MAMMOGRAPHY

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MAMMOGRAPHY

• RADIOGRAPHIC IMAGING OF THE BREAST
• Part 2
• Statistics

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• A mammogram can find breast cancer when it is
  very small -- 2 to 3 years before you can feel
  it.
• No screening tool is 100 effective. Good quality
  mammograms can find 85-90 of cancers

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Regular breast screening can find cancer when it
is small which means

• there is a better chance of treating the cancer
  successfully
• it is less likely to spread
• there may be more treatment options

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MAMMOGRAM

• REMAINS THE SINGLE MOST SENSITIVE TECHNIQUE IN
  DETECTION OF BREAST CANCER (ACR)
• OTHER MODALITIES
• ULTRASOUND
• MRI
• OTHER - thermography

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PATIENT FEARS

• PAINFUL
• FIND SOMETHING
• WRONG / DENIAL
• UNINFORMED
• causes cancer

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RISK FACTORS

• SEX 99 WOMEN
• 1 MEN
• AGE INCREASE WITH AGE
• YOUNGER WOMEN- FASTER GROWING CELLS

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MORE RISK FACTORS

• HISTORY
• PREGNANCY ABORTIONS
• OBESTIY
• EARLY MENSES
• LATE MENOPAUSE

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ACS GUIDLINES

• women age 40 to 49 have a routine screening
  mammogram
• every one to two years
• with the first one beginning at age 40
• BASELINE - for comparison

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EDUCATION

• BSE breast self exam -MONTHLY
• CBE clinical breast exam
• 3-6 months
• MAMMOGRAM ANUALLY BEGIN AGE 35

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Best Time For BSE

• The American Cancer Society urges women to
  perform breast self-examination (BSE) once a
  month
• about a week after the menstrual period
• Post-menopausal women should choose a set day,
  such as the first of the month, to practice
  self-examination.

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• Begin by looking at your breasts in the mirror
  with your shoulders straight and your arms on
  your hips.
• Here's what you should look for
• Breasts that are their usual size, shape, and
  color.
• Breasts that are evenly shaped without visible
  distortion or swelling.
• If you see any of the following changes, bring
  them to your doctor's attention
• Dimpling, puckering, or bulging of the skin.
• A nipple that has changed position or become
  inverted (pushed inward instead of sticking out).
  
• Redness, soreness, rash, or swelling.

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Some cancers are not found until they reach this
size                  A mammogram can find
cancer when it is only this size    
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Cancer statistics

• Breast cancer strikes about 180,000 American
  women yearly
• and kills about 44,000
• Next to skin cancer, breast cancer is the most
  frequently diagnosed cancer in women in the
  United States
• It is second only to lung cancer in
  cancer-related deaths

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RISK

• "Lifetime risk is the likelihood that a newborn
  girl will develop breast cancer sometime during
  her entire life.
• The 1-in-9 statistic does not apply to women of
  all ages

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RISK VS REALITY chance of being diagnosed with
breast cancer

• 30-year-old woman has a 2 (1 in 50) in the next
  20 years
• a 40-year-old has a 4.5 (1 in 20)
• 50-year-old woman's risk of developing invasive
  breast cancer--the most serious kind--in the next
  5 to 20 years
• ranged anywhere from 1 in 15 to 1 in 133
  depending on her ethnicity.

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four major ethnic group

• Asian/Pacific Islanders
• Hispanic
• African American
• Caucasian

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"For women currently aged 50the estimated risk
of developing invasive breast cancer within 5
years

• 0.8 (1 in 133) among Hispanics
• 1.3 (1 in 75) among Caucasians
• Within the next 20 years
• 3.7 (1 in 27) among Hispanics
• 6.6 (1 in 15) among Caucasians
• 5 (1 in 20) among African Americans
• 3.9 (1 in 26) among Asian/Pacific Islanders

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TYPES OF BREAST TISSUE
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FIBROGLADULAR (DENSE)

• 15 30 YO
• NO CHILDREN OVER 30
• PREGNANT/LACTATING
• UNDER 25 ULTRSOUND RECOMMENDED

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19-year-old woman who has never been pregnant.
Note the dense glandular tissues with small
amounts of fat
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FIBRO-FATTY

• AVERAGE DENSITY
• 50 FATTY 50 GLANDULAR
• 30 50 YRS OLD
• YOUNG WOMEN W/ 3 PREGNANCIES

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FATTY

• MINIMAL DENSITY FATTY
• OVER 50 YRS OLD
• POSTMENOPAUSAL ATROPHIC
• MALE BREAST
• CHILD BREAST

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68-year-old woman. Most of the glandular tissue
is atrophic