Breast prevention is a fundamental aspect of every woman’s health, but simply mentioning ‘mammography’ and ‘breast ultrasound’ does not always guarantee peace of mind. It is also crucial to rely on experienced professionals and advanced technologies. Early, or even very early, detection of breast cancer can really make a difference. But how does one choose where to go? We asked Dr. Barbara Pesce, Radiologist and Head of the Breast Centre at Paideia International Hospital.
Dr. Pesce, what should women consider when choosing where to have a mammogram and ultrasound?
In the case of mammography – which remains a key appointment for the early detection of breast cancer – it is important that the technology used is state-of-the-art, which includes the use of tomosynthesis. This is a tool that allows for a three-dimensional evaluation of the mammary gland, overcoming the limitations of traditional two-dimensional images. It is thanks to tomosynthesis that we can detect even small alterations. This is the first question to ask when booking an appointment.
Another innovative element is the use of contrast agents, which, combined with the latest generation of mammography machines, allows for extremely high-quality images while simultaneously reducing the radiation dose for the patient. It is therefore essential that women turn to facilities dedicated to breast diagnostics and specifically ask if the equipment used includes tomosynthesis.
While technology is easy to assess, evaluating the doctor’s experience is more difficult. Why is it important for both the radiologist and the ultrasound operator to have highly trained eyes?
It’s true that breast ultrasound has undergone significant technological advances, but we must not forget that it is an ‘operator-dependent’ examination, so it is essential that it is performed by an experienced breast specialist. The best scenario is for the same doctor to perform both the mammogram and the ultrasound, as this facilitates the correlation between the two exams and improves diagnostic accuracy. Ultrasound is often used to complement mammography, so it is crucial that the operator is well-versed in the patient’s anatomy and capable of precisely identifying any potential alterations. The Italian Society of Radiology tells us that an experienced breast radiologist is one who reads at least 5,000 mammograms a year, a criterion that ensures a high level of expertise and diagnostic precision.
Keeping this concept in mind, it becomes clear that you should go to specialised centres that not only use advanced technology, as mentioned earlier, but also have experts with extensive, continuous, and daily experience to ensure a correct interpretation of the exams and an early and accurate diagnosis. Moreover, in the event of uncertainty or a concerning lesion, a Specialised Breast Centre can immediately proceed to the next step for a more targeted and sophisticated diagnosis, so the woman is not left with all the fears that arise without knowing where to go, who to turn to, or what to do, risking losing valuable time.
Mammography and breast ultrasound: why are both needed for proper prevention?
Because they help us see different things. Ultrasound is essential for distinguishing cystic lesions from solid ones, but in many cases, it is used to characterise suspicious lesions. Additionally, to improve diagnostic accuracy, tools and software adapted to specific needs are used for the analysis of suspicious lesions. Mammography is the primary investigation for breast diagnostics. A valuable complement to direct digital mammography is tomosynthesis. This is a diagnostic tool that allows the study of extremely thin sections of the breast, facilitating early diagnosis of breast pathology. Women are often frightened by mammography because they fear that breast compression will cause pain. The latest-generation mammography machines, such as those at Paideia International Hospital and Mater Dei General Hospital, are able to reduce discomfort and pain for the patient without compromising image quality, while maintaining a minimal radiation dose.
