When to do an ultrasound of the breast, and when to do an MRI: the mammologist put everything on the shelves.

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We all know that feeling – putting off important things. Especially when it comes to health. Go to an ultrasound, check moles, be examined by a gynecologist and a mammologist. What if they find something serious and have to solve the problem, take responsibility? Our author Natalya Pikus even wrote a column about it. Meanwhile, many diseases can be prevented and effectively dealt with in the early stages. According to WHO, for example, oncology of the first stage can be defeated in 90-95% of cases. The sooner specialists determine the disease and begin treatment, the higher the chances. The number of cases of breast cancer in Russia is growing every year by 2%, however, the mortality rate over the past 10 years has decreased markedly – also by 2% annually. If in 2011 65% of cases were diagnosed at stages I and II, then in 2020 – already 72%. How not to miss the moment when it’s time to see a doctor? We discussed this with an expert.

– When is it better to go to a mammologist: first do an ultrasound and only then to him or first to him, then an ultrasound?

– Is it really better to do mammography after 40, or if you have bad heredity, is it worth playing it safe?

– For me, playing it safe means going through the list of examinations prescribed by a specialist on time and in full. Each examination method has its own indications and contraindications, as well as its value in identifying certain changes. If we talk about mammography, then it is really more often recommended to be carried out after 40 years. Why at this age? Because after the physiological regression of the glandular tissue begins. Simply put, tissue density decreases and visualization of changes in the mammary glands improves.

If there was no breast cancer in the family, it is recommended to perform the examination once every 2 years

In this case, it is possible to clarify the diagnosis of changes using ultrasound. Also, in the interinterval interval, a visit to a mammologist and an ultrasound scan are recommended.

If the patient has a burdened family history of oncology, then the first mammographic examination is recommended at the age of 35. In case of suspicion of a malignant process, mammography is mandatory as part of a comprehensive examination, regardless of age.

There are other methods as well. For example, standard MRI (lasts 25-30 minutes) and screening MRI (lasts 7 minutes). The sensitivity is much higher than digital mammography and ultrasound, especially for women under 40 who still have high breast density. In a study published in the Journal of Clinical Oncology, 11 out of 443 patients who had a screening MRI were diagnosed with breast cancer. At the same time, the disease was not detected earlier during mammography and ultrasound. Thanks to MRI, specialists can recognize tiny, only 4-5 mm, malignant neoplasms that are not visible in other studies. This makes it possible to detect breast cancer at an early stage, when treatment is effective and least traumatic. However, in order to correctly assess the results of an MRI, the doctor must compare them with the results of previous examinations conducted by other methods.ami.

In the structure of oncological diseases of women, breast cancer ranks first – 19.3%

– How often do you need to go to the doctor’s office and do an ultrasound?

– Preventive examination by a mammologist is recommended once a year. This is in the event that there was no oncology among close relatives, if there are no changes that require observation. If there is any of the above, the frequency of visits to the doctor is decided on an individual basis. And most importantly, there is no age division. It doesn’t matter how old you are, you should see your doctor regularly. Unfortunately, breast cancer is steadily getting younger. And if a couple of decades ago, the detection of a disease in a woman under 30 was considered a rarity, but now the situation is different.

On what day of the cycle is it better to be examined?

– MRI should be done from 5 to 12 days from the first day of menstruation, and ultrasound and mammography – on any day of the cycle.

Which women are particularly at risk of developing breast cancer?

  • those who began menstruating before the age of 13 (doubling the risk of tumor formation);
  • those who have late menopause – after 54 years (leads to a fourfold increase in the incidence);
  • those who have had abortions;
  • those with elevated estrogen levels;
  • those who had previously suffered ovarian cancer;
  • women with endocrinological diseases (for example, with pathologies of the thyroid gland) and metabolic disorders;
  • over 35 years old;
  • with a genetic predisposition ( about a quarter of patients in close relatives had cases of breast oncology);
  • with specific mutations that increase the risk of breast cancer, in particular in the BRCA1 and BRCA2 genes;
  • after radiation therapy, especially in the chest area.

However, do not set yourself up for the worst. Not every formation in the breast is oncology; benign tumors, in particular cysts and adenomas, are much more common. If the formation looks suspicious, experts do a biopsy. In more than 50% of cases, cancer is not confirmed.

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