mammography matters by ryan polselli



First, the doctor that told you about the radiation with ultrasound is dead wrong. Automated whole breast ultrasound (ABUS) is also referred to as automated breast volume scanner (ABVS). They are essentially the same thing but different manufacturers of the equipment like to distinguish their products and techniques. Both are forms of ultrasound and have no ionizing radiation at all. Zero. Period.

Now that that’s out of the way, ultrasound of the breast has recently been shown to be useful in detecting some cancers that mammography may not show.Note, please keep in mind there are many cancers that will definitely not show up on breast ultrasound and therefore screening for breast cancer with ultrasound alone should never be done because cancers will definitely be missed.

While ultrasound can be useful for screening for breast cancer, one problem with the traditional method (ultrasound tech or doctor holds probe in hand and moves it around to look at the breast tissue) is that it can take a long time. Many complete and thorough exams can take 30 minutes or even an hour depending on the size of the breast, complexity of breast tissue, and experience of the ultrasound technologist or doctor.

Another problem with the traditional ultrasound method is that the quality of the exam completely depends on the ability of the ultrasound technologist or doctor. Some people are good at it, some are...


The terms BRCA1 and BRCA2 (sometimes pronounced "bracka" 1 and 2) generally refer to important portions of the human genome that make proteins in cells that suppress tumors (typically breast or ovarian cancer) by repairing DNA that may be damaged during the course of one's life. Any damage to the BRCA 1 or 2 gene segments therefore predisposes an individual to breast and ovarian cancer. Although there are many similarities between the two genes, there are many important differences that are important to understand.

In general, both BRCA1 and BRCA2 mutations have been found to increase the lifetime risk of breast cancer very roughly between 50 and 85%. BRCA1 mutations however result in a higher risk of lifetime ovarian cancer (up to 60% in some studies) than BRCA2 (up to 20% in some studies). There is also a predilection for the two mutations to present with different types of cancer with some differences between the sexes. For example, BRCA2 is more likely to produce ER+ (estrogen receptor positive) cancer. It is also (for less than definitive reasons) more likely to cause male breast cancer. BRCA1 is more likely to result in a more aggressive form of breast cancer typically known as "triple negative" breast cancers. Interestingly, prophylactic oophorectomy (removal of ovaries) is effective in decreasing the risk of breast cancer in the setting of a BRCA2 mutation but not BRCA1. This is believed to be the result of decreasing the estrogen levels which could encourage an ER+ breast cancer from BRCA2.

The incidence of BRCA1 and BRCA2 also varies by ethnicity. African Americans are more likely to have BRCA2 mutations while Caucasians are slightly more likely to have a mutation in BRCA1. I hope this helps anyone looking for a concise breakdown of some of the most important differences between these two genes.


A big part of radiology is strictly defining terminology so that there is no misunderstanding. This is not nearly as easy as it sounds and your question underscores precisely this point.

For example, the word “nodule” has multiple different meanings depending on the context. A nodule can be something felt (a palpable nodule), something that grows like a tumor (a regenerative nodule), or something that is seen as an opacity on CT or x-ray (lung nodule). There are numerous other examples.

Because a lack of specific definition often leads to confusion, the trend in radiology has been to adopt strict lexicons. A good example is the “BI-RADS” system used in breast imaging which actually excluded the term “nodule” from reporting in favor of the more well defined terms of asymmetry, focal asymmetry, and mass.

In the case of thoracic imaging, the term “nodule” remains in use, but is specifically defined as any lesion (abnormality) that is smaller than 3 cm. If it is larger than 3 cm it is considered a mass. This can be a tumor (benign or malignant), infection, inflammation, or any number of other causes. In other words, a tumor (malignant or being) IS a nodule if it is less than 3 cm.Because it is very difficult and often impossible to determine the cause of many lesions in the lung on CT scans, most of these lesions are simply referred to generically as an “nodules.” Tumors, inflammation, and infection (the most common causes of nodules) often look the same and the radiologist must rely on other characteristics to determine what is causing the nodule. If it goes away after treatment with antibiotics it's usually infection. If it grows steadily with time it could be a tumor such as cancer, etc. Often, only a biopsy can determine the cause of the nodule. I hope this helps.