FUNDAMENTALS OF MAMMOGRAPHIC DIAGNOSES OF BENIGN AND MALIGNANT DISEASES

(1) Breast cancer is a serious public health problem. There has been no significant increase in the survival rate of women with this disease during the past several decades. (2)There has been much rccent interest in mammography as an objective approach to the diagnosis of breast diseases and as a possible means of earlier detection of breast cancer. Many specific, definite, and objective roentgenographic criteria are reproduced on good quality mammograms and are applicable to the smaller cancers. (3)Following the development of a satisfactory roentgenographic technique, mammography has proved to be a procedure that is highly accurate, safe, simple, nontraumatic, acceptable to the patient, and reproducible. (4) Mammography can be definitive in the diagnosis of normal, benign, and malignant breast conditions. (5) Mammography has proved to be the only means by which breast cancer can be demonstrated before clinical signs and symptoms are present; such cancers are relatively small and have a low incidence of axillary lymph node metastasis. (6) Just as has every diagnostic procedure, mammography has its limitations and errors are made. (7)Mammography can be encouraged as a valuable adjunctive diagnostic procedure in the over-all evaluation of patients with breast disease.(8)Although at time malignant lesions of the breast are overlooked and benign lesions are interpreted as cancer, mammography is usually definitive in distinguishing the two types of disease. Mammography is not a substitute for biopsy. For this reason, whether elicited by palpation alone, by mammography alone, or by both, every suggestive nodule should be removed for histologic examination before mastectomy is performed. This policy will lead to a larger number of biopsies; however, it should also lead to discovery of a larger number of cancers during the early course of their development and a higher percentage of positive biopsy diagnoses. (9)The most advantageous applications of mammography will be attained through the teamwork of the roentgenologist who conscientiously strives for the best quality of mammograms, the pathologist who attempts to study thoroughly the proper tissue at all times, and the radiotherapist and surgeon who combines keen judgment of the clinical findings with the findings of the roentgenologist and pathologist.© 1969 S. Karger AG, Basel.