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Role of imaging modality

How will you approach the 35 year old, with a 2 x 2 x 2cm, firm, mobile, well circumscribed non tender mass on the right breast?. Role of imaging modality. Mammography

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Role of imaging modality

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  1. How will you approach the 35 year old, with a 2 x 2 x 2cm, firm, mobile, well circumscribed non tender mass on the right breast?

  2. Role of imaging modality • Mammography • plays a central part in early detection of breast cancers because it can show changes in the breast up to two years before a patient or physician can feel them. • Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.

  3. Digital and conventional mammography • both use x-rays to produce an image of the breast • Conventional mammography: image is stored directly on film • Digital mammography: images stored as a computer file • full-field digital mammography (FFDM); mammography system in which the x-ray film is replaced by solid-state detectors that convert x-rays into electrical signals used to produce images • can be enhanced, magnified, or manipulated for further evaluation more easily • Digital mammography advantages over conventional mammography: • Health care providers can share image files electronically, making long-distance consultations between radiologists and breast surgeons easier. • Subtle differences between normal and abnormal tissues may be more easily noted. • Fewer follow-up procedures may be needed. • Fewer repeat images may be needed, reducing the exposure to radiation. http://www.radiologyinfo.org/en/info.cfm?pg=mammo

  4. Ultrasound • to differentiate solid from cystic masses; looks for shape and texture • to provide guidance for interventional breast procedures such as cyst aspiration or core biopsy • useful when a palpable mass is partially or poorly seen on a mammogram, especially in young women • When added to mammography= improved breast cancer detection in high-risk women (Journal of the American Medical Association, 2008)

  5. A mammogram was taken as seen in the picture. Is this benign or malignant? Dx: BENIGN CYST

  6. Differentiate radiologically a benign lesion from a malignant one.

  7. Difference in ultrasound findings.

  8. Should the patient have a mother who is a breast cancer survivor, how wouldthat information change your management?

  9. Breast Cancer Screening Tests • Mammogram • is the best tool available for early breast cancer detection • can often identify cancer before symptoms appear and can reveal calcium deposits in the breast, which may be an early sign of cancer • HIGH RISK: annual mammogram beginning at an age that is 5 to 10 years younger than the youngest member of the family with breast cancer

  10. Breast Cancer Screening Tests • Clinical breast exam • thorough physical examination of the breasts done by a physician or nurse practitioner • HIGH RISK: recommended every 6 to 12 months • Self breast exam • identify breast abnormalities and should be performed monthly, about one week after the end of your period • Breast MRI • For extremely dense breast tissue that make mammograms difficult to interpret

  11. Self breast Exam National Cancer Institute

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