Abstract
This article summarises the information to be offered to women about mammography. After a delineation of the aim of early diagnosis of breast cancer, the difference between screening mammography and diagnostic mammography is explained. The need to bring images and reports from the previous mammogram (and from other recent breast imaging examinations) is highlighted. Mammography technique and procedure are described with particular attention to discomfort and pain experienced by a small number of women who undergo the test. Information is given on the recall during a screening programme and on the request for further work-up after a diagnostic mammography. The logic of the mammography report and of classification systems such as R1-R5 and BI-RADS is illustrated, and brief but clear information is given about the diagnostic performance of the test, with particular reference to interval cancers, i.e., those cancers that are missed at screening mammography. Moreover, the breast cancer risk due to radiation exposure from mammography is compared to the reduction in mortality obtained with the test, and the concept of overdiagnosis is presented with a reliable estimation of its extent. Information about new mammographic technologies (tomosynthesis and contrast-enhanced spectral mammography) is also given. Finally, frequently asked questions are answered.Key Points• Direct digital mammography should be preferred to film-screen or phosphor plates.• Screening (in asymptomatic women) should be distinguished from diagnosis (in symptomatic women).• A breast symptom has to be considered even after a negative mammogram.• Digital breast tomosynthesis increases cancer detection and decreases the recall rate.• Contrast-enhanced spectral mammography can help in cancer detection and lesion characterisation.
Highlights
Malignant tumours and benign diseases are very common in the breast
This article— aimed at summarising the most important information to be offered to women about mammography—updates a previous article published in 2012 [1] by the European Society of Breast Imaging (EUSOBI), taking in consideration the most recent evidence in favour of mammography and of two mammographic technique tools available for clinical practice: digital breast tomosynthesis and contrast-enhanced spectral mammography (CESM)
We took into account the recent position paper on screening for breast cancer by EUSOBI and 30 national breast radiology bodies [2], which should be considered complementary to the current article
Summary
Malignant tumours (cancers) and benign diseases are very common in the breast. Aside from clinical history Insights Imaging (2017) 8:11–18 therapy, personal well-being and complaints), inspection (external viewing) and palpation, which compose the so-called clinical breast examination, imaging procedures and especially mammography are of crucial importance in the detection and diagnosis of breast cancer and other breast diseases. Its purposes are first early detection of breast cancer before symptoms (screening mammography) and second diagnosis in patients with symptoms such as a palpable lump (diagnostic mammography, named clinical mammography). This article— aimed at summarising the most important information to be offered to women about mammography—updates a previous article published in 2012 [1] by the European Society of Breast Imaging (EUSOBI), taking in consideration the most recent evidence in favour of mammography and of two mammographic technique tools available for clinical practice: digital breast tomosynthesis (or tomosynthesis) and contrast-enhanced spectral mammography (CESM). We took into account the recent position paper on screening for breast cancer by EUSOBI and 30 national breast radiology bodies [2], which should be considered complementary to the current article
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