Many women are confused about why I should have a mammogram after having an ultrasound. Is mammography more advanced than ultrasound? How should I choose? In fact, ultrasound and mammography have their own advantages and disadvantages and complement each other, depending on the patient’s disease condition, there is no winner or loser between the two. Let’s take a closer look at them.
Ultrasound mainly identifies masses and is less sensitive to small calcifications.
Ultrasound advantages.
(1) Ultrasound of the breast is not radioactive and can be repeated as needed;
②Ultrasound can clearly distinguish the levels, and the accuracy rate of identifying cystic (cystic nodules with fluid inside) and solid masses can reach 100%, which can roughly determine the benignity and malignancy of tumors;
③Ultrasound can guide puncture biopsy;
④Ultrasound can also understand whether the lymph nodes in the axilla and supraclavicular area have metastasis.
Disadvantages of ultrasound: Ultrasound is difficult to distinguish many tiny calcified foci.
Some people may ask, “What if ultrasound is not sensitive to “calcifications”? Why do we have to use mammogram to look at it again? It is because malignant calcification is the main manifestation of cancer, and microcalcifications in clusters, mud-like, rod-like, or branch-like foci often suggest the possibility of breast cancer. However, there is no need to be nervous when you see calcification, as malignant “calcification” is very rare, but a clear diagnosis is necessary just in case.
Mammography mainly looks for calcifications and can easily miss masses
Advantages of mammography: Mammography is most advantageous in detecting microcalcifications, which in turn can detect asymptomatic or non-touchable tumors, and is even more efficient than MRI.
Disadvantages of mammography.
①The mammogram flattens the entire breast for fluoroscopy, so if the patient has an abundance of breast glands, the glands will overlap with the lesion, making it difficult to distinguish between the gland and the lesion;
②If the breast volume is small and the lump is close to the chest wall, it cannot enter the fluoroscopic range, resulting in no inspection and easy to miss;
③Mammogram is radioactive and not suitable for frequent examination;
④Some patients report that it is painful to take mammograms. This is because 5~7 days before a woman’s menstrual period, her breasts will be swollen and painful, so it is natural to have a mammogram at this time and the pressure plate will be clamped on the breast, which will be more painful. Therefore, it is most appropriate to do the examination about 10 days after the menstruation is clean, and the pain is usually not unbearable.
Some patients also ask what is the purpose of infrared examination of the breast? In fact, infrared examination has only a reference value, and its sensitivity and specificity are not high, so it is not suitable for breast disease screening.
When should I have an ultrasound? When should I have a mammogram? When to do both?
1. Ultrasound only: Ultrasound is the first choice for breast screening in young people. It is generally recommended that women over the age of 35 have an ultrasound examination of the breast once a year.
2, only mammography: women over 60 years old, the glands have begun to shrink, do not worry about the problem of overlapping glands together, at this time, only a mammography can be checked.
3.Both examinations should be done.
①Suspicious lesions (such as suspected malignancy) are found after having an ultrasound and need further confirmation;
If the examiner is over 40 years old and has never had a mammogram before, the doctor may recommend a mammogram screening test.
4.Which test can see the lesion clearly, which test will be used for follow-up.
①Some patients who have had a mammogram find suspicious lesions but do not look obvious under ultrasound, then the mammogram should be the main test for follow-up. Generally, if the mammogram is performed no more than 2 times in a year, the radiation level will not exceed the standard;
If the patient’s lesion can be seen with ultrasound, but cannot be found with mammography, then ultrasound should be the main focus of the review.