Diagnosis of breast diseases

 

Mammography

X-ray digital mammography

X-ray digital mammography is a type of medical diagnostics that deals with the non-invasive examination of the mammary gland, mainly female. X-ray mammography allows you to detect pathological changes in the mammary gland in patients and determine their nature. Currently, X-ray mammography is one of the main methods for diagnosing the following breast diseases:

• fibrocystic breast disease
• breast fibroadenoma
• malignant neoplasms of the breast

Also, X-ray mammography is the only way to detect pathology directly inside the breast ducts.

 

X-ray digital mammography with tomosynthesis

The most informative method of modern X-ray examination of the breast is digital mammography with the function of tomosynthesis.

The clinic uses a unique, custom-made, full-size digital mammography system SELENIA Dimensions of the latest generation with the possibility of 3-dimensional tomosynthesis. It is combined with the Secure ViewDX imaging station. At the same time, a horizontal stereotaxic system for breast biopsy with targeted digital mammography Lorad Multicare Platinum manufactured by HOLOGIC Inc. (USA). This equipment allows to conduct of breast examinations, unique in its efficiency and has an excellent safety profile for the patient because uses the minimum dose of X-ray radiation.

According to the reviews of mammologists, the mammographic diagnostic complex used for patients in the clinic is currently the best in Moscow.

 

Benefits of X-ray digital mammography with tomosynthesis

Breast tomosynthesis is a series of digital X-rays (digital X-ray mammography) that are processed into a series of one-millimeter slices. The following advantages of such a diagnostic method as digital X-ray mammography of the breast with tomosynthesis can be distinguished:

• tomosynthesis of the mammary gland enables the mammologist to see the structure of the breast tissue in three dimensions; this reduces the number of unnecessary breast biopsies;
• a mammologist or plastic surgeon has the opportunity to assess the condition of the mammary gland after implantation (consistency or inability of breast implants);
• when using tomosynthesis of the mammary gland, the information content of the study increases when performing ductography, and the procedure itself is performed for women with any size of mammary glands, and most importantly, it is painless;
• tomosynthesis of the breast is used as a screening method for clinical examination;
• tomosynthesis of the mammary gland gives a low dose of X-ray radiation to patients;
• tomosynthesis of the breast is a highly sensitive and informative method;
• tomosynthesis of the mammary gland allows the use of telecommunication networks for the transmission of images for remote consultation of the patient by leading specialists in mammologists from other countries;
• tomosynthesis of the mammary gland shortens the examination time of patients.

 

The optimal period for a woman to have a breast mammogram

Mammographic examination of the mammary gland is recommended to be performed at the beginning of the menstrual cycle from 5 to 12 days from its beginning. During this period, the mammary glands are not tense, softer, and the study is not only less sensitive, but also more informative for the doctor.

 

Indications and contraindications for breast mammography in women

Mammography of the mammary gland is advisable for all women after 35-40 years of age 1 time in 1-2 years, even if the woman has no complaints about the condition of her mammary glands. Women after 45-50 years old should have mammography annually. If necessary, the doctor may prescribe a more frequent examination. If something bothers you, you should consult a doctor (gynecologist, mammologist, surgeon, or oncologist). The specialist will determine the need for breast mammography and prescribe a study.

The only contraindication to breast mammography is pregnancy and lactation in a woman.

 

How is the preparation and examination of breast mammography

In the department of radiation diagnostics in the mammography room, the patient is asked to stand in front of the mammography machine. The specialist places the mammary gland between two plastic plates. At the same time, a woman experiences a light touch to the mammary glands for several seconds, which is necessary to obtain high-quality images. A mammographic image is taken for each breast in two projections: direct and oblique. After the mammography of the mammary gland, the images obtained are described by a qualified radiologist.

 

Ductography of the breast ducts

Ductography is a contrast x-ray mammography examination of the breast ducts. Ductography is indicated for patients in the case of an existing pathological (most often bloody) secretion (discharge) from the nipple. Ductography is performed to diagnose intraductal formations of the mammary glands.

Before the ductography procedure under local anesthesia of the areola, a contrast agent is injected into the milk ducts, after which X-rays are taken in the upper-lower (frontal) and oblique projections. The contrast-enhanced images (ductograms) clearly show the contrasted duct along with the branches. In the presence of an intraductal breast tumor, its location and size are determined.

 

Ultrasound examination of the breast

The procedure of mammography of the breast is almost always supplemented by ultrasound with Doppler scanning. Ultrasound examination of the breast is a simple and painless way to detect neoplasms and seals in the breast without additional radiation exposure. Ultrasound examination of the breast is particularly informative in the diagnosis of cysts.

In the clinic, breast ultrasound is performed on an expert-class MyLab 70 device from Esaote with an optimal set of functions and all types of sensitive doppler. Modern technologies and the versatility of the device, if necessary, provides the possibility for a doctor to perform any type of breast biopsy in a patient under the control of ultrasound.

 

Magnetic resonance imaging (MRI) of the breast

If there are difficulties in interpreting mammography and ultrasound data, magnetic resonance imaging (MRI) of the mammary glands can be prescribed. Magnetic resonance imaging (MRI) of the mammary glands is the main method of choice when monitoring the condition of implants after cosmetic or reconstructive mammoplasty (prosthetics). Magnetic resonance imaging (MRI) of the mammary glands is also prescribed for the diagnosis of breast diseases in women under 35-40 years of age, or for follow-up of women with a high risk of breast cancer.

The clinic is equipped with unique equipment, the first in the history of magnetic resonance imaging, an ultra-high-field open MR system of the expert class Magnetom Verio from SIEMENS with a magnetic field strength of 3 Tesla, equipped with a special high-tech MR coil for the breast. Due to the high power of the magnetic field of the tomograph, this method has an unprecedented informative value for specialists in the examination of patients with breast diseases.

 

Breast biopsy

This diagnostic procedure can be performed in the clinic thanks to the Lorad Multicare Platinum horizontal stereotaxic system for breast biopsy with targeted digital mammography manufactured by HOLOGIC Inc. (USA).

Targeted fine-needle aspiration biopsy of breast tissue using a pistol-needle system consists of two stages. At the beginning of the biopsy procedure, two sighting images of the breast area of interest are performed using a special technique. Then, with the help of computer processing of the received information, a virtual marking of the breast is made and the length of the needle is selected. This information is transmitted to a stereotaxic device for performing puncture biopsy of the mammary gland using a pistol-needle system with an accuracy of 1 mm. The notch in the needle makes it possible to obtain breast material not only for cytological but also for histological examination, which makes it possible to perform immuno-histochemical and molecular-biological studies of biopsy specimens, determination of hormone receptors, and tissue prognosis factors.