What are ultrasound and mammograms used for?

This is what ultrasound diagnostics bring to mammography

Source: Shutterstock / Dmytro Zinkevych

Breast cancer

Breast cancer ?! As soon as this is suspected, patients become very concerned. With an early diagnosis, the chances of a cure are quite high, but many tumors remain undetected for too long.

The problem: With the X-ray examination of the breast - the most common diagnostic method in this country - a large part of the so-called breast cancers often cannot be clearly identified. However, if ultrasound diagnostics are used in addition, up to 45 percent more invasive carcinomas can be detected. At a press conference of the German Society for Ultrasound in Medicine (DEGUM), experts therefore demand that ultrasound breast examinations should be used as standard in routine examinations for the early detection of cancer. The press conference will take place on Tuesday, June 19th in Berlin.

The problem is that the breast density is currently not systematically recorded and communicated in the German mammography screening program. However, women with extremely dense glandular tissue are at higher risk of developing breast cancer

Alexander Mundinger

"The high added value of sonography for early cancer detection is far too little known", complains DEGUM expert Professor Dr. med. B. Joachim Hackelöer, who, among other things, held professorships for gynecology and obstetrics at universities in Hamburg and Marburg. The medical service of the Central Association of Health Insurance Funds (MDS) recently classified the benefits of this study as unclear in an assessment process of several individual health services (IGeL services). In Hackelöer's opinion, there is an urgent need for clarification against this background.

But why are breast ultrasound so useful? “The female breast consists of a mammary gland tissue. Connective tissue and fat envelop this glandular tissue, ”says Hackelöer. "The ultrasound examination of the breast shows the glandular and connective tissue with light echoes, whereas carcinomas often have dark echoes." This creates an echo contrast that enables the diagnosis to be made effectively. In contrast, the X-ray examination of the breast - the so-called mammography - does not show such a clear contrast between the tumor and the rest of the glandular and connective tissue. Here the carcinomas are shown light or white and can therefore be masked or hidden by the rest of the remaining glandular and connective tissue. This is particularly common in women with dense tissue - i.e. a high proportion of mammary gland tissue. In the opinion of DEGUM, these women should therefore urgently be examined by ultrasound - and there are many: “According to the latest data, almost half of women aged 50 and over have dense breast tissue. “The problem is that the breast density is currently not systematically recorded and communicated in the German mammography screening program. However, women with extremely dense glandular tissue have a higher risk of developing breast cancer, ”says Professor Dr. med. Alexander Mundinger, Chief Physician of the Breast Center Section Imaging and Minimally Invasive Breast Diagnostics at the Niels Stensen Clinics at the Franziskus Hospital Harderberg in Georgsmarienhütte. At the same time, the risk of masking breast cancer is highest in these patients. “But they are also only recommended and financed an X-ray examination every two years for the early detection of breast cancer in this country. That has to change urgently. "

So that more breast cancer tumors can be detected earlier in the future, the DEGUM experts are calling for a new concept: “We urgently need a risk-adapted, optimized screening program in Germany. Here, mammography should be supplemented by ultrasound diagnostics of the breast, ”says Hackelöer. "In addition, the early detection must be carried out very individually." According to the DEGUM experts, it would be ideal if the ultrasound and X-ray examinations - depending on the density of the breast - were used in a standardized manner for women over the age of 40 about once a year. If possible, these examinations should be carried out by DEGUM-certified gynecologists and radiologists. According to the ultrasound experts, the DEGUM concept should already be integrated into the screening training of prospective doctors - this is the best way to guarantee high quality sonography.

Source: DEGUM