Page 37 - Petelin, Ana, Nejc Šarabon, Boštjan Žvanut, eds. 2017. Zdravje delovno aktivne populacije ▪︎ Health of the Working-Age Population. Proceedings. Koper: Založba Univerze na Primorskem/University of Primorska Press
P. 37
Discussion the mammography efficiency in breast cancer detection 35
BRC is difficult to diagnose in younger women (Sentis, 2010). Wang et al. (2010)
claim that there is no good strategy for early detection of BRC in younger wom-
en. Massat (2014) also claims that they misdiagnosed between 40 and 50% of
cancer in younger women which had dense breast tissue using mammography.
Mammography is especially unreliable in younger women with small breast
and dense tissue. The latter also represents bigger risk for false negative re-
sults (Ying et al., 2012; Shao et al., 2013; An et al., 2015). Brem (2012) states that
one third of cancers are overlooked in women with dense breast tissue. Sever-
al other authors (Kriege et al., 2006; Sardanelli et al., 2011; Ying et al., 2012; An
et al., 2015) are discussing about sensitivity of mammography in younger wom-
en which results in 33–61%.
US is desired to use in women with breast tissue density rate 3–4 and
where mammography is negative. 0.6% of BRCs are discovered with that meth-
od. Next study showed that 0.3% of BRC is detected with US, especially in those
with dense breast tissue. They state that US shows especially invasive small size
(< 9 mm) tumours (Shao et al., 2013; Massat, 2014; Chetlen et al., 2015).
MRI is the most effective method for detecting BRC in dense breast tis-
sue (Massat, 2014). Study shows that MRI is the best way for detecting BRC in
women with BRC in family – heredity (Ying et al., 2012). Advantage of MRI is
high sensitivity (80 – 91%) for BRC detection but it is limited with low specific-
ity. It is especially suitable for women with more than 20% of risk for develop-
ment of BRC (Kriege, 2006; Sardanelli et al., 2011; Shao et al., 2013).
Authors state that it is crucial to use two or three diagnostic methods to
achieve good sensitivity. Great reliability can be achieved if we combine mam-
mography and US (Ying et al., 2012; Sardanelli, 2011; Shao et al., 2013). Because
of dense parenchyma tissue in younger women, they advise the use of US and
MRI. Both methods show excellent sensitivity compared to mammography
(An et al., 2015).
Conclusions
BRC is the most common cancer in women. In the past, when BRC awareness
was small and there was no screening programs, women had symptoms before
the diagnosis. Today we thrive to detect cancer in early phase with screening
programs, when there is no symptoms and there is larger possibility for suc-
cessful treatment. It is mandatory to take precautions to prevent prediagnosis.
Younger women have mostly dense breast tissue which interferes with mam-
mogram interpretation which can lead to false positive or false negative results.
Possible methods for detecting cancer in younger women are US and MRI with
higher sensitivity compared to mammography. Mammography is currently the
most used method for BRC detection. Is is important that we are well aware of
its limitations.
BRC is difficult to diagnose in younger women (Sentis, 2010). Wang et al. (2010)
claim that there is no good strategy for early detection of BRC in younger wom-
en. Massat (2014) also claims that they misdiagnosed between 40 and 50% of
cancer in younger women which had dense breast tissue using mammography.
Mammography is especially unreliable in younger women with small breast
and dense tissue. The latter also represents bigger risk for false negative re-
sults (Ying et al., 2012; Shao et al., 2013; An et al., 2015). Brem (2012) states that
one third of cancers are overlooked in women with dense breast tissue. Sever-
al other authors (Kriege et al., 2006; Sardanelli et al., 2011; Ying et al., 2012; An
et al., 2015) are discussing about sensitivity of mammography in younger wom-
en which results in 33–61%.
US is desired to use in women with breast tissue density rate 3–4 and
where mammography is negative. 0.6% of BRCs are discovered with that meth-
od. Next study showed that 0.3% of BRC is detected with US, especially in those
with dense breast tissue. They state that US shows especially invasive small size
(< 9 mm) tumours (Shao et al., 2013; Massat, 2014; Chetlen et al., 2015).
MRI is the most effective method for detecting BRC in dense breast tis-
sue (Massat, 2014). Study shows that MRI is the best way for detecting BRC in
women with BRC in family – heredity (Ying et al., 2012). Advantage of MRI is
high sensitivity (80 – 91%) for BRC detection but it is limited with low specific-
ity. It is especially suitable for women with more than 20% of risk for develop-
ment of BRC (Kriege, 2006; Sardanelli et al., 2011; Shao et al., 2013).
Authors state that it is crucial to use two or three diagnostic methods to
achieve good sensitivity. Great reliability can be achieved if we combine mam-
mography and US (Ying et al., 2012; Sardanelli, 2011; Shao et al., 2013). Because
of dense parenchyma tissue in younger women, they advise the use of US and
MRI. Both methods show excellent sensitivity compared to mammography
(An et al., 2015).
Conclusions
BRC is the most common cancer in women. In the past, when BRC awareness
was small and there was no screening programs, women had symptoms before
the diagnosis. Today we thrive to detect cancer in early phase with screening
programs, when there is no symptoms and there is larger possibility for suc-
cessful treatment. It is mandatory to take precautions to prevent prediagnosis.
Younger women have mostly dense breast tissue which interferes with mam-
mogram interpretation which can lead to false positive or false negative results.
Possible methods for detecting cancer in younger women are US and MRI with
higher sensitivity compared to mammography. Mammography is currently the
most used method for BRC detection. Is is important that we are well aware of
its limitations.
