Mammography
A mammogram is an X-ray, especially suited to women's breasts to detect nodules whose presence may indicate the existence of breast cancer.
Issue
Mammography is to detect early abnormalities before they have caused clinical symptoms. It can thus detect cancers long before they are palpable.
Since 2006, it was shown that the results of the Swedish study in 1985 announced a reduction in breast cancer mortality by 30% in the screened group is not valid. This demonstration of non-validity of the study in 1985 based on the incompatibility of the positive results of mammography with the official records of diagnoses and deaths in Sweden. At the instigation of a radiologist, pressure was exerted to remove the demonstration article posted by the European Journal of Cancer in March 2006. This removal procedure has violated the ethical rules in use in scientific publication. The final synthesis of comparative studies on the effectiveness of screening mammography from the network Cochrane concludes if a death from breast cancer is preventable by screening 2000 women followed for 10 years, now leads 10 surdiagnostics causing many surtraitements.
The current proposal for regular mammograms for all women 50 to 75 years in France relies on an expert report prepared in 2001-2 by the Department of Technology Assessment of the National Agency of Evaluation and accreditation of health care. The objective of this report included the recall of the French force recommendations. The report concluded that the ineffectiveness of mammography screening is not proven, it should keep the recommendations in use for screening of breast cancer.
The technique
To achieve this review, the handler uses a mammography. This device consists of a generator of X-rays of low energy (between 20 and 50 keV) and a compression of the breast.
The examination is used to compress alternately both breasts then expose them to a low dose X-ray The compression is achieved by a compression pad specially designed for this type of exploration and regulated by a specialized handler for it to be painless or perfectly tolerated by the patient. This compression allows the spread of breast tissue which facilitates the visualization of breast structures and reduces the dose of X-rays delivered. Several shots were made.
Radiography was performed on silver films or on digital radiology systems, high quality (pixels of 50 m and a maximum detectors high Detective Quantum Efficiency (DQE).
Results
After the mammogram, a radiologist will analyze the photos, interviews the patient and performs a clinical examination: examining the appearance of the skin and nipple. It palpe breasts and looking for abnormal lymph nodes. Mammography does not always give a definitive diagnosis outset: it can see if there is an abnormality in the breast, but it can not determine with certainty whether or not cancer .
Further tests are needed to establish the diagnosis:
* Breast Ultrasound
* Sampling
* Breast MRI
Risks
The first risk due to mammography screening is the surdiagnostic. Mammography uses X-rays and no radiation-induced damage has been demonstrated since this technique exists. However, if the mammogram is done well, the dose of radiation is generally very low (After such a dose, the body can usually repair a few damaged cells).
Restrictions
Before menopause, the screening has not proved its effectiveness, because the minimal suspicious abnormalities are more difficult to select, and disadvantages, such as unnecessary biopsies, appear higher than its benefits, except for women with particular risk (mastopathies benign, family history), which should be particularly monitored.
Read also Breast
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