Mammography or breast ultrasound, which one is better for you?

This is the 4737th article of Da Yi Xiao Hu

With the rapid development of medical technology and the improvement of people's health awareness, many female compatriots have many choices when doing breast-related examinations. At present, the commonly used methods of breast examination in my country include mammography (molybdenum target), ultrasound examination, ductoscopy, MRI (nuclear magnetic resonance imaging), and PET-CT. Among them, ultrasound and molybdenum target are widely used in physical examination screening of breast diseases because of their convenience and low price. However, many friends will find that the breast examinations in different hospitals or different physical examination packages in the same hospital are not the same. Some people choose physical examination molybdenum target, and some people choose ultrasound. Then some friends will have doubts. What is the difference between these two examinations? Do I need to do both or choose one of them?

1. Breast Ultrasound

Breast ultrasound uses an ultrasound machine to transmit ultrasound waves into the breast to obtain ultrasound images. The nature of the lesion is comprehensively judged based on the ultrasound images of the breast tissue, such as its morphology, size, blood flow, etc.

1. Adapt to the crowd

Ultrasound is non-radioactive, so it can be basically applied to all people, including expectant mothers. Ultrasound has a high detection rate for breast nodules, and can be repeated in a short period of time. It is recommended that normal adult female friends have a breast ultrasound examination once a year. Friends with high-risk factors, such as family history of breast cancer, menarche before the age of 12, menopause after the age of 55, obesity, etc., should have a breast ultrasound examination every six months, and seek medical attention in time if any abnormality is found.

2. Preparations

Ultrasound examination is non-invasive and radiation-free, so women do not need to worry or be anxious. It is best to have the examination 7 to 10 days after the menstrual period ends. Wear loose clothing on the day of the examination to facilitate the doctor's operation. For those who have nipple discharge, do not squeeze the nipple, because the filled duct is more conducive to showing the lesion.

3. How to understand the ultrasound report?

"Your breast disease is benign, and regular checkups are enough." When many friends are told that they have breast disease and want to consult doctors about follow-up treatment, doctors often tell them to have regular checkups based on ultrasound results. What is the basis for doctors to make such judgments? — BI-RADS classification. BI-RADS is a grading evaluation standard commonly used in breast ultrasound diagnosis. Doctors will make comprehensive judgments and grading based on the morphology, blood supply, and boundaries of surrounding normal tissues of breast nodules.

From this table, we can see that the possibility of malignancy of BI-RADS 4 nodules ranges from 2% to 95%, which is a very large span. Therefore, when diagnosing BI-RADS 4, it depends on the specific situation. Generally, the possibility of malignancy of BI-RADS 4A lesions is not high, only 2-10%, and can be monitored through short-term follow-up (3-month review). If you are worried, you can also perform a puncture or surgical biopsy to further clarify the diagnosis; the possibility of malignancy of BI-RADS 4B, 4C, and 5 lesions increases, and surgical resection or puncture biopsy is usually recommended at this time.

Therefore, there is no need to be too nervous even if it is BI-RADS 4. If it is BI-RADS 4A and the lesion is large, it can be combined with other examination results. If there is no high suspicion of malignancy, it can also be followed up and observed for a short period of time.

2. Mammography

Mammography is actually a kind of X-ray examination of the breast. The X-ray machine emits X-rays, and the target of the transmitting tube is made of molybdenum, that is, metal molybdenum. The X-ray tube made of metal molybdenum emits very clear rays for the transmission and imaging of soft tissues. In this way, the soft tissue shadows in the breast can be more clearly understood, and whether there is local thickening or thickening of the breast. Among them, mammography plays an important role in the identification of breast calcification foci, and breast ultrasound cannot match it in this regard.

1. Adapt to the crowd

According to the diagnosis and treatment guidelines of the Chinese Breast Cancer Association, it is recommended that people over 40 years old undergo a routine mammography examination every 1 to 2 years. If a lump has been found or breast cancer has been diagnosed, mammography can also help understand the extent of the lesion, whether it has metastasized, and whether breast-conserving surgery can be performed. For people at high risk of breast cancer, a combination of breast ultrasound and mammography can be used to determine whether the breast is diseased.

2. Taboo groups

Since mammography is a special type of X-ray examination, it is radioactive, so it is forbidden for those who are preparing for pregnancy or pregnant. For young women, breast glands are sensitive and may cause cell mutations in some cases, so breast ultrasound examination should be chosen as much as possible. In addition, the examination should be avoided during menstruation as much as possible. The best time for examination is 7 to 10 days after menstruation.

3. How to understand the molybdenum target report?

BI-RADS is also the main criterion for doctors to diagnose the disease. It is worth mentioning that for some women, the nodules indicated in the ultrasound report will not be mentioned on the mammography report. This is because ultrasound has a higher diagnostic value for breast nodules, and mammography mainly targets calcification foci in breast tissue. The two should be combined to better judge the condition.

3. Prevention of Breast Diseases

Breast diseases can occur in women of different ages. If you want to prevent breast diseases, you have to pay attention to breast health protection from infancy. Different protection and care measures should be taken for the breasts of women of different ages, such as menstruation, pregnancy, and lactation. However, with the accelerated pace of life, what are the inducing factors that cause the age of breast disease to become younger and younger? Mental depression and excessive mental stress will increase the chance of breast disease. Now, with the faster pace of social development, young people are under increasing pressure in life and work. Coupled with irregular rest time and unhealthy eating habits, young women will be overly tired physically and mentally stressed, which will increase the incidence of breast diseases.

"Early detection, early diagnosis, and early treatment" should be kept in mind. Due to the privacy of the breasts, it is also very important to learn self-examination.

① View

Sit in front of the mirror, with your hands hanging naturally, and carefully observe whether the size of the breasts on both sides is symmetrical, whether there is local redness, swelling, or depression on the surface of the breasts on both sides, and whether the nipples are deformed, sunken, or have eczema. If there is unequal size of the breasts on both sides, inverted nipples, sunken skin, or changes in skin epidermis, you should go to the hospital for treatment in time.

②Touch

With the nipple as the center, draw two straight lines vertically and horizontally to divide the breast into four quadrants. Use a clockwise technique, put four fingers together, and gently touch the breast with the fingertips, in the order of outer upper, outer lower, inner lower, inner upper, and finally the areola and nipple. During the whole process, use the fingertips to gently press the breast to check for lumps or nodules.

③Squeeze

Use your thumb and index finger to squeeze the nipple and areola to see if there is any discharge. Finally, touch the armpits on both sides to see if there are obvious swollen nodules.

In summary, breast ultrasound and breast mammography have their own advantages for female friends of different ages and different diseases. We should reasonably choose auxiliary examination methods and develop a good habit of regular self-examination and physical examination. Finally, it is recommended that young patients have a breast ultrasound examination once a year, and patients over 40 years old should have a mammography examination once every 1 to 2 years.

Author: Shanghai Tenth People's Hospital

Chu Juhang Qian Mingping