peculiar evaluation of an abnormal ...

peculiar evaluation of an abnormal mammogram issue is important because approximately 90 percent of women with abnormal outcomes do not have breast cancer. Breast clears also are an evaluation vexed question because 9 to 11 percent of them are associated with breast cancer, and the association increases with age. Approximately undivided in 10 patients with abnormal mammogram proceeds or a breast lump will have breast cancer; therefore, an accurate and minimally invasive evaluation is essential.

Kerlikowske and associates reviewed the literature onward evaluating abnormal mammogram results and palpable breast masses to bring out an appropriate approach. Studies upon mammography or an invasive diagnostic step with a sample size of at least 100 women with confirmed breast cancer were included. Three high-quality studies were used to unfold recommendations.

Screening mammography has higher sensitivity and specificity in women older than 50 Sensitivity decreases and specificity increases with following testing. Masses and calcifications are the principally common abnormalities detected by mammography. Diagnostic mammography includes multiple views that allow better classification of abnormal findings. When biopsy is necessityed for nonpalpable abnormalities, image-guided fine-needle aspiration biopsy (FNAB) or core-needle biopsy is faster, cheaper, and easier than standard-needle localization make open biopsy. Sensitivity and specificity of FNAB are high with experienced technicians.

Women with negative mammography proceeds (Breast Imaging Reporting and Data combination of parts to form a whole [BI-RADS] 1) or "benign findings" (BI-RADS 2) should have repeat mammography in common to two years. Although the risk for cancer is soft in women with "probably benign findings" (BI-RADS 3) a repeat mammogram can be done in six month When the rise is "need additional imaging evaluation" (BI-RADS 0) the abnormal area should be palpated carefully. If the area is not palpable, diagnostic mammography and ultrasonography should be performed. Mammography outcomes of "suspicious abnormality" (BI-RADS 4) or "highly suggestive of malignancy" (BI-RADS 5) warrant biopsy.

Dominant palpable breast abnormalities, including perspicuouss or suspicious changes in breast organization that differ from the surrounding breast tissue and the corresponding area in the contralateral breast require FNAB, ultrasonography, diagnostic mammography (which is les able to distinguish a pouch from a solid mass), or core-needle biopsy. Because FNAB can identify sacs and is easy, inexpensive, and accurate, it is a fit first step in patients with lesions that are not clearly simple pouchs The follow-up evaluation depends forward the results of these initial criterions (see the accompanying figure).

The authors bring to an end that when tests provide inconsistent or inconclusive consequence s or the abnormality remains suspicious forward follow-up, excisional biopsy is appropriate.

Kerlikowske K et al. Evaluation of abnormal mammography originates and palpable breast abnormalities. Ann Intern M August 2003;139:274-85

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group