Mammography


Mamography 1
Mamography 2
Mamography 2

Mammography is the examination of the breasts using a low-dose x-ray system. It is a non-invasive procedure used to help in the early detection and diagnosis of breast disease in women and sometimes men. Regular breast self-examination is essential in the early detection of disease.

Patient Q & A
How is it done?

The biopsy can be done under stereotactic or ultrasound guidance . Stereotactic biopsy is used when a lesion is not palpable or is not seen on other imaging modalities. This is in the setting of micro-calcifications, distortion in breast architecture or abnormal looking breast tissue with no defined lesion. Stereotactic guidance uses x-rays and accurate co-ordinates to sample the lesion in question. The procedure is done under local anaesthetic and no sedation is required. The patient will be able to drive home.You should avoid using any pain medication which has aspirin in it. Panado is safe and usually adequate to control any pain.

What is ultrasound?

Ultrasound examination is the use of high-frequency sound waves to produce pictures from inside the body. Breast ultrasound is usually done routinely following evaluation of the mammogram. It is useful to differentiate solid from cystic lesions and also to characterise a solid lesion. Ultrasound is often used to assist in doing a biopsy of a lesion for laboratory evaluation.

Will I need a MRI?
MRI of the breast is an advanced investigation which is not done routinely currently. The main indication for breast MRI is to detect more than one lesion in the breast and also for disease in the other breast in the setting of breast cancer. MRI is also of value in the setting of screening young patients with a very high risk for breast cancer (eg BRCA gene positive).
The decision on doing an MRI will be made after all the investigations are complete and are usually requested by the referring clinician before any intervention.
What is a biopsy?

Breast biopsy is the sampling of a lesion detected during the procedure which is evaluated for any malignant cells. It may be done at the same time or a special booking may be made depending on the needs of the patient and clinician.

Mammogram


To obtain a mammogram, the patient is seated and the breast is positioned on a special platform. Gentle compression of the breast is essential to obtain good diagnostic images.
 
X-rays are than taken of each breast in 2 views and printed on film. Plain film x-rays are being replaced with digital mammography. With this advance, x-ray film is replaced with solid-state detectors which convert x-rays into electrical signals. Images are viewed on a computer screen.
 
The Radiologist will review the images and decide on further investigations/management including ultrasound, MRI and biopsy.

Bone Densitometry


This investigation is used to evaluate bone mass in the setting of osteoporosis. These patients are at high risk for fractures in the absence of significant trauma.

Strong risk factors for osteoporosis include:
  • Early menopause (<45y)
  • Oestrogen deficiency
  • Prolonged steroid use
  • Chronic medical conditions like chronic renal failure
  • Hyperthyroidism, chronic liver disease
  • Low body mass index Maternal family history of hip fract