ABSTRACT
Breast constitutional density may be altered and increased (acquired density) by hormonal interventions such as hormone replacement therapy (HRT). The effects of endogenous (steroids, prolactin, insulin-like factors...) and exogenous (HRT, levonorgestrel IUD, tibolone, tamoxifen, SERMs) hormones will be reviewed. Continuous combined estrogen-progestin preparations are most likely to cause an increase in density. Estrogen alone and tibolone are less likely to cause an increase in density. The sensitivity and specificity of mammography are decreased, with increased risk of interval carcinoma and rate of short interval follow-up from false positive results. The issue with regards to interruption of the hormonal therapy prior to mammography, and the duration of the interruption, are discussed.
Subject(s)
Breast Neoplasms/chemically induced , Breast , Estrogen Replacement Therapy/adverse effects , Hormones/physiology , Mammography , Adult , Aged , Biopsy , Breast/drug effects , Breast/pathology , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Contraceptive Agents, Female/pharmacology , Diagnosis, Differential , Female , Gonadal Steroid Hormones/physiology , Humans , Intrauterine Devices , Levonorgestrel/pharmacology , Menopause , Menstrual Cycle , Middle Aged , Norpregnenes/pharmacology , Prospective Studies , Randomized Controlled Trials as Topic , Risk Factors , Selective Estrogen Receptor Modulators/pharmacology , Sensitivity and Specificity , Tamoxifen/pharmacologyABSTRACT
The most important roles of ultrasound in breast imaging include the diagnosis of cysts and the characterization of masses that have been incompletely assessed by mammography. Ultrasonography techniques such as harmonic and compound imaging have recently been introduced and are more efficient than conventional imaging in terms of lesion conspicuity and the characterization of breast nodule. The BI-RADS classification is an important system for describing and classifying breast lesions. With this approach, a population of benign solid breast lesions that does not require biopsy can be accurately defined. Ultrasonography should be performed as first-line examination in juvenile, in pregnant women and in patients with inflammatory syndrome. Ultrasound can detect mammographically occult breast the way they develop.
Subject(s)
Breast Neoplasms/diagnostic imaging , Ultrasonography, Mammary , Breast Diseases/diagnosis , Breast Diseases/diagnostic imaging , Breast Diseases/pathology , Breast Neoplasms/classification , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Female , Humans , Mammography/methods , Sensitivity and Specificity , Ultrasonography, Mammary/methodsABSTRACT
The aim of this paper is to report the mammographic predictive positive value by decade of age using the assessment categories described within the BI-RADS lexicon.
