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Breast screening (mammography) and ultrasound
Breast screening: when and how often ?
- If you do not have any special risk factors, according to the French screening programme a mammogram is recommended every 2 years after the age of 50, and up to the age of 74 years, as this is the age group most affected by the disease.
- If there are personal or family risk factors, monitoring might begin earlier and be more frequent.
Interpreting breast screening images
In the mammogram, images revealing cancer include opaque areas, distortion of the architecture or microcalcifications in the breast are benign. They are suspicious when they are grouped together in the same part of the breast or if they have a particular morphology suggestive of cancer.
Mammography assessment categories by the ACR (American College of Radiology).
ACR1 Normal mammography
ACR2 Benign (non-cancerous) mammographic image. As for ACR1, this is a reassuring mammogram, but the radiologist wishes to draw attention to the presence of a typically benign abnormality (fibroadenoma, lymph nodes in the breast, benign calcifications, etc.)
ACR3 Probably benign mammographic image. The radiologist has detected an abnormality which is very probably benign. Most often in this case, a follow-up mammogram with repeat imaging is scheduled for a few months later to ensure that the area has not evolved.
ACR4 Mammographic image requiring histological exploration (biopsy).
ACR5 Malign mammographic image. Abnormalities are almost certainly due to cancer. Additional tests and specialist advice are essential.
The painless and non-irradiating method of ultrasound is used in combination with mammography, given that 15% of breast cancers are not visible on a mammogram (in particular when the breasts are dense and therefore opaque). Ultrasound also enables doctors to examine the axillary lymph nodes (located in the armpits).