Mammographies declared safer
Risks and Benefits of MR Mammography
For any 45-year old woman, having a mammography
currently increases the breast cancer risk. In
the western Hemisphere, the risk of being diagnosed
with breast cancer is approximately 10%. A mammography
will raise the risk factor to 10.0055 %, increasing
it by 1/1800.
The benefit of a thorough mammography screening
in comparison to an increased breast cancer risk
is approximately 300 to 1. "Results from
current screening programs clearly prove decrease
in mortality," stresses Prof. Dr. Uwe Fischer,
Diagnostic Breast Center Goettingen, Germany,
and author of the book Practical MR Mammography.
Fischer admits that many women might be receiving unnecessary
mammographies.
Practical MR Mammography addresses radiologists
in clinical settings and in private practice,
researchers, and gynecologists. The authors discuss
the history of MR mammography, techniques and
methods, tumor angiogenesis, diagnostic criteria,
artifacts and sources of error, indications for
MR mammography, differential diagnoses and strategic
considerations, MR-guided interventions, and quality
assessment. More than 400 images allow a comparison
between normal findings and benign and malignant
changes. Also included is a chapter devoted to
MR mammography in men.
In the past 25 years, the technical development
of MR mammography has changed significantly. The
amount of radiation that the patient is exposed
to has been greatly reduced. "Many of the
current concerns about mammography are still based
on the old, much higher doses," states Dr.
rer. nat. Klaus-Peter Hermann of the university
clinic of Goettingen, Germany, in his chapter
about exposure to radiation. It is up to the doctor
and depends on the individual case to determine
if a mammography will be necessary. Simply the
fact that a woman is fifty years or older will
not suffice. Factors such as pain or findings
after a self-examination play a much more important
role.
Evaluating radiation risk is still connected
with much uncertainty. The risk depends to a great
extent on the age of the examined woman. It is
high for young women whose breasts are still developing.
The not yet fully developed tissue is very receptive
for radiation, and the risk for growing abnormal
tissue is the highest, whereas it is the lowest
for women 60 years or older. The benefit of a
mammography in a patient can be seen after only
a few years. The aftereffects of the radiation
exposure however, might surface only after 20
or 30 years.
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