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Inventory Of Various Breast Imaging Equipment

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Update time : 2023-09-06 16:36:00
Every October is the International "Breast Cancer Prevention Month", and we take stock of all kinds of breast imaging equipment.
In 1992, Evelyn Lauder, senior vice president of Estee Lauder Group, and Ms. Penny, editor-in-chief of "Self" magazine, initiated a global breast cancer prevention campaign marked by wearing "pink ribbons".
Under its advocacy, the "Pink Ribbon" has become the symbol of the global breast cancer prevention campaign. Every October is the World Breast Cancer Prevention Month or Warning Month. For Pink Ribbon Caring Day. "Early prevention, early detection, early treatment" is the purpose of the Pink Ribbon Breast Cancer Prevention and Control Campaign.
1. The 5-year survival rate of early breast cancer is 85%
The World Health Organization's International Agency for Research on Cancer (IARC) released the latest global cancer burden data for 2020. In 2020, there will be about 19.3 million new cancer patients worldwide, of which 2.26 million are newly diagnosed female breast cancer, accounting for 11.7%, becoming the number of new diagnoses in the world most cancers.
However, in terms of fatality rate, about 10 million patients will die from cancer in 2020, among which 685,000 patients will die from breast cancer, ranking fifth, which shows that the treatment and prognosis of breast cancer may be better than other tumors. good.
According to data, the 5-year survival rate of early breast cancer patients can reach more than 85%, while the 5-year survival rate of advanced breast cancer patients will drop significantly to 50% or even lower. A large number of clinical practices have proved that early detection, early diagnosis and early treatment of breast cancer can significantly increase the survival rate of patients and improve the prognosis.
Therefore, experts suggest that women over the age of 30 should learn breast self-examination and develop the habit of self-examination every one to two months, paying special attention to early manifestations such as small nodules, lumps, and nipple fluid. In addition, it takes about 5-8 years for a breast cancer mass to grow to about 1 cm, so it can be detected early through imaging examinations such as ultrasound, mammogram, and breast magnetic resonance.
Q: Is it more likely to get breast cancer with large breasts or small breasts?
A: It has nothing to do with big breasts or small breasts. Breast density is the key. because:
1) The incidence of breast cancer with dense breasts is higher, and the risk of developing breast cancer is increased by 4-6 times;
2) Dense breasts are more likely to be missed. For example, the sensitivity of mammography in the diagnosis of breast cancer is 85%. If the density is high, the sensitivity drops to 47.8%~64.4%.
In medicine, breasts with less fat and more glands are called "dense". Women with small breasts due to less fat are more likely to have dense breasts. It can be said that "flat breasts" are relatively more prone to breast cancer than "big breasts". According to data, Asians account for 38% of dense breasts at a young age, and only 20% in Europe and the United States.
In addition, it needs to be explained that whether the breast is dense or not has nothing to do with the hardness of the breast, and it cannot be confirmed by self-breast examination, only imaging examination. For example, on mammograms, dense breast tissue looks white or grayish, and breast cancers are always white, so they can sometimes hide the disease.
2. Conventional breast imaging equipment
Because it is non-invasive and radiation-free, it has high resolution of breast tissue and can better display the location, shape, structure, etc. of tumors. It is suitable for breast examination of women of any age, especially pregnant and lactating women. Ultrasound (US) has become a The most common method of breast cancer screening. It is recommended that general risk groups undergo breast ultrasound examination every 1 to 2 years; high-risk groups are recommended to undergo breast ultrasound combined with mammography once a year.
Ultrasound has many advantages:
1) Can easily distinguish breast lumps from dense breast tissue and determine whether they are solid or cystic;
2) The color Doppler mode can be used to check the blood flow filling of the breast and lesions, which is more conducive to judging the type and nature of breast lesions. However, ultrasound can easily miss lesions smaller than 1 cm, and the detection rate of non-massive breast cancer is low, especially for tiny calcifications in breast glands, and calcifications are often highly correlated with malignancy.
In addition, more importantly, ultrasound is highly subjective and greatly depends on the doctor's level and experience. The professionalism of the ultrasound doctor accounts for 90% of the conclusion, while the image quality only accounts for 10%.
New Technology: Automated Breast Volume Ultrasound
Automatic breast volume ultrasound, a three-dimensional ultrasound imaging technology specially developed for breast examination, makes up for the deficiencies of traditional ultrasound in breast examination, and combines the traditional working mode of mammography with the principle of ultrasound imaging to provide a standard, Standard new breast ultrasonography modality, hence the name "ultrasound CT". In terms of automatic breast volume ultrasound, there are GE's ABUS and Siemens' ABVS.
In terms of the same operation, automatic breast volume ultrasound has the advantages of dense gland sensitivity, three-dimensional volume data, good operation repeatability, and standardized procedures. It can become a breast cancer screening tool for young women, especially those with dense glands.
Compared with mammography (MG) in the diagnosis of breast cancer, ABUS ultrasonography has a higher cancer detection rate, sensitivity and specificity, especially suitable for dense breasts.
Mammography (Mammography, MG, also known as "molybdenum target") is also the standard method for breast cancer screening. Compared with other imaging methods, mammography can obviously find small calcifications in breast tissue, and can make qualitative diagnosis from the scope, shape and distribution characteristics of lesions, which is irreplaceable.
Today's mammograms are basically full-field digital mammography (FFDM), which plays an important role in discovering and evaluating most breast calcifications and detecting ductal carcinoma in situ (DCIS). High sensitivity.
New Technology: Digital Breast Tomography (DBT)
Conventional mammography is for plain film imaging, which has the stacking effect of breast tissue, which reduces the detection rate of lesions and easily leads to misdiagnosis and missed diagnosis. Digital breast tomography (Digital Breast Tomography, DBT) technology is based on traditional digital mammography. It exposes breast tissue several times within a limited angle. It can not only generate two-dimensional digital breast images, but also reconstruct breast tomographic images. Breast tissue and lesion structures can be seen more clearly.
DBT better solves the problem of breast fibroglandular tissue overlap, and avoids the missed diagnosis caused by breast cancer tissue covered by overlapping breast tissue to a large extent, thereby improving the sensitivity of breast cancer detection and reducing the false positive rate .
Compared with FFDM, the two-dimensional synthetic mammogram generated by DBT has significantly improved the diagnostic efficiency of breast cancer without increasing the radiation dose, especially in dense breasts. . According to a document published in "The Lancet Oncology" in 2018, for breast cancer screening, the specificity and sensitivity of DBT are 97.2% and 81.1%, respectively, while the specificity of traditional methods is also 98.1%, but The sensitivity is only 60.4%.
3. Magnetic resonance
With the deepening of research on breast cancer, ultrasound and mammary X-rays can no longer meet the requirements of clinicians for preoperative histopathological grading of tumor patients and prediction of tumor molecular classification. Magnetic resonance imaging (Magnetic Resonance Imaging, MRI) has the characteristics of high resolution of soft tissues. When suspicious tumor tissue lesions are found in mammography, CT or ultrasonography, MRI can provide further analysis and diagnosis. And unnecessary biopsies can be avoided. Commonly used magnetic resonance imaging techniques include:
1) Dynamic contrast-enhanced MRI (DCE-MRI)
A functional magnetic resonance imaging technology, as the most mature breast MRI imaging technology, its sensitivity in diagnosing breast cancer can reach 92%~100%, and its sensitivity can reach 91%~95%. It has played an important role in the differential diagnosis, guided treatment and prognosis monitoring of breast cancer, and is widely recognized clinically.
2) Diffusion-Weighted Imaging (DWI)
DWI, whose principle is based on the difference in the diffusion degree of water molecules in normal breast tissue and diseased breast tissue, is an important part of tumor magnetic resonance imaging. Compared with DCE-MRI, DWI can improve the sensitivity of detection of cancer histopathological changes. According to the characteristics of breast cancer tissue showing high signal on DWI and water molecule diffusion-restricted image showing low signal on ADC map, it can be used to diagnose breast cancer and monitor the response of breast cancer patients to related treatments.
3. Emerging breast imaging equipment
Breast CT
Cone Beam Breast Computed Tomography (CBBCT), specially used for breast imaging, can clearly and accurately display breast details and lesions, and improve the detection rate of lesions.
The detector of breast CT surrounds the breast for imaging. During the whole scanning process, the breast is not squeezed and painless. The radiation dose is equivalent to that of mammary X-ray. It can generate high-contrast 3D breast images with excellent spatial resolution, and can clearly display breast lesions The size, number, shape, location, and distribution of blood vessels allow doctors to evaluate from any angle.
In a study conducted by the hospital, the correct diagnostic rates of CBBCT and MRI were 84.2% and 87.5% respectively, and the diagnostic accuracy rates for malignant breast lesions were 92.6% and 100%, respectively, and the diagnostic accuracy rates for benign breast lesions were 63.6%. %, no statistical difference.
Currently, both AB-CT and Koning focus on breast CT. Taking the breast CT of AB-CT as an example, its detector adopts a single-photon counting detector made of CdTe. It only takes 7 to 12 seconds for a complete helical scan, and up to 2000 projection images can be created in one scan.
Breast PET
Compared with structural imaging such as ultrasound, mammography, and nuclear magnetic resonance, breast-specific PET is functional imaging, which can distinguish benign and malignant tumors from the level of functional metabolism, and is a good supplement to conventional detection methods. It should be noted that the 18F-FDG nuclide used in PET has a very short half-life. After metabolism, it will be excreted with urine and will not cause other effects. However, try not to contact healthy people during this period, especially It's old people and children.
Breast PET is suitable for the early detection of the general population and high-risk groups of breast cancer. Only by breast PET examination can achieve excellent negative results. PET can detect very early tiny lesions and clearly define them.
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