Mammology

Mammologist — the doctor who deals with the diagnostics, treatment and prophylaxis of various breast diseases: mastopathy, fibromas, cysts, and breast cancer.

Every woman aged 40 and above should annually refer to mammologist for prophylactic purposes.

These are the most frequent diseases of breast:

1. Mastitis — inflammatory breast disease
2. Mastalgia — breast pain
3. Fibrocystic breast disease (diffuse form) — disharmonic breast disease
4. Breast tumours:
   • benign: breast and nipple adenoma, intraductal papilloma, cysts, fibroadenoma, lipoma.
   • pre-malignant conditions: proliferative fibrocystic breast disease; phylloid fibroadenoma; epithelial dysplasia.
   • malignant — breast cancer represents one of the most widespread localization of malignant tumour in women. Malignant neoplasms do not show in themselves, they are preceded by benign breast diseases, with the various forms of mastopathy as the most commonly encountered.

Breast cancer at the early stages is asymptomatic and painless!

The warning signals, which call for special attention and mammologist’s consultation:

• the presence of redensification and masses in one or both breasts; Breast deformation;
• any nipple discharge, which is not associated with pregnancy or lactation;
• erosions, scabs, scaly crust, and nipple or areolar ulceration;
• groundless deformation, edema, enlargement or reduction of breast;
• enlargement of axillary or supraclavicular lymph nodes.

At our Centre, the diagnostics of breast diseases involves:

• Consultation and examination by oncologist-mammologist
• Mammographic investigation:

Reliable radiographic method, simple and safe for patients, which is performed without the use of contrast agents, in frontal and lateral projections on both sides. Mammography is indicated in the presence of indistinct calcifications in order to specify the form of mastopathy and to monitor its progression, in breast cancer, to establish the diagnosis and to determine its stage. Typically, the investigation is preventive as it facilitates early determination of breast cancer. For the preventive purposed, it is recommended to perform mammography on annual basis to women at the age of 40 and above.

The radiation exposure during the procedure of mammography is minimal (for the current technologies 0.001-0.008 Gr)

Ultrasound investigation — ultrasound investigation represents supplementary technique aimed to diagnose pathological breast changes, determined in the course of mammography. This method is simple and safe. Repeated examinations are often performed in order to access the efficiency of received treatment.

Computer and magnetic resonance imaging. These methods are very susceptible and informative, which are mainly used to confirm mammographic findings.

Puncture thin-needle aspiration biopsy of breast neoplasms under ultrasound control. Cytological investigation of the material obtained during biopsy makes it possible to determine malignant or benign character of breast tissue changes. This method is more conservative as compared to resection biopsy.

The following material may be submitted for cytological investigation:

• The tissue obtained for needle biopsy from the tumour or breast masses
• Nipple discharge
• Scraping of abnormal breast surface

Exploratory breast puncture is performed with the use of thin needles under ultrasound control; the given manipulation is minimally painful and safe.

Blood test for tumour markers

Detection of genes which stand for the development of breast cancer BRCA1 and BRCA2 in blood. Their presence does not speak for inevitable disease development, though in the certain setting these genes may actually transform and result in the development of the given major illness.