UP-TO-DATE BREAST CANCER IMAGING .

SAVREMENI IMIDŽING KARCINOMA DOJKE.

Introduction. Breast cancer is a major health and economic problem in Serbia. On the one hand, most patients see a the doctor at an advanced stage of the disease, and on the other hand, screening response rate is low. Early detection increases the chances of survival. Digital mammography is the gold standard in breast cancer imaging, together with supplemental ultrasound and tomosynthesis. Mammography combined with tomosynthesis has a greater detection rate regardless of breast density, although the difference is more pronounced in high-density lesions, and it has fewer false negative results than mammography alone. Ultrasound, apart from being a complementary method, is ideal for ultra sound guided breast biopsy. Magnetic resonance mammography is an imaging method with the highest sensitivity in the detection of invasive breast cancer and has an important role in the evaluation of the post-therapeutic response and in preoperative preparation. Magnetic resonance spectroscopy measures the choline levels and helps to differentiate malignant from benign lesions. It is also a promising method for early assessment of the post-therapeutic response. Positron emission tomography is likely to gain more significant roles in breast cancer imaging in the near future, especially in measuring the treatment response. [ABSTRACT FROM AUTHOR]

Uvod. Karcinom dojke predstavlja ozbiljan zdravstveni, pa i ekonomski problem u Srbiji. U većini slučajeva žene se javljaju lekaru u odmaklom stadijumu bolesti, a sa druge strane imamo problem relativno niskog odziva žena na poziv u skrining program. Rana detekcija bolesti povećava šansu za preživljavanje. Digitalna mamografija je zlatni standard u imidžingu karcinoma dojke, uz dopunu ultrazvukom i tomosintezom. Mamografija kombinovana sa tomosintezom uspešnija je u detekciji lezija nezavisno od gustine dojke, mada je razlika izraženija kod denznih dojki i ima manje lažno-negativnih rezultata u odnosu samo na mamografiju. Ultrazvuk, osim što je dopunska metoda, je idealan za navođenje biopsija lezija dojke. Magnetnorezonantna mamografija je imidžing metoda sa najvećom senzitivnošću u detekciji invazivnog karcinoma dojke i ima važnu ulogu u evaluaciji postterapijskog odgovora i u preoperativnoj pripremi. Magnetnorezonantnom spektroskopijom se meri nivo holina na osnovu čega je moguća distinkcija malignih od benignih lezija. Takođe, obećavajuća je i kao metoda rane procene postterapijskog odgovora. Pozitronska emisiona tomografija će vrlo verovatno u bliskoj budućnosti dobiti značajnije uloge u imidžingu karcinoma dojke, pogotovo kao alat za merenje postterapijskog odgovora. [ABSTRACT FROM AUTHOR]