Mammography: getting ahead of breast cancer

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Extract from the article: Mammography is an X-ray examination of the breasts, carried out using an X-ray machine known as a mammograph. It is indicated as a first-line screening and diagnostic procedure for breast cancer, which is both the most common and the most deadly dise

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Mammography is an X-ray examination of the breasts, carried out using an X-ray machine known as a mammograph. It is indicated as a first-line screening and diagnostic procedure for breast cancer, which is both the most common and the most deadly disease affecting women. This examination is also useful for investigating other breast diseases. It can be performed on both women and men, although men generally do not have large breasts. What is the advantage of having this test? When is it recommended? 

Mammography is an X-ray of the breasts using low-dose X-rays. It is carried out using a device called a mammography machine. This may be equipped with an analogue system that is already obsolete in technical centres, or a digital system with two types of sensor depending on the device: a radioluminescent screen with memory and a flat sensor. Flat panel mammography is today's leading technology. It does exist in Lomé, albeit rarely. It allows optimum computerised acquisition and processing of the images taken. Mammography is a routine breast imaging procedure.

Kouamivi Sédo, Radiology and Medical Imaging Engineer-Manipulator at the Association Togolaise pour le Bien-Etre Familial (ATBEF) centre, talks about the situations in which mammography may be prescribed: « Mammography may be recommended for women at risk, based on socio-clinical data such as age (close to 40 and over), gestational age, parity, previous breastfeeding, family history of cancer, personal history of breast disease and history of hormonal treatment. It is also indicated in women who have dense breasts or who have genetic risk factors predisposing them to cancer, for the pre-surgical assessment of breast plastic surgery, for monitoring breast cancer that has been operated on, for monitoring breast prostheses, for monitoring breast reconstruction (cosmetic surgery) », he stresses.

This examination is not only carried out on adults. There are some special features. It can be carried out on young people with atypical physical signs of breast disease, depending on their age, socio-clinical data, personal history or suspicious biology.

Frequency of mammography

Mammography is not routinely performed for all breast complaints. It should be prescribed at the time of consultation, after the patient's socio-clinical data has been collected, and a careful visual inspection and palpation of both breasts has been carried out by an obstetrician-gynaecologist or other authorised health worker. There is a lexicon of breast lesion characterisation formulated by the ACR (American college of Radiology) known as BI-RADS (Breast Imaging Reporting And Data System). This lexicon is used to classify lesions according to whether they are benign or malignant, and to determine the next time or frequency of mammography after the first examination for follow-up or monitoring after treatment.

What is the point of carrying out this examination?

According to Kouamivi Sédo, radiology and medical imaging engineer/manipulator, « it can be used to diagnose breast cancer, particularly small cancers that are not clinically palpable, but also cancers that are clinically palpable. Apart from that, it can detect other non-cancerous lesions. Clearly, unlike other radiology examinations, mammography can be carried out at the request of the patient himself to the carer as part of a screening programme. »

Are there any risks involved in this examination?

There are risks, but the risks are so small because low-dose X-rays are used to minimise all these risks. It has to be said that the risk-benefit ratio is very much in favour of the benefit. This is why there are indications for carrying out this examination.

Abel OZIH