Oshaani Abeyakoon MBBS, BSc, Presenter: Nothing to Disclose

Ashleigh Victoria Genever MBChB, Abstract Co-Author: Nothing to Disclose

Christine Ingram, Abstract Co-Author: Nothing to Disclose

Ingrid Jolly, Abstract Co-Author: Nothing to Disclose

Olga Hatsiopoulou, Abstract Co-Author: Nothing to Disclose

Mammography plays a significant role in the assessment of patients who present with benign and malignant breast disease. In the UK women over the age of 50 are offered breast cancer screening using mammography. The screening programme is currently trialling age extension to include women from 47-73 years old. Younger women are known to have a higher percentage of glandular tissue making mammography more challenging in assessing disease. In our institution symptomatic patients under the age of 35 are assessed with targeted ultrasound. Women over the age of 35 will undergo bilateral mammography as well as targeted ultrasonography. Recently published UK best practice diagnostic guidelines recommend the use of mammography for patients over 40. The purpose of our study is to evaluate the contribution of mammography in the 35 to 39 year age group.

We retrospectively searched our local CRIS/PACS systems and identified 467 women between 35-39 years of age referred to the Sheffield breast unit between Jan 2009 -Jan 2010. Patients who had not had both examinations were excluded from the study. We reviewed their mammography, ultrasound findings and histology results where applicable. In the cases that were referred for surgery, surgical records and histology data were collected.

Of the 467 patients 258 patients had normal mammography and ultrasound findings. 112 cases had benign breast disease on both ultrasound (US) and mammography, these were fibroadenomas or simple cysts. 54 cases had normal mammography but benign disease on US. These were fibrocystic change and benign cysts that were often aspirated to dryness. 35 cases had indeterminate lesions on mammogaphy and US which were biopsied.33 cases were fibroadenomas and 2 were papillomas on histology. 6 cases had malignant appearances on both modalities. These were proven to be carcinoma on biopsy and referred to surgery. 2 cases had normal US but suspicious microcalcification on mammography that were proven to be DCIS on biopsy.

In our experience mammography did not add a considerable diagnostic value to the 35 to 39 year old patient group. Out of the 467 patients, there were 2 cases of incidental pick up of DCIS (0.4%)

This study will add evidence whether the use of mammography in the 35 to 39 year old group in the symptomatic setting is appropriate and has added diagnostic value to that of sonography.

Abeyakoon, O, Genever, A, Ingram, C, Jolly, I, Hatsiopoulou, O, Does Mammography Contribute to the Management of Symptomatic Disease in Women between 35-39 Years of Age?.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11015063.html