Breast imaging
Breast cancer
Comprehensive breast exam
Mammotest
Breast cancer
The most common cancer in women (breast cancer accounts for 1 in 4 cancers), breast cancer is the leading cause of cancer deaths in women and the leading cause of death in women between the ages of 35 and 64. One in 9 women is at risk of developing breast cancer during her lifetime.
25% of breast cancers are diagnosed before the age of 50, 75% after the age of 50.
Screening mammograms should therefore start at age 40.
Early detection can save lives… An early diagnosis detects a smaller tumour, increases the chances of recovery, reduces the risk of metastases and recurrence, and supports less severe, conservative treatment, often avoiding removal of the breast.
Don’t wait for symptoms to appear (palpation of a lump, pain, nipple discharge, redness, skin retraction, etc.) before seeking medical attention.
However, many ‘lumps’ are benign and non-cancerous: cysts, adenofibromas, etc.
The timeline for breast cancer screening
- Women should start to get annual mammograms at age 40.
- From age 50, an exam (Mammotest or breast exam) is recommended every two years, except in special cases or where there are risk factors.
Currently there are two types of screening:
- Mammotest : for patients between the ages of 50 and 69 with no signs or symptoms of breast cancer. In the vast majority of cases, this test is sufficient and no other tests are necessary. If you are the right age, the Province of Walloon Brabant will send you an invitation for a screening.
- Comprehensive breast screening: available to all women, regardless of their age, on prescription from your GP or gynaecologist.
We use digital imaging techniques in our centre. This provides a more effective diagnosis and reduces the dose of radiation for the patient.
All our mammograms, whether performed as part of the Mammotest or a comprehensive breast exam, benefit from Ai-supported double reading.
Artificial intelligence now complements the resources available to radiologists.
The Rixensart Radiology Centre recently became one of the first centres of its kind to use ProFound AI, iCAD’s workflow solution, which uses AI to detect cancer.
This software is based on a database of several million clinical cases.
It helps the senologist or breast surgeon to analyse mammograms accurately,
performing a fast, accurate, and systematic double reading of all mammograms, alerting radiologists to any suspicious sites that warrant further investigation, and guiding the ultrasound exam.
The software also makes it possible to downplay certain images, avoid additional exams, and therefore reduce radiation exposure for the patient.
A recent clinical study showed that ProFound AI enabled radiologists to improve their breast cancer detection rate by 8% and reduce the rate of false positives, additional exams, and patient recalls by 7%.
In addition to this double reading, the solution also estimates the patient’s risk of developing breast cancer in the short term, within two years, based on age, breast density, and subtle abnormalities on the mammogram.
Its clinically proven results enable doctors to personalise the breast cancer screening programme for each patient.
Comprehensive breast exam
Study of diseases of the breast. The assessment may depend on the patient’s age.
Execution
1. Questionnaire: identifying family or personal risk factors.
2. Clinical examination: carried out by a doctor. This involves inspection and palpation of the breasts and armpits.
3. Mammogram:
A mammogram is an X-ray of the breasts. This exam, which is done by a doctor or technologist, is the preferred reference exam for breast cancer screening.
GOOD TO KNOW!
• Ideally, the exam should be performed during the first 10 days of the menstrual cycle, when a woman’s breasts are less sensitive.
• Don’t forget to bring any old mammograms for comparison!
• Most abnormal findings do not necessarily result in a cancer diagnosis. Some anomalies may require more frequent checks.
• Unfortunately, not all cancers can be detected with a mammogram: a small cancer may be present at the time of screening, in spite of a normal mammogram. Regular surveillance with mammograms and clinical breast exams are vital!
– You will be standing for a mammogram
– The breast is positioned on the detector and then compressed.
While this compression may feel unpleasant, it is vital for the quality of the images and the diagnosis. It also reduces the amount of radiation to which you are exposed.
Typically, two photos are taken of each breast. Additional exams may sometimes be necessary for more detailed imaging.
4. Ultrasound:
This exam is not performed systematically. It is carried out by the radiologist in addition to a mammogram when an abnormality has been detected and the radiologist requires more detailed imaging, or simply because of the density of the breasts.
5. FNA:
Following these exams, the radiologist may consider performing a fine needle aspiration (FNA), a type of biopsy that is used to determine the nature of any abnormality.
The entire procedure lasts between 20 and 30 minutes. Where possible, the radiologist will give you an initial provisional indication of the results at the end of the exam. You will, of course, have to wait for the result of your biopsy to come back from the lab.
When a case is deemed problematic, the radiologist systematically discusses it with the other team members.
At the end of this first consultation, the radiologist may suggest further tests (MRI, biopsy) for a more accurate diagnosis.
Mammotest
Le programme fédéral de dépistage propose aux femmes âgées de 50 à 69 ans une mammographie gratuite tous les 2 ans ! Cette mammographie s’appelle « le Mammotest ».
Ce programme résulte de la collaboration entre l’Etat Fédéral et les Communautés. Il est établi selon des recommandations émises par l’Union Européenne afin d’offrir aux femmes un dépistage dont la qualité est contrôlée, tant au niveau des appareils que des clichés et des médecins.
The procedure
The federal screening programme offers women between the ages of 50 and 69 a free mammogram every 2 years! This mammogram is called the ‘Mammotest’.
This programme is the result of a collaboration between the federal government and the Communities. It was established in line with EU recommendations so that women can benefit from quality-controlled screening, with quality equipment, imaging, and doctors.
Your Mammotest is done by a technologist who has been specifically trained for this purpose. A radiologist does not necessarily need to be present.
- During the Mammotest, 4 pictures are typically taken (2 of each breast).
- The radiologist, the approved first reader, then analyses the Mammotest.
- The Mammotest images are then sent digitally to the second reading centre, where they are analysed by a second radiologist. If there is no consensus between the first and second readers, a third reader reviews the file.
- The second reading centre (SRC) records your administrative and medical details, the doctor’s name, and the result of the exam. He sends the result to your designated doctor, who generally receives it within 15 days of the exam.
Depending on the result, further exams may be required: ultrasound, FNA, MRI, 6-month check-up, etc. This may be due to an abnormality or simply because of the density of your breasts.
Useful links:
• Community Reference Centre for Breast Cancer/Centre Communautaire de Référence pour le Cancer du Sein
• List of approved radiology centres for the Mammotest