Abstract
This paper summarises the basic information to be offered to women who undergo mammography. After a delineation of the general aim of early diagnosis of breast cancer, the main difference between screening mammography and diagnostic mammography is explained. The best time for scheduling mammography in fertile women is defined. The need to bring images and reports from the previous mammogram (and from other recent breast imaging examinations) is highlighted. The technique and procedure of mammography are briefly described with particular attention to discomfort and pain experienced by a fraction of women who undergo the test. Information is given on the recall during a screening program and on the request for further work-up after a diagnostic mammography. The logic of the diagnostic mammography report and of classification systems such as BI-RADS and R1-R5 is illustrated, and brief but clear information is given about the diagnostic performance of the test, with particular reference to interval cancers. 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. Finally, five frequently asked questions are answered.
Highlights
Malignant tumours and benign diseases are very common in the breast
Aside from clinical history, inspection and palpation, which compose the so-called clinical breast examination, imaging procedures and especially mammography are of crucial importance in the detection of breast cancer and diagnosis of breast diseases
If something suspicious is found, the woman is recalled for a tailored further assessment. Diagnostic mammography This is performed in patients presenting with clinical symptoms such as a palpable lump, nipple discharge, or skin or nipple retraction, in order to diagnose or exclude breast cancer
Summary
Malignant tumours (cancers) and benign diseases are very common in the breast. Aside from clinical history (conversation about disorders in the family, previous breast diseases/surgery, hormone 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 of breast cancer and diagnosis of breast diseases. Its purposes are (1) early detection of breast cancer before symptoms (screening mammography) and (2) diagnosis in patients with symptoms such as a palpable lump (diagnostic or clinical mammography). The general aim is to enable early treatment of breast cancer, to improve survival rates and to reduce the need for aggressive treatment such as mastectomy [1, 2]
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