Mammography - Awareness to Breast Cancer

Thursday, March 5, 2015

Breast Cancer

Incidence are increasingly worldwide. In united states, one in 8 women who live to the age of 95 years old will develop a breast cancer sometime through the their generation. Breast Cancer is distinctly one of the most common malignancies detected in women, and it is the principal reason of cancer deaths in females among the ages of 15 and 54. On lung cancer kill more women globally. Study has failed to tell the exact etiology of breast cancer, and only a few main reasons, such as family history, are identified to rise a woman’s risk of evolving the disease. Yet most women who develop breast cancer have no family history of the disease. Regardless of its frequency, breast cancer is one of the most treatable malignances. Since this malignancy is most curable when it is detected early, efforts have been focused to develop breast cancer screening and early detection techniques.

Before the radical mastectomy was presented, breast cancer was measured as a fatal illness. Rarer than 5% of patients lived 4 years after identification of disease, and the local recurrence rate for surgically treated breast cancer was higher than 80%. Radical mastectomy increased the 4 year survival rate to 40% and reduced the percentage of local recurrence to about 10%. Even though this was definitely a great step forward, no extra improvement in breast cancer survival rates happened over the next 60 years.
The evidenced to support the increased risk of breast cancer from breast irradiation comes from the studies of three groups of women in whom the incidence of breast cancer increased after they were eposed to large doses of radiaton.
These groups are as follows:
  • Women exposed to the atomic bombs at Hiroshima and Nagasaki
  • Women with tuberculosis who received multiple fluoroscopic examinations of the chest
  • Women who were treated with radiation for postpartum mastitis.
However, the radiation dose received by these women is 600 to 700 rads, this is many times higher than the dose received from mammography.
MGD (mean grandular dose) is used to meausre of radiation risk to the patient.
In 1997 the average MGD for two view screen film with grid mammogram for all facility in united states inspected under MQSA was 320 mrad compared to 600 to 700 rads. Using these level of radiation the lifetime risk of mortality from mammography induced radiation is 5 deaths per 1 million patients. In other terms, the risk received from having an x-ray mammography using a screen-film combination is equivalent to smoking several cigarettes or driving a speed of 60 miles per hour on your car. Furthermore, a 20 year old teenage breast tissue is more sensitive than a woman over 30 year old. Because breast irradiation is concern, x-ray examination of needs to be performed with only the radiation dose that is necessary for providing accurate detection.
Seeing this principles, the theory of eliminating all palpable breast masses in faiths of finding earlier cancers was developed, and it was known that carefully physical examination of the breast could detect some early breast cancers. But then most patients with breast cancer still stays undiagnosed until their disease where become advanced. This fact, coupled with the dismal breast cancer survival statistics, high lighten the need for a means for the early detection of breast cancer, the Mammography filled this needs.
breast images
Mediolateral Oblique Bilateral Breast
Craniocaudal Bilateral Breast

Breast Cancer Screening

The term screening mammography is applied to a procedure performed on an asymptomatic patient or a patient who presents without any known breast problems.
The Following criteria for screening method:
  • It must be simple
  • It must be acceptable
  • It must demonstrate high sensitivity
  • It must demonstrate high specificity
  • It must be reproducible
  • It must be cost-effective
  • It must have a low risk versus benefit ratio.
The frequency with which women should undergo screening mammography depends on their age and personal risk of developing breast cancer. Recommendation of American Cancer Society and the ACR are that women over 50 years old should under go annual mammography. And Women between 40 to 49 years should have a mammogram every year or every other year.

Conditions - Radiographic Findings
Breast Carcinoma - Malignant new growth composed of epithelial cells
    Calcification - Deposit of calcium salt in tissue, charateritics may suggest either benign or malignant Processes
      Cyst - Closed epithelial sac containing fluid or a semisolid substance
        Epithelial Hyperplasia - Proliferation of the epithelium of the breast
          Fibrosis - Formation of fibrous tissue in the breast
            Tumor - New tissue growth where cell proliferation is uncontrolled
              Fibroadenoma - Benign tumor of the breast containing fibous elements
                Intraductal Papilloma - A benign, neoplastic papillary growth in a duct
                  Breast Cancer Treatment for females has several options, Surgical treatment, Radioactive therapy, Chemotherapy, Hormone Therapy and biological (targeted) therapy are can be done.
                  Whereas breast malignancy for male patient choices are limited.
                  Since men have fewer breast soft tissue, lumpectomy is not considered practical. A revised radical mastectomy is generally the preferred clinical method. Radiation and systemic therapy is well thought-out once the malignant cells is situated near the chest wall or if indicated by lymph node analysis.
                  Similar to female breast cancer is directly related to stage of the disease at diagnosis.
                  An early diagnosis indicates a superior chance of survival. Survival rate among male patients with localized breast carcinomas are positive. 97% survive for five years.

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