[Fat Bear Science] Can't understand the breast examination report? Learn these professional "code words" to unlock the physical examination report with one click

Breast disease is the number one killer threatening women's health

The "Pink Ribbon" is a recognized "symbol" for global breast cancer prevention activities.

To convey the concept of "early prevention, early detection, early treatment" to the society

Call on people to pay attention to breast health and stay away from breast diseases

Every October is #PinkRibbon#Breast CancerAwarenessMonth

Cherish life, "milk" this beauty

I heard that regular physical examinations can keep you away from this "killer"

Physical examination is a small matter, but not understanding the report is a big deal.

Hypoechoic nodules? Anechoic nodules? Spiky edges?

…

A bunch of terms that make people confused

Today we invite experts from the Breast Cancer Center

Teach you how to read the physical examination report step by step

The most basic physical examination items for breast examination are breast color ultrasound and breast mammography. Let’s first talk about how to understand the color ultrasound report.

Expert Profile

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Yu Feng

Attending physician at the Breast Cancer Center of the Affiliated Cancer Hospital of Chongqing University.

He has been engaged in the differential diagnosis of benign and malignant breast tumors and the diagnosis and treatment of early breast cancer for a long time. He is particularly good at minimally invasive breast surgery, ductoscopy and other technologies.

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Zeng Junjie

Attending physician at the Breast Cancer Center of the Affiliated Cancer Hospital of Chongqing University.

He has been engaged in the diagnosis and treatment of breast diseases for 10 years and is good at minimally invasive breast surgery and early diagnosis of breast malignant tumors.

Understanding Color Doppler Ultrasound Reports

Conclusion is the key

Don’t be fooled by the color Doppler ultrasound doctor’s eloquent “articles” in the report, but what we really need to pay attention to is the content of the final conclusion. In the conclusion part, the doctor will write down all the problems found during the examination. For example, if there is a low echo nodule, it means that a solid mass is found in the breast. Most benign and malignant breast tumors are mainly solid masses. If there is an anechoic nodule, it means that the mass is liquid in nature, mainly a cyst.

Regardless of the nature of the nodule, the doctor will mark a grade after the diagnosis. The specific writing method is BI-RADS (Breast Imaging Reporting and Data System), which is a risk assessment and quality assurance tool developed by the American College of Radiology. It assesses the risk of breast imaging results and is divided into 5 categories. The meanings of different combinations are as follows:

BI-RADS 0

The test is incomplete, no valid information, additional testing is required

BI-RADS I

Negative, no problem, just follow up as directed by the doctor

BI-RADS 2

Benign, follow up as directed by the doctor

BI-RADS 3

The possibility of benign disease is high, and regular follow-up is required according to the doctor's instructions (e.g., once every six months).

BI-RADS 4

The results of this category are relatively complex, and there is a possibility of malignancy, which requires further confirmation by breast MRI and breast biopsy.

BI-RADS 5

If malignancy is highly suspected, a biopsy should be performed and treatment should be promptly performed.

BI-RADS 6

Malignancy confirmed by biopsy

To put it simply: if you see BI-RADS 1, 2 or 3 on the report, you don’t need to worry too much, because nodules of Category 3 and below mean almost certain benign lesions, with the possibility of malignancy between 0% and 2%. The routine treatment is a short-term follow-up examination (usually 6 months).

If the BI-RADS classification on your report reaches 4 or above, then you need to be vigilant, because this means that the possibility of malignancy of the lesion has increased. Category 4 is further divided into three subcategories: A, B, and C.

Category 4A has a 2% to 5% chance of malignancy;

Category 4B has a 10% to 50% chance of malignancy;

Category 4C is more suspected of being malignant, but not as typical as category 5. The possibility of malignancy is 50% to 95%.

If the BI-RADS classification reported above reaches category 5, it is highly suspected of malignancy (almost certainly malignant), and the possibility of malignancy of this type of lesion is greater than 95%.

The correct approach when encountering the above situation is to immediately take the physical examination report to a breast specialist for treatment. At this time, you need a professional breast tumor specialist to help you solve the problem.

Mammography

The key is whether there is a mass or not

Mammography is actually a special X-ray examination for breast tissue. Its advantage is that it can detect tiny calcifications that are difficult to detect with color Doppler ultrasound and MRI. Some specific forms of calcifications, such as segmental, linear, and clustered calcifications, may be one of the manifestations of early breast cancer. Therefore, mammography plays an important role in the early screening of breast cancer.

So what are the key points to look for in the mammography report? The main thing is to see if there is a mass in the description of the final conclusion. If the boundary is clear, it is likely to be benign. If there is a burr on the edge, it is a bad sign and may be malignant.

Another thing to note is the presence or absence of calcifications. If they are small and vague, bilateral, and diffuse, they are mostly benign. If the calcifications are arranged in a linear pattern, or clustered in a smaller space (clustered distribution), they are first considered to be suspected malignant calcifications, and further biopsy is required to clarify their nature.

Of course, in addition to the above description, the breast mammography report also has the same BI-RADS classification standards as color ultrasound, and its meaning can be directly referred to color ultrasound.

After mastering these techniques of reading medical examination reports, try it out during this medical examination - "I have the final say over my report."

Well, I understood the medical examination report, but I have new questions~

If you have any questions, please tell us and we will help you solve them~

My mother was diagnosed with breast cancer during a physical examination. I wonder if I will be diagnosed with it too.

It shouldn't be possible. If you don't believe it, let's listen to what the experts say...

Experts advise

A family history of breast cancer is a high-risk factor for breast cancer. Even if a family member unfortunately suffers from breast cancer, you don't have to worry too much. Although a family history of breast cancer increases your chances of getting the disease, it is not 100% hereditary, and you can also take the right measures to minimize the risk.

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Know your genetic background

Most breast cancers are sporadic, while 5%-10% are hereditary. BRCA1/2 is a susceptibility gene for breast cancer. If the BRAC1/2 gene itself contains a pathogenic mutation, the risk of breast cancer will increase significantly (the cumulative risk at the age of 70 is 85%-90%). Now many large hospitals have the ability and equipment to perform blood tests for BRAC1/2 gene mutations, which can be used to detect pathogenic mutations in a timely manner, and receive consultation from specialist breast surgeons, and take preventive treatment when necessary.

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Pay attention to your lifestyle

Breast cancer is an estrogen-related disease. High-fat diet, overnutrition, obesity, drinking and other factors can strengthen or prolong the stimulation of estrogen on breast epithelial cells and increase the risk of cancer. Therefore, strengthening physical exercise, controlling weight, low-fat diet, eating more green vegetables and fruits, not smoking, and not drinking can reduce the risk of breast cancer. In addition, women now have greater mental stress at home and at work, which leads to an imbalance in the internal environment, hormone disorders in the body, and decreased immunity, which increases the risk of breast cancer. The secretion of melatonin by the hypothalamus during sleep at night has the effect of enhancing the immune system and balancing the estrogen level in the body. In modern society, the pace of life is fast and the work pressure is high. Staying up late for a long time will lead to a decrease in the secretion of melatonin in the hypothalamus, resulting in an increased risk of breast cancer. Therefore, keeping a positive and optimistic spirit, a reasonable work and rest schedule, and avoiding excessive fatigue can also reduce the incidence of breast cancer.

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Pregnancy and breastfeeding

According to statistical analysis, the earlier an adult woman becomes pregnant, the lower her risk of breast cancer. It is recommended that the first pregnancy be no older than 30 years old. At the same time, breastfeeding can also reduce the risk of breast cancer by 20%-30%.

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Hormone replacement therapy

Perimenopausal women can relieve menopausal symptoms by taking exogenous estrogen orally. However, some studies have shown that the risk of breast cancer in women taking hormone replacement therapy increases by 30%, especially in women with BRCA1/2 gene mutations and a family history of breast cancer. If you need to take it, you should follow the advice of a specialist. In addition, there is no sufficient data to show that abortion and oral contraceptives increase the risk of breast cancer.

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Ionizing radiation

Long-term exposure to ionizing radiation, such as a history of chest radiotherapy or excessive chest X-ray examinations, will increase the risk of breast cancer in women, especially those who have been exposed to radiation during the developmental age, that is, the breast growth period, when the risk is highest. Therefore, the chance of exposure to ionizing radiation should be minimized.

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Regular inspection

Regular examinations include breast self-examination and regular breast examinations at medical institutions. Breast self-examination is generally performed once a month. If abnormal lumps, nipple discharge, or skin redness and swelling are found, you need to go to a breast specialist for examination as soon as possible. For adult women, it is recommended to go to the hospital for regular examinations once a year before the age of 40; after the age of 40, it is recommended to go to the hospital for examinations every six months, and those with a family history of breast cancer should go to the hospital for examinations in advance at the age of 35. Specific imaging examination items vary depending on age and condition, and the opinions of breast specialists should be followed.

In summary, when a family member has breast cancer, do not worry too much about getting breast cancer yourself and live in fear and anxiety for a long time. You can reduce the risk of breast cancer through relevant breast cancer gene testing, a correct lifestyle, early pregnancy and breastfeeding, regular check-ups, etc.

Text/Fat Bear

Picture/partially from the Internet (please contact us to delete if there is any infringement)

Audit/Breast Cancer Center

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