and complicated cyst
BI-RADS 4: Suspected abnormality: Biopsy should be performed and histopathological diagnosis should be made. No characteristic breast cancer findings but potentially malignant findings
BI-RADS 5: Findings that show malignancy morphology: Irregular, spicular mass
BI-RADS 6: Malignant mass with known pathological diagnosis
USG Basic indications
• Cyst-solid mass distinction
• Sharply circumscribed nodule seen on mammography
• For the evaluation of a palpable mass not seen on mammography
• Dense breast pattern
• Palpable mass under 30 years of age
• Pregnancy and lactation period
• As a guide for interventional procedures
Disadvantages
Evaluation is subjective compared to mammography
Cannot detect microcalcifications
It is problematic to document
Not used for scanning purposes
MRI Basic indications
• For the detection of additional foci in those who are planned for breast-conserving surgery and have dense breasts.
• In cases where mammography and USG are insufficient to distinguish recurrence / fibrosis after surgery or radiotherapy
• When primary tumor cannot be detected by mammography-USG in patients with metastatic axillary lymphadenopathy
• In cases that cannot be resolved with mammography and USG
• To screen the population, especially those with dense breasts and at high risk for breast cancer.
Galactography
• It is done by giving contrast material from the nipple orifice. The inside of the duct is displayed.
• Its main indication is the demonstration of intraductal papillomas in bloody nipple discharge.