Diagnosis of breast cancer. Part 2

Ultrasound-mammography

breast cancelt mammography

Ultrasound examination is currently an additional method of diagnosing malignant breast tumors, although it has several advantages over radiography. For example, it allows you to take pictures in different projections, does not have harmful effects on the body.

The main indications for the use of ultrasound diagnosis in breast cancer:

  • observation in dynamics after the tumor was detected during X-ray mammography;
  • the need to distinguish a cyst filled with a liquid from dense formations;
  • diagnosis of breast diseases in young women;
  • control during the biopsy;
  • need for diagnosis during pregnancy and lactation.

The procedure is no different from the usual ultrasound. The doctor uses a special sensor that applies to the mammary gland. The image is translated to the monitor, can be recorded or printed.

During the ultrasound examination of the mammary glands, dopplerography and duplex scanning can be performed.

Computer tomo mammography

Computed tomo mammography

The study is a computed tomography of the mammary glands.

Advantages of computer tomomammography before x-ray mammography:

  • possibility to get pictures with layered sections of tissues;
  • the possibility of more precise detailing of soft tissue structures.

The disadvantages of computer tomomammography:

  • The study is worse than the X-ray mammography, reveals small structures and calcinates.
  • The study is conducted in the same way as conventional computer tomography. The patient is placed on a special table inside the device. It must be stationary during the whole study.

Biopsy – excision of a fragment of a tissue of a mammary gland with the subsequent studying under a microscope.

Puncture biopsy

breast biopsy

The accuracy of the technique is 80 – 85%. In 20 – 25% of cases receive a false result.

Fragment of the breast tissue for the study is obtained with a syringe or a special aspiration pistol.

The procedure is performed under local anesthesia.

Depending on the thickness of the needle, two types of puncture biopsies are distinguished:

  • fine-needle;
  • thick-needle.

Manipulation is often performed under the supervision of ultrasound or X-ray mammography.

Trepanobiopsy

Trepanobiopsy breast cancer

Trepanobiopsy of mammary glands is carried out in cases where it is necessary to obtain more material for the study. The doctor receives a piece of breast tissue in the form of a column.

Trepanobiopsy is performed using a special instrument consisting of a cannula with a mandrel, into which a rod with a chisel is inserted.

Intervention is performed under local anesthesia. The surgeon makes an incision on the skin and inserts through it a tool for trepanobiopsy. When the tip of the incisor reaches the tumor, it is pulled out from the cannula. With the help of a cannula, a column of tissues is cut and extracted.

After receiving the material, the wound is carefully coagulated to prevent the spread of cancer cells.

During the research in the laboratory, it is possible to determine the sensitivity of tumor cells to steroid hormones (including estrogens, including them). This helps with the further choice of treatment tactics.

Excisional biopsy

breast cancer biopsy

Excision – complete removal of the tumor with surrounding tissues. The whole mass is sent to the laboratory for research. This makes it possible to detect tumor cells at the boundary of the incision, to study the sensitivity of the tumor to sex hormones.

The surgeon removes the tumor with surrounding tissues during surgery. Thus, excisional biopsy is both a therapeutic and diagnostic procedure.

Stereotactic biopsy

Stereotactic biopsy breast cancer

During stereotactic biopsy, samples from several different places are taken through a single needle.

The procedure resembles a conventional puncture biopsy. It is always carried out under the control of X-ray mammography.

The needle is injected into a specific place, the sample is received, then it is sipped, the angle is changed, and again injected, now in a different place. Several samples are obtained, which makes the diagnosis more accurate.

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