Mammography is a fundamental test to detect breast cancer . Thanks to it, there are between 7 and 9 fewer deaths from this tumor for every 10,000 women, according to scientific data published in The Journal of Medical Screening . This is due to the fact that it allows an early diagnosis and detect cancer in its early stages, which increases the chances of survival.
In this article we will discover all its secrets, but keep in mind anyway that it must be the gynecologist who will tell you what the radiologist's diagnosis is. This is responsible for establishing the degree of suspicion of cancer and making the pertinent recommendations. So don't "skip" the visit for me to review.
1. Breast pattern
The BI-RADS system breast pattern classifies breasts into 4 types according to their density. The denser, the more difficult to detect tumors.
- Type A: Fat breasts. Very little fibrous and easier to diagnose.
- Type B: Medium density. They have scattered areas of fibrous and glandular tissue, such as patches of this tissue that occupy between 25% and 50% of the breast.
- Type C: Heterogeneously dense. The breast has even more areas of fibrous and glandular tissue (50-75%). It can make it difficult to see lumps that could be malignant.
- Type D: Extremely dense. With more than 75% fibrous and glandular tissue. It is the most difficult type of breast to diagnose.
2. Findings
It refers to abnormalities that can lead to suspicion of cancer.
- Microcalcifications. They are small dots of calcium, similar to grains of salt, that sometimes indicate the presence of early-stage breast cancer. They are not normally seen on palpation of the breast, but appear on mammography. Depending on how they are grouped and their shape, size and quantity, your doctor may order further tests.
- Masses or nodules. They are areas of greater density of breast tissue. They can be cysts or fibroadenomas. Cysts are fluid-filled and are rarely associated with cancer. Fibroadenomas are round, solid, mobile lumps made of normal breast cells. They are not cancerous, but if they grow they are usually removed.
- Distortion. This is the name given to the existence of several lines that converge in a point of the breast that is not the nipple, but without there being any lump. This finding can be a sign of cancer.
3. Category
In the categories is where you will see if there is any suspicion that cancer has been detected and what recommendations the radiologist gives.
- Category 0. Incomplete radiological evaluation. This result means that additional imaging studies or comparison with previous mammograms are needed to see if there have been any suspicious changes.
- Category 1. No major anomaly detected. The breasts are symmetrical, there are no lumps, distorted structures or suspicious calcifications. In this case, negative is good because it means that everything is fine.
- Category 2. Benign finding. The result is also negative because there are no signs of cancer, but something like calcifications or calcified fibroadenomas has been found, although they are benign, that is, not cancerous.
- Category 3. Possibly benign finding. These findings have a greater than 98% chance of being benign. But since they haven't been 100% proven, it's important to do a short-term follow-up to avoid unnecessary biopsies.
- Category 4. Suspicious abnormality. A biopsy should be considered. The findings do not seem to definitively indicate that they are cancerous, but the radiologist is doubtful enough to recommend further testing.
- Category 5. High probability of malignant finding. The findings look like cancer and there is a high probability (95%) that they are a malignant tumor. A biopsy is recommended.
- Category 6. Biopsy results of proven malignancy. In these cases, mammography is used to see how treatment is responding to a cancer that has already been previously diagnosed in a previous biopsy.
BI-RADS system
What is it?
The BI-RADS system was created by the American College of Radiology (ACR) in 1993 so that all radiologists would have a standard way of assessing results and deciding how to act. It is a unified way of describing breast type, suspicious findings, and mammogram results.
