MAMMOGRAPHICALLY DETERMINED ASYMMETRIES OF THE MAMMARY PARENCHYMA: CAUSES AND OPPORTUNITIES OF THEIR MAMMOGRAPHIC AND ULTRASOUND DIFFERENTIAL DIAGNOSIS

Abstract

The incidence of asymmetries is 1-2% of all mammographic studies performed. However, there is no data in the literature on the prevalence of individual causes for mammographically determined asymmetries, as well as information about the opportunities of mammography and ultrasound examination (U/S) in their differential diagnosis. The aim of the study is to assess the incidence of individual causes for mammographically determined asymmetries and the opportunities of mammography and ultrasound of the mammary glands in their differential diagnosis. Material and methods. The results of mammographic and ultrasound examination of 202 patients were analyzed, in whom zones of asymmetrically distributed breast tissue were detected during mammography. Results. Technical asymmetries were detected in 14 out of 202 cases (6.93%) and could not be adequately analyzed. The true ones were asymmetries without space-occupying lesions caused by asymmetric uneven distribution of glandular (as a rule) or fibrous tissue (161 out of 202; 79.70%), as well as asymmetric edema of the breast parenchyma not associated with edematous infiltrative form of breast cancer (1 out of 202; 0.50%). These cases have always required performing breast ultrasound. The causes of true asymmetries caused by the presence of a space-occupying lesion were malignant neoplasms (breast cancer; 7 out of 202; 3.47%), benign formations (cysts, fibroadenomas, granulomas, abscesses, hematomas, chronic mastitis and other focal benign processes; 11 out of 202; 5.45%). These cases also required to perform breast ultrasound. The cause of the true asymmetries were also postoperative scars (8 out of 202; 3.96%), the differential diagnosis of which did not require ultrasound, but it and/or magnetic resonance mammography were required to assess the condition of the scar for its possible malignant transformation. Conclusions. The largest proportion of mammographically determined asymmetries in the density of mammary parenchyma (79.70%) are physiological variants of asymmetrically distributed tissues of this organ; their differential diagnosis and that of asymmetries caused by space-occupying lesions, according to mammography findings, is difficult, which requires additional ultrasound of the mammary glands. At the same time, mammography makes it possible to confidently identify technical asymmetries of the breast requiring no use of ultrasound, however, the interpretation of such sets of mammograms does not seem correct.