Working principles of mammogram. Mammograms are machines used in imaging breasts. It takes X-rays on relatively lesser doses compared to the normal X-rays. Since X-ray are not capable of penetrating human tissue, mammograms have two plates that compresses breast in order to increase tissue surface. This forms the basis of the good pictures and gives a room less radiation usage.
Ultrasound technique is another common imaging procedure. In this technology, breast is subjected to a sound wave of high frequency forming images. This scanning process involves placing a sound emitting probe on human breast. This does not involve any form of radiation.
Women showing symptoms of breast cancer or those with palpable findings upon clinical examination are usually subjected to clinical examination via breast imaging. The breast imaging techniques generally consist of either ultrasound or mammography or both.
Comparison between Mammography and Ultrasound.
The choice of a more suitable imaging technique of the two or their combination is partially dependent on age. Age is known to delineate initial diagnosis choice of the breast imaging in symptomatic women. According to Stindl (2016) there is little evidence to support the assertion that age is a key determinant in choosing between ultrasound and mammogram in diagnosing breast cancer in women. Devolli Disha et al. (2011) however suggest that women who are aged 35 or younger can be easily examined using ultrasound technique because of the high dense tissue breast. Gaffer Sadist, Janani Shoran, Jafarnejad, & Esmaily, (2018) showed that there is a progressive improvement in mammography sensitivity for women who are 60 and above years older compared to ultrasound.
Difference in sensitivity of the two technologies is also a key determinant in choosing between the two technologies. Generally, based on previous studies on mammography and ultrasound techniques in breast cancer diagnosis, the difference in sensitivity of the two technologies is statistically significant. According to Zhang (2012), ultrasound is found to be significantly more sensitive in women who are 45 years and below than mammography. Besides the two techniques have a difference in specificity. Ultrasound imaging technique has greater specificity compared to mammography. This explains the variations in study findings of various studies with some studies recording higher specificity in ultrasound compared to mammography.
Historically, ultrasound is employed in as tool of diagnosis that helps in evaluating abnormalities and mammography. Ultrasound screening is relatively more sensitive compared to mammography in cases where the breasts have denser tissues.
Advantages, disadvantages of mammogram and ultra sound in the diagnosis of breast cancer. Advantages
Mammogram reduces the risk of succumbing to breast cancer. According to Gøtzsche & Jørgensen (2013) out of 1000 women who undergo for mammogram in every 2 years for 20years, about 7 deaths have been avoided.
Mammography also lessens the risk of undergoing chemotherapy. The screening process involved in mammogram helps in cancer detection at early development stages. This makes it conceivable to have a treatment program at an early stage.
Mammography gives women a chance to be aware their breast health. About 98% of women do not experience cancer if the mammogram and additional examination shows that they do not have cancer.
Possibility of over diagnosis. Over diagnosis in this case3 refers to cancer detection that would have not been identified were it not for the screening process. As a result, women are exposed to diagnosis of cancers that would have had no impact on their health. This happens because mammogram detects cancer at an early stage. According to Welch, Prorok, O’Malley, & Kramer (2016) out of 77 breast cancer diagnosis using mammogram, 10 are cases of overdose.
Periods of anxiety and waiting whenever additional examination are involved. Nearly a half of mammogram screening participants for 20 years (453 in 1000 women) are subjected to at least 1 additional examination (Ohuchi et al., 2016). This causes unrest and anxiety because the patients are unsure whether they have breast cancer or not.
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