Breast screening: how it works

MAMMOGRAPHY IS the basic screening investigation for a woman who develops breast cancer symptoms

MAMMOGRAPHY IS the basic screening investigation for a woman who develops breast cancer symptoms. Essentially an X-ray of the breast, the process ends with the production of a hard copy of the test in the form of a traditional X-ray film.

An ultrasound of the breast, however, involves a more dynamic process carried out by a consultant radiologist using a jelly-covered probe. The ultrasound probe is placed on the skin overlying the breast and moved slowly over it.

Real-time images are displayed on a computer monitor and the radiologist may decide to "capture" a number of images of the breast.

Typically, the radiologist writes a one- or two-paragraph report on the ultrasound findings; this is filed in the patient's chart and a copy is sent to the referring doctor. Unlike mammography, however, breast ultrasound does not result in hard-copy films that can be stored and later retrieved.

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Because ultrasound images are unique to the operator, they do not lend themselves to formal review in the way mammograms can be re-read.

Breast ultrasound is seen as complementary to mammography. It is more commonly used with younger women. In the case of a woman with a palpable breast lump, it offers greater diagnostic accuracy.

An ultrasound can tell whether the lump is full of fluid (a cyst) or if it is solid. When a breast biopsy is needed, ultrasound facilitates the accurate placing of a needle in the lump, thus ensuring that the specimen sent to the pathologist is actually from the precise area of the breast that is causing clinical concern.