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X-ray of mammary glands (mammography)

 
, medical expert
Last reviewed: 18.10.2021
 
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Diseases of the breast develop very often. It is enough to note that the cancer of this organ is the most often malignant tumor detected in women. Diagnosis is based on the results of clinical examination and special studies, which are critical for detecting early stages of the disease. Radiodiagnosis in recent years has occupied an honorable place in this complex.

Mammography - radiography of the breast without the use of contrast agents.

Radiography is performed on X-ray machines specially designed for this purpose, mammographs. The power of their x-ray tubes is 19-32 kV, they have two focal spots with a diameter of 0.3 and 0.1 mm. The tube anode is made of molybdenum, and the exit window is made of beryllium. These design features are necessary to obtain a uniform beam of low-energy radiation and to achieve in the images a differentiated image of breast tissue.

Mammography is produced by compressing the tissues of the breast. Pictures are usually performed in two projections - direct and oblique or straight and lateral. In addition to survey mammograms, in some cases, targeted images of individual sections of the gland are needed. Mammographs are equipped with a stereotaxic device for puncture of the gland and collection of material for cytological or histological analysis.

Mammography is performed in the first phase of the menstrual cycle (from the 5th to the 12th day, counting from the first day of menstruation). Women in menopause can take pictures at any time. Radiation load at mammography does not exceed 0,6-1,210 ° Gy. Complications and pathological reactions in the study does not happen. The risk of cancer of the gland, induced by radiation (radiogenic cancer), is negligible. A priori it is defined as 5-6 cases per million examined, in addition, with a latent period of 10-20 years. But spontaneous breast cancer occurs in 90-100 thousand women, and only because of the periodically conducted mammography, about half of them can be saved from death due to cancer.

Method of mammography 

Diseases of the mammary glands

There are two groups of radiation studies of the breast: check and diagnostic. The first is the periodic mammogram of healthy women in order to identify hidden diseases, primarily cancer. Figuratively speaking, this is a "mammogram of healthy women who want to stay healthy". In all women who have no signs of breast disease, it is recommended that a mammogram ("basic mammograms") be performed at the age of 40 years. Repeated clinical and mammographic examinations should be performed at intervals of 2 years, if a woman is not included in the group at high risk of developing breast cancer. Mass screening surveys of the female population using mammography (mammography screening) provide a reduction in mortality from breast cancer by 30-50% and a significant reduction in the frequency of mastectomy.

Breast cancer is a chronic and slowly developing disease. The tumor originates from the epithelium of the milk ducts or glandular lobules. Accordingly, there are two main types of cancer: protocoll and lobular. Transformation of the epithelium is stereotyped: norm - hyperplasia - atypia - cancer. Before the formation of a tumor with a diameter of 1 mm, an average of 6 years, and up to 1 cm - 6-10 years.

Small-cystic perestroika, as a rule, occurs in both mammary glands. Larger cysts give round and oval shadows of different sizes - from 0.5 to 3-4 cm with clear, even arched contours. The multi-chamber cyst has polycyclic outlines. The shadow of the cyst is always uniform, there is no lime deposit in it. The radiologist produces a puncture of the cyst, aspiration of its contents and introduces air or sclerosing composition into it. The most demonstrative cyst on sonograms.

Mixed forms of mastopathy cause a variegated x-ray picture: instead of the sharply marked shadow of the glandular triangle with the trabeculae radially diverging from the base of the gland to the areola, a restructuring of the gland structure with multiple areas of darkening and enlightening of different shapes and sizes is revealed. This picture is figuratively called "lunar relief".

Mammographic signs of breast diseases

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