Mammography-special x-ray study -is usually reserved for
special situations. Mammography is often more accurate than physical examination
but less accurate than biopsy. A skilled radiologist is needed to read these
x-rays.
Newer radiological techniques promise to make the x-rays easier to read
and may help to make the test more feasible for screening purposes. Mammography
often helps in cases where the physician feels that the lump is not cancerous
but would like additional supportive evidence. It is also employed when many
cysts are present in a breast, making it difficult to detect a new mass.
Mammography often is helpful when a lump is difficult to feel and outline
clearly, or when there is persistent pain in one breast.
It is often used routinely for women who have a strong
family history of breast cancer or who have had a cancer removed from one
breast, since they may have a higher-than- average risk of developing breast
cancer. Many women between the ages of 30 and 50 have benign cystic disease of
the breast. The condition is characterized by dilatation and cyst formation in
the glandular tissue, perhaps connected with estrogen secretion.
There does not
seem to be any relationship between cystic disease and cancer development, but
many physicians will not prescribe estrogen-containing medications (such as
birth control pills) for women with cystic disease, because there is a tendency
with such medications for the cysts to become larger and more numerous, making
cancer more difficult to detect. The most common lump in the breast of a woman
less than age 30 is a fibro adenoma. This is usually an isolated and
well-demarcated lump. It may grow to large size and cause pain.
Treatment is removal of the mass to make certain that it is
not cancerous. Early detection and prompt treatment are vital for winning out
over cancer of the breast. If the cancer is removed before it has spread to
local lymph tissue, the five-year cure rate is 75 to 90 percent; e.g., 75 to 90
percent of patients are alive and well at the end of five years.
If removed
after such spread, the cure rate is in the 50 percent range. At present, the
recommended treatment is radical mastectomy-removal of all breast tissue and
adjacent lymph nodes. Most women withstand the surgery well.
