With the increasing awareness of the importance of breast screening for early detection of cancer, breast imaging has found a place in today’s diagnostic armamentarium.

The common imaging modalities are mammography, ultrasound and MRI. Mammography is the investigation of choice and is an essential part of screening programmes in the West.

Mammography and ultrasound are corroborative and are generally done together. MRI finds a place in the evaluation of dense breasts and in multi-centric cancer, said Dr Padmaja Canumalla, Specialist Radiologist, Zulekha Hospital, Dubai.

The high risk factors in breast cancer are patients with mother/sister having cancer breast or cancer ovary, patients on HRT, patients over 60 years, late motherhood and short lactation.

Screening mammography has been proved to have a place in the early detection of breast cancer. The American Cancer Society Recommendations are:

Physical exam regularly after 20 years age
Base line exam - between 35 and 39 years
Annual/biannual exam - between 40 and 49 years
Yearly after 50 years

Breast reporting has been standardised by the American College of Radiologist so that there is good understanding between the reporting radiologist and the treating clinician. Reporting is done based on the breast lexicon and every report is given a category of the BIRADS (Breast Imaging Reporting and Data System). This allows a uniform standard interpretation of the report.

According to the RCR guidelines, mammography is not recommended for generalised lumpiness, long standing nipple retraction and cyclical breast pain associated with periods.

The factors which protect from breast cancer are:

Four or more hours of exercise per week results in about 40 per cent reduction in breast cancer risk.

Physical exercise in adolescence was associated with significantly delayed breast cancer onset.

Healthy weight at menarche and at 21 years significantly delayed breast cancer onset.
Women who average 1.5 drinks per day have a 30 per cent increase in risk.

Radiation is dangerous for young women, especially if they have not completed breast development.