Breast surgery method chosen until the 1970s, when radical mastectomy, modified radical mastectomy, taken in later years to be implemented, and better cosmetic results of breast conserving surgery methods have been used more frequently. Breast-conserving surgery and radiotherapy, tumor recurrence in early stage, there is widespread use brought about the necessity of (36).
And radiotherapy after breast-conserving treatment is 3-6 months after the first mammogram. Basic control mammography mammography after 6 months, and if more then 1 year monitoring is sufficient. As a routine craniocaudal (CC) and mediolateral oblique (MLO) radiographs taken. Main objective is to fully display the surgical scar area. Magnifiye radiographs are very useful, especially the evaluation of microcalcifications. The basic purpose of mammography after treatment to determine the new mammographic pattern. Is well known that long-term changes after radiotherapy of breast cancer. These radiation pneumonitis and fibrosis, myocardial infarction, pericardial effusion, brachial plexus neuropathy, bone and skin, with necrosis and fractures, radiation, and complications of secondary malignant neoplasms (13.91). In the breast after lumpectomy and radiation therapy followed collections of fluid between mammographic changes, scar tissue, breast, and breast skin edema, thickening, increased breast density, fat necrosis secondary to punctate and pleomorphic calcifications (36).
General Information on Mammography
Mammography is a method for revealing changes in the breast and soft tissue. Which is the primary imaging method for breast screening and diagnostic mammography to be used in two ways, after the 1960s, the overkill extends through screening nonpalpable breast lesions more often and began to be encountered in earlier periods. Indications for mammography;
1. Routine breast cancer screening as an early diagnostic method
2. Curriculum Vitae, or family history of breast cancer patients,
3. Hardness in the breast of a new, mass, swelling, redness, nipple retraction, pain, nipple discharge at the beginning, the symptoms of mastitis, breast skin changes, clinical, nonpalpable mass lesions in patients with non-detection of symptoms, those with a palpable mass audience with the assessment of U.S.
4. Estrogen therapy or hormone replacement therapy areas
5. Risks of major or minor in terms of breast cancer risk in patients with one or more of the
6. Ta is a palpable mass in patients with a diagnosis of cancer by biopsy, multicentric tumors, or that the detection of focal, the investigation of intraductal component, tumor size determination, evaluation of the breast against the
7. Assessment of response to neoadjuvant chemotherapy treatment of breast cancer patients receiving radiation therapy before surgery postoperative controls, in terms of relapse after completion of therapy, the long-term follow-up, and the detection of local recurrences.
Opacities were detected with mammography, irregular contours or irregular contours of the masses seen in U.S. cytological and / or histologic evaluation should be done with a needle biopsies.
According to the American Cancer Society recommendations of the Base-Line's first mammogram should be taken between 35-40 age, 40-49 years of age or women, mammography should be taken once every two years. Women over fifty years of age and mammography should be taken once a year. In addition, women at least once a month should be given the training needed to carry out breast examinations using mammography for screening, early diagnosis of breast cancer mortality due to chance of approximately 1 / 3 ratio decreases, but is not available because of low sensitivity in patients under the age of 40.
Positions used in mammographic
Routine mammograms should be made in two positions. Craniocaudal and lateral oblique, the standard projections. Assess the need for additional positions within the specific areas of the breast.
Craniocaudal (CC) Position: standard transverse position of the breast.
Mediolateral oblique (MLO) Position: This position in the lower part of the breast and pectoralis major muscle and axillary tail of the breast may appear to include the whole tape is a 30-degree angle, the patient goes back to the same side as the right side. In this position, the pectoralis major muscle and the chest wall is the easiest way forward is pulled, the rear portions of the breast provides the best display of
Mediolateral (ML) Position: ML sagittal image of a real image. Upper-inner quadrant lesions in the upper parts of the oblique position shows better. In addition, deep near the chest wall, or are already breast inferomedial or inferolateral lesions at the show better.
In addition, the position medial oblique, (overstated) CC position, the position of the spot compression, axillary position, magnification X-rays, patients must be taken in addition to routine positions.