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DIGITAL MAMMOGRAPHY (FFDM) - TOMOSYNTHESIS

It is a special method used to examine the breast using low dose x-ray beam.

MM is performed in order to detect breast cancers early and decrease deaths due to breast cancer.

Breast cancer risk is 1/8. Breast cancer ranks second among cancer-related causes of death in women after lungs. Between the ages of 40-55, it climbs to the first place.

Many studies have shown that screening and examining the breast with mammography at regular intervals significantly reduces deaths due to breast cancer.

However, examining the breast with mammography is far from perfect yet. Many cancers do not show early enough.

Out of 100 cancers, 68 can be diagnosed by mammography and 12 by examination. However, 20 cancers are not recognized by either mammography or examination. Therefore, there is a delay in diagnosis.

For these reasons, there have been two important developments in mammography recently.


1. Digital mammography (FFDM)
It is also called full field digital mammography. With this method, digital detectors replace the film. Detectors convert X-rays into electrical signals and images are created from electrical signals by computers.

Advantages of digital mammography over normal mammography:
* Imaging difficulties due to the structure of the breast can be overcome much more easily.
* Anything that may occur at the stages such as the quality of the film used in conventional mammography, its processing and transportation, reduces the quality.
* Digital images can be copied as many times as desired, transferred to computer media or simple CDs and archived.
* In the conventional method, many operations that require re-shooting can be created in a computer environment without the need for repetition. Image can be enlarged.
* Less X-ray beams are sufficient in digital mammography.
* Review time is shortened.


2. Tomosynthesis (TS)
A 2-dimensional image is obtained in normal mammography. With tomosynthesis, millimetric sections of the breast are taken and 3-dimensional images are obtained. In this way, the internal structure of the breast can be viewed more clearly and the tumor can be located in 3 dimensions, if any.

If we consider mammography as a kind of x-ray, it can be called tomosynthesis tomography.

In normal mammography, normal tissues can overlap and hide cancerous tissue or create false cancer-like images.

This problem has been overcome by tomocentesis. Unnecessary biopsy and surgery rate decreases. The breast is less compressed during shooting.

FREQUENTLY ASKED QUESTIONS

How often and when should I have mammography?
Annual screenings allow breast cancer to be detected at an earlier stage.
American cancer association recommends follow-up with mammography once a year after the age of 40.
20-39 years: Personal examination every month and doctor examination once in 3 years.
40+ years old: Personal examination each month, doctor examination once a year, and mammography once a year.
If there is a BRCA gene mutation, it is started to be monitored at the age of 25.
If the first degree relative has breast cancer, it is started to be monitored 10 years before the age of cancer in the relative.
For women who received chest wall radiotherapy before the age of 30 for any reason, screening is started 8 years after RT treatment.

What are the main risk factors for breast cancer?
- Previously having breast cancer
- To have a biopsy diagnosis that may have cancer in the future. (atypical ductal hyperplasia, atypical lobular hyperplasia etc.)
- To be diagnosed with breast cancer in first degree relatives (mother, father, sibling, daughter) or biopsy that may have cancer in the future.
- To be diagnosed with breast cancer in second degree relatives (grandmother, aunt, aunt, nephew) or biopsy that may have previously become cancerous.
- Being a BRCA genmutation
- Previous radiotherapy to the chest or lung for another reason.
- Having dense breast tissue.
- Being of white race.
- Having a long menstruation period (starting at an early age and ending at a late age).
- Not having children or having children at an early age.
- Taking birth control pills.
- Using long-term postmenopausal hormone therapy.
- Not breastfeeding.
- Alcohol.

How should I prepare?
The best time for mammography is the first week after menstruation. If you have a sensitive breast, it is recommended not to do this examination in the week before menstruation.
Before the examination, deodorant, talcum powder, lotion etc. should not be applied.
Previous mammograms should always be brought to the mammography examination. The doctor thus gets the opportunity to compare.
If pregnancy or pregnancy is suspected, the technician and doctor should be informed.

How to review?
In mammography examination, the radiology technician positions your breast and applies some compression.
Compression is important. Because compression prevents small cancers from being masked with normal tissue. The x-ray dose required is reduced.
Images are taken in several positions for both breasts. The process takes 10 to 15 minutes. is in progress.

Is anything noticeable during and after the procedure?
During the procedure, some women experience compression-related discomfort. Compression can be reduced if this discomfort is felt.
After the procedure, daily life continues.

What are the limitations of mammography?
Since every woman's breast structure is different from each other, it is very difficult to evaluate mammography. For this reason, it is very useful to examine and compare previous mammograms.
The presence of powder or similar cosmetics on the breast, previous surgery are other factors that make it difficult to evaluate.
Since breast implants do not pass X-rays, it is not possible to examine the tissues adjacent to the implant.
Although mammography is the best method used to prevent breast cancer these days, it cannot detect all breast cancers.