Breast Diagnostics

Position statement

National Mammography Screening Committee, Hungary (Országos Mammográfiás Szűrési Munkabizottság) (02. version)

According to WHO, mammography is the only effective method for breast cancer screening.

Breast screening with tomosynthesis

The standard method of modern diagnostic breast imaging is X-ray mammography, during which native X-ray images are taken of the female breast. During tomosynthesis, or as called as 3-D mammography, 1 mm thick slices are produced of the breast. This provides images rich in detail and better resolution. According to literature data, 41% more invasive type breast cancers can be detected using tomosynthesis, when compared to traditional, so-called 2-D mammography.
The examination of patients having complaints and symptoms is called clinical mammography.

The examination of women having no complaints and symptoms is called screening mammography.

The advantages of mammography

• high diagnostic accuracy (true positive rate is 90% in clinical practice, 80% in screening examinations)
• breast cancer can be diagnosed generally 2 years before clinical symptoms appear
• based on scientific evidence, regularly performed, repeated mammography screening reduces the risk of deaths from breast cancer by half

Breast ultrasound over 35 years of age is complementary to mammography, while under age 35 - except when a malignant tumour is suspected - it can be done on its own, or as an initial examination also.

When breast ultrasound is performed on its own, or done as an initial examination, it is not suitable for diagnosing cancers primarily, or screening either.  It can be used for follow-up only if the lesion is clearly visible and identifiable with ultrasound, but it does not replace periodic mammography. Due to the reasons mentioned above, breast ultrasound can only be performed by a person specialized in mammography (according to current regulations: by a radiologist). Methods of traditional complex breast diagnostics clarify pre-operative diagnoses with high accuracy in most of the cases, it may happen however that the diagnosis is recommended to be supported by an MRI (MRM) scan.

At Buda Health Center clinical mammography, so-called complex breast diagnostics is performed. A 2-view image is taken of each breast with tomosynthesis, and an ultrasound scan is performed thereafter. The specialist evaluating the images performs a physical assessment and an ultrasound scan as well.  The first specialist writes a medical opinion, then additionally, another radiologist specialized in breast diagnostics evaluates the images. If there is any difference between the two medical opinions, the patient is recalled for additional examination(s). If necessary, cell or tissue samples are taken, and it is possible to perform MRI scans as well.