Table of contents:
- “The equipment for the diagnosis of breast cancer in our country is the same as abroad. The question is in the organization "
Video: “The Equipment For The Diagnosis Of Breast Cancer In Our Country Is The Same As Abroad. The Question Is In The Organization "
“The equipment for the diagnosis of breast cancer in our country is the same as abroad. The question is in the organization "
Timely detection of breast cancer is a guarantee that the patient will be able to fully recover and return to a full life. The head of the department told about the technologies of early detection of cancer. Research Department of Prevention, Comprehensive Diagnostics and Treatment of Breast Diseases of the Russian Scientific Center for Roentgenoradiology, Ph.D. Elena Meskikh.
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Timely detection of breast cancer is a guarantee that the patient will be able to fully recover and return to a full life. The head of Mednovosti told about the features of various technologies for detecting cancer at an early stage. Research Department of Prevention, Comprehensive (including Radiation) Diagnostics and Treatment of Breast Diseases of the Federal State Budgetary Institution "Russian Scientific Center for Roentgenoradiology" Ph.D. Elena Meskikh.
Elena Valerievna, what kind of technologies are these, and what determines the choice of a diagnostic method for each specific patient?
- Today, there are many technologies for detecting cancer at an early stage: digital X-ray mammography with the ability to perform tomosynthesis and contrast mammography, multiparametric ultrasound, MRI of the mammary glands, targeted biopsy under X-ray and ultrasound guidance.
The choice of a particular method depends on various reasons. The anatomical structure of the mammary glands is individual for each woman. There are simple cases when it is enough to make a mammogram and obtain an X-ray image of the breast tissue, which will give the doctor complete information to exclude malignant tumors. There are more complex ones, for example, if the patient has a dense mammary gland. This occurs in women under 40 and less often in women during menopause. This means that a large amount of glandular tissue is present in the structure of the gland - against its background it is often difficult for a doctor to see pathology. In this case, it will be optimal to use two complementary methods - mammography and ultrasound.
The method of ultrasound examination is good in that it can sightly show the object of interest to us, but at the same time it still does not give an idea of the entire structure of the gland. Therefore, it is used as an additional diagnostic method.
In addition, today, Russian patients have access to automated ultrasound scanning techniques, which make it possible to assess the entire structure of the mammary gland layer by layer in different planes in one study. Together with X-ray tomosynthesis, this method can improve the accuracy of cancer diagnosis up to 95% and practically eliminate the subjectivity of the assessment when making a diagnosis.
X-ray tomosynthesis is a sequence of images from different angles, which allows you to study in detail the structure of the organ and reduce the effect of the density of the gland on the possibility of detecting pathologies. This method makes it possible to significantly increase the detection of cancer without increasing the dose load on the patient. Now, when using modern mammographs with tomosynthesis function, we can use specialized computer programs based on artificial intelligence. They independently find areas of distress in the pictures, mark them, thus "prompting" the doctor that there may be a malignant neoplasm in this place. This helps doctors not to miss the pathology and diagnose it in time.
In addition, contrast mammography is in the arsenal of new radiological techniques. It is used in cases where, due to the structural features of the tumor, neoplasms are not visible in other studies. For its implementation, the patients are injected intravenously with a contrast agent. This substance accumulates in areas where malignant neoplasms are present. Healthy tissues do not accumulate these substances or accumulate to a lesser extent. This allows the doctor to determine where the tumor is and how far it has spread. Unlike, for example, contrast-enhanced MRI, contrast mammography is performed quickly (within 5-7 minutes) and is psychologically comfortable for the patient.
If a patient's mammograms reveal a small area of local accumulations of microcalcifications suspicious of cancer, an invasive research method is used - stereotactic biopsy. It allows you to confirm the diagnosis and verify changes in the mammary gland with high accuracy, without the use of diagnostic sectoral breast resection.
Advances in science and technology already today make it possible to take control of the incidence of cancer and significantly reduce mortality, but Russian diagnostic centers and polyclinics dealing with breast pathology have different levels of equipment, which means they have different possibilities for diagnosis
- The principle of the examination is, as a rule, the same: for patients under 35-40 years of age, at the first stage of diagnosis, an ultrasound examination of the mammary glands is performed, for women over 40 years of age - mammography. Each study can subsequently be supplemented with either mammography or ultrasound. Ultrasound examination of the mammary glands, as a rule, is multiparametric, includes color Doppler mapping, elastography, contrasting is possible. This allows for a more accurate differential diagnosis between benign and malignant processes.
But, in fact, although there are a lot of methods for detecting breast cancer, there is a problem associated with the quality of diagnostic equipment, which is presented in different ways in Russia. There are high-class equipment: mammography machines with tomosynthesis and the option of contrast mammography, with biopsy under the guidance of tomosynthesis, as well as automated ultrasound. But such equipment is available only to large oncological institutes, private centers and centers specializing in the diagnosis and treatment of malignant neoplasms.
In the regions of Russia, analog devices are still operating instead of modern digital ones. Research on such equipment is carried out twice as long in time, the result largely depends on the qualifications and professionalism of the doctor and radiologist. The dose load on the patient is high, and the information content of the method is low. In addition, during the study, the patient may experience painful sensations due to severe compression of the breast. Whereas now there are modern models of equipment with special devices that allow a woman to independently regulate compression on the mammary gland.
And it also happens: the equipment is there, but people cannot work on it
- Unfortunately, this is so, and the lack of relevant knowledge affects the quality of diagnostics. Radiologists have very heterogeneous knowledge of the diagnosis of breast diseases. The field is highly specialized, isolated, associated with the fact that one specialist must have many certificates: in ultrasound, surgery, oncology. A lot of time and effort is spent on training specialists of this kind.
How different is diagnostics in Russia and abroad?
- Both abroad and in Russia use the same equipment for the diagnosis of breast cancer in women. The only question is how it is organized. In France, for example, the OneStopClinic has been organized on the basis of the Gustave Roissy Institute since 2004. A woman can come for an examination and in one day undergo a full range of diagnostic procedures, as well as consultations with an oncologist, surgeon, radiologist and receive a conclusion about her condition. We use a similar approach in our center.
Foreign colleagues already have unified centers and unified databases, for example, on screening. We are just going to this. The question is in organizing a single community, common approaches and personnel. We are not inferior to any other foreign colleagues.
The situation is changing thanks to the active promotion of the fight against cancer, and the state cancer program. If 20 years ago, there were a lot of patients with 3rd and 4th stages of cancer, now women come with precancerous or early stages of cancer. Another thing is that we still do not have centralized screening. But, I think that over time we will come to a single standard, and this will be a big breakthrough.