Screening mammography possibilities regarding the detection of pathological changes in the different structural types of mammary glands in women of mature and old age
Keywords:
mammary gland, mammography, type of structure, mature age, old age.Abstract
Background. The high level of mammary gland (MG) pathology, that is observed in the world and the pronounced tendency to its growth during the last decades, makes the search for effective methods of its early diagnosis particularly relevant. Numerous described results of MG examinations using various diagnostic methods testify the significant variability and pronounced age dynamics of its structure. The aim was to study the frequency of manifestation of different types of mammary gland structure, as well as to clarify the possibility of visualization of pathological changes at different density of glands during screening mammographic examination in a randomized sample in women of mature and old age. Methods. A randomized sample of archival anonymized mammograms of 100 women (50 - mature and 50 - old) who underwent primary screening or preventive examination was processed. Examinations were performed on the Fujifilm Amulet Innovality device (Japan) in direct (SS) and medial-lateral oblique (MLO) projections. According to BI-RADS density classification, four types of mammary glands structure were distinguished: A – fibro-glandular MG tissue occupies less than 25% of the mammogram area; B – there are focus of fibro-glandular tissue 25-50% of the mammogram area; C – fibrous-glandular tissue occupies 50-75% of the mammogram area; D – fibro-glandular tissue occupies more than 75% of the mammogram area. Since the examinations were of a screening nature, their results were evaluated on the BI-RADS scale according to the degree of risk of the presence of neoplasms. Results. In a randomized sample of mature and elderly women, type B of the breast structure was most often manifested (42%), type D (3%) and asymmetric structure (2%) were the least common. In mature women, type C of the structure of the mammary gland is most often manifested (40%), type D is the least common (6%). In elderly women, type B is most common (46%), breast structure asymmetry is the least common (4%), type D was not found in any of the examined women. With age, the share of individuals with types A and B of the mammary gland structure, as well as cases with asymmetry of its structure, increases, while the particular share of individuals with types C and D decreases. Among elderly women, the percentage of individuals with types A and B of the mammary gland structure is higher than among women of mature age, with types C and D - lower. Cases of asymmetry of breast structure types in elderly women may indicate the asymmetric nature of the course of its age-related changes, in particular, fat involution. Category 2 (benign changes) and calcifications were found in 100% of examined individuals with type D breast structure. Among women with other types of gland structure, category 2 (benign changes), category 0 (necessary additional examination) and calcifications were most often visualized in women with type B structures of the mammary gland (76%, 43% and 79%, respectively, from the total number of examined persons with B structure type), the rarest category 2 and 0 - in women with A type of mammary structure (73% and 14%, respectively), calcifications - in women with type C structure of the gland (61%). Conclusion. Studying the possibilities of visualization of mammary glands of different types of structure using different methods of radiation examination will allow to optimize the diagnostic criteria of age-related and pathological changes during screening examinations of women of different age groups.
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