Advantages and disadvantages of breast ultrasound.
Advantages.
(1) For areas that are difficult or not illuminated by X-ray molybdenum-palladium irradiation techniques. (e.g., breast margins, internal breast area, tumors deep in the chest wall and small, dysplastic mammary glands, etc.)
②The identification of cystic or solid masses in the breast is better than any examination method.
③High resolution of high-frequency probe can detect 0.3-0.5cm micro masses and 0.1-1.0mm micro calcification foci.
④While examining the breast, the presence of metastatic lymph nodes in the axilla and supraclavicular fossa ipsilateral to the lesion can also be observed.
Diagnostic ability of ultrasound for breast diseases: it can detect 2-3mm cystic lesions; 3-4mm substantial lesions; it can show 1mm ductal structures and lesions in the milk ducts; it can show microcalcified foci within breast cancer; it can detect enlarged lymph nodes in the parasternal, axillary, upper and lower clavicle, and neck.
Disadvantages.
①It is difficult to diagnose with certainty microlumps <0.5cm, especially those within hyperplastic glands, which are easily misdiagnosed as hyperplastic nodules or missed.
②It is still difficult to differentiate inflammatory masses in the breast from inflammatory breast cancer.
③It is not clear to show very tiny fine sandy or punctate calcification.
Defects.
①Low sensitivity in detecting microscopic calcified foci in breast, which makes some early breast cancer’s missed diagnosis.
②Poor diagnostic specificity for <1cm masses.
Mammography
1.X-ray – The commonly used method is mammography.
①The radiation dose is <0.01Gy, and its carcinogenic risk is close to the natural incidence rate.
(2) The X-ray of breast cancer appears as a swollen and fast shadow with irregular border or burr sign.
③Calcified spots with fine and dense particles are sometimes seen on X-ray of breast cancer.
If there are more than 15 calcification points per square centimeter, the possibility of breast cancer is high.
2.Mammogram BI-RADS grading
Mammography Lymph nodes: size is of little diagnostic significance; morphology is of great significance; round and dense is of great significance; lipid-containing and kidney-shaped is of little significance. Mammography dense lymph nodes should be asked if the patient has any recent infections, etc.
Molybdenum palladium report.
Dense type – poor display of lesions, further other examinations if necessary, no significance.
Fatty – good visualization of the lesion, high contrast, meaningful.
Multiple glands – approximately the same significance, dense.
Few glands – approximately the same meaning, fatty.