It is often said that ‘better safe than sorry’!
Adhering to a screening is the first and most important step for a possible early diagnosis: it is essential to talk to your family doctor or a specialist and have the tests done. If there are family risk factors, the recommendation is always to seek advice from your doctor.
Mammography is not usually a painful examination and is therefore performed without hospitalisation, anaesthesia or sedation of the patient. One should not be afraid to have it done and the advice is always to go to specialised centres.
Mammography, what it consists of and who performs it
Mammography is an X-ray examination of the breast, using a low dose of ionising radiation for a few seconds. It allows early detection of breast tumours, as it is able to detect lumps, even small ones, that are not yet perceptible to the touch. Mammography is performed by a specialist doctor in senology on an outpatient basis, so there is no need for admission or day hospital.
No preparation is needed in the hours or the day before the examination, and you can eat and drink. The advice is to wear comfortable clothes and not to apply creams or deodorants to the skin in the area affected by the examination, as they may alter the image available to the doctor for the examination. If you have had previous examinations, starting with the screening mammogram, you should bring them with you and inform your doctor.
Practical information for breast screening
The time of an examination is about 15 minutes, not including the phases of acceptance and interview with the doctor. The examination involves positioning the breast on a plane (detector) and compressing it with a plate (compressor) to ensure immobility during the examination and to obtain sharp, quality images. A total of 4 projections are performed: viewing the breast both from above and from the side.
The actual duration of the examination on the machine is only a few seconds per projection. Greater accuracy in diagnosis is achieved by the evaluation of the mammogram performed separately by 2 radiologist doctors. If the result is positive, you are invited for a second mammography, an ultrasound scan and a clinical examination to confirm or not the actual presence of a tumour.
Mammography, tomosynthesis and ultrasound: how they work
The traditional digital mammogram acquires a single image of the compressed breast. Traditional mammography allows for two-dimensional images of the breast. In newer systems, a three-dimensional acquisition is added to this so-called “traditional” examination, which, by breaking down the breast into thin layers, allows even the most minute structures to be appreciated.
Ultrasound, on the other hand, is a diagnostic examination that scans the breasts and axillary cords using a probe that emits ultrasound and allows for the detection of any palpable breast lumps or any changes in the axillary lymph nodes.
In practical terms, breast ultrasound is also used as a second-level examination to complement or supplement an initial diagnosis of mammography, particularly in breasts with particularly dense tissue. Or if the screening mammogram finding presents the need to deepen tissue: this second step should not be frightening, but is precisely a preventive practice to further investigate what may be cancerous lesions still in an early stage. Again, it is good to rely on a specialized center or breast unit that has all the machinery to immediately perform an ultrasound to support a mammogram examination.
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