Brustdiagnostik

Mammography and breast diagnostics

We provide this service at the following locations:
Breast imaging based diagnostics

Three different imaging procedures are available for breast imaging diagnostics (breast examination). The indication for an examination using one or more methods depends on age, medical history and the question being asked.

Mammography

Mammography is the X-ray examination of the breast (lat. mamma). Alongside other procedures (including sonography), the aim is both the early detection of breast cancer (mammary carcinoma) and the clarification of breast complaints. Breast cancer is the most common malignant disease in women. As part of the mammography screening program, women between ages 50 and 69 are therefore invited to have a routine mammogram every other year. Read on to find out what procedures are available in mammadiognostics, how a mammography examination is carried out at the Mammo Centre Munich, how you can prepare yourself and whether a mammography hurts.

Mammo Centre Munich

Our comprehensive breast diagnostics includes advanced diagnostic methods for the early detection of breast cancer, breast cancer diagnostics and tumor care.

Through our cooperation with treating physicians, clinics and breast centres, we work in interdisciplinary collaboration. This enables us to provide targeted diagnostics as a prerequisite for optimal treatment planning. Our mammography competence team will be happy to answer any technical questions you may have using the contact form. Please write to us.

Digital mammography

Digital mammography is the central examination method for breast diagnostics. This applies both to the early detection of breast cancer and to the clarification of complaints.

We carry out all mammograms using direct digital technology. Neither film nor foils are used for image acquisition, so that the X-rays used are converted into image information with virtually no loss. This leads to a considerable reduction in dose. Compression of the breast continues to play an important role, as this makes a significant contribution to reducing the dose and improving image quality.

All images are digitally archived and can be used for comparison purposes at any time.

As a rule, an ultrasound examination (sonography) is carried out in addition to the mammography. Magnetic resonance imaging of the breast is carried out for special questions.

Basic information on breast diagnostics in Munich

If you have already had a mammogram elsewhere, please bring the previous images with you, if available. Please do not apply skin cream, deodorant or powder to the breast and armpit area on the day of the examination.

More about the mail from “Zentrale Stelle Bayern”

The Zentrale Stelle Mammographie-Screeening Bayern is the appointment allocation office for the Mammo Screening Programme. You can only take part in this nationwide program by their invitation. The invitation will include your fixed appointment in a provider practice. Appointment changes must be made directly via the central office.
We are both, a provider practice in the screening unit Oberbayern-Süd and in addition, our doctors Dr Schubert, Dr Schneider and Dr Schloßbauer are the doctors responsible for the program and are available to you if required.

Mammography and pain

For optimum image quality with minimal X-ray radiation, the breast must be compressed during a mammogram. This creates a feeling of pressure, similar to squeezing the breast with both flat hands. To avoid pain, we recommend carrying out the examination preferably between the 7th and 15th day of the cycle. The MZM staff take great care to ensure that the mammography is carried out gently and as comfortably as possible.

Mammography useful or not

In general, early detection of cancer by means of mammography from the age of 50 is stipulated every two years throughout Germany as part of the mammo screening programme (Bundestag resolution, Federal Coverage Agreement). The reason for this is that the risk of breast cancer in women increases with age. In the USA, screening is offered from the age of 40.

European experts agree that screening at a younger age without any symptoms, e.g. pain or palpable lumps, is not statistically meaningful.
If you are unsure because of your family history or if you have breast complaints, please discuss with your gynaecologist whether it makes sense to come to us for breast diagnostics.

Mammography is not screening

Mammography is a method for the early detection of breast cancer. The aim is to detect malignant findings at an early stage, as the course of the disease depends very much on the size of the tumor. Therefore, mammography is not a screening examination. From our point of view, it is therefore not possible to speak of “preventive mammography”. Colonoscopy is different: a polyp can be recognised before it becomes malignant. The term “screening” is appropriate here.

There are but a limited number of indications with scientifically proven benefits. Only the indications in bold are reimbursable under statutory insurance.

We will be happy to advise you on the appropriate use of breast MRI.

  • Differentiation of scar and tumour recurrence after breast-conserving therapy. The examination should be carried out if there is reasonable suspicion and can be performed at the earliest one year after completion of radiotherapy. If radiotherapy has not been carried out, the examination can be carried out 6 months postoperatively at the earliest.
  • Clinical suspicion of breast cancer without the tumor having been found by mammography and/or sonography.
  • Regular early detection in patients with an increased familial risk of breast cancer. Genetic counselling must be conducted beforehand. This is usually carried out by a specialist in human genetics or gynaecology.
  • Preoperative planning for breast cancer that has already been histologically confirmed. Particularly in the case of lobular carcinoma and a known familial risk of breast carcinoma. It is also useful if there is a discrepancy between the estimated mammographic and sonographic tumor size of > 1 cm.
  • Clarification of a mammographic finding that is only visible in one plane and cannot be localised sonographically.
  • Under certain circumstances, to monitor the effectiveness of neoadjuvant chemotherapy in the case of discrepant mammographic and sonographic findings.
  • Clarification of a bloody secretion if a previously performed galactography is not conclusive or technically unsuccessful.

Mammography is an X-ray examination of the breast that can be used to detect changes in the breast tissue. These include, for example, small calcium deposits (microcalcifications), lumps, thickening, asymmetries or other disorders in the tissue architecture of the breast. The most important benefit of mammography is breast cancer screening.

Mammography at our practice in Munich-Starnberg and at our other locations is an outpatient examination. During your first visit, you will receive a question and information sheet from us, which you will fill out with the radiographer. This includes your personal details, information on previous illnesses and any breast cancer in your family.

For the examination itself, please make your upper body completely free and remove all jewellery – including breast piercings. We will then place your breasts between two special Plexiglas plates, which will be pressed flat together. Now the mammography begins. Two images are taken of each breast from different directions: Number one from top to bottom, number two at an angle from the centre to the side.

Once the images have been created, we review them according to the dual control principle. If there is a particular problem, we consult one of our specialists. Every doctor at our Radiology Centre in Munich has her/his special field  of expertise. This ensures that there is at least one expert for every medical question.

If the findings are unclear, we can call in further examinations. These include an ultrasound examination (breast sonography), an MRI examination (breast MRI) and the removal of a tissue sample (breast biopsy).

Analogue mammography is the conventional examination procedure. The X-ray image is produced classically on an exposed roll of film. Digital mammography is a newer, more modern version of the examination that we use at our radiology centre in Munich. The examination procedure offers you various advantages: The radiation dose is significantly lower compared to the analogue procedure. In addition, the images can be saved on the computer. If necessary, we can enlarge or rework certain areas. It is even possible to produce three-dimensional images of your breast. The images are stored in the archive and can be used to assess any changes during subsequent examinations.

For women under the age of 50, a mammogram is usually ordered if there is a specific suspicion of breast cancer – e.g. if a suspicious lump can be felt in the breast.

Mammography is routinely recommended for women aged between 50 and 69 years. This is because breast cancer can occur more frequently at this stage of life. For this reason, women in this age group should have their breasts x-rayed every two years. The costs of the examination are covered by health insurance companies as part of the statutory cancer screening program.

Of course, mammograms can also be carried out beyond this. The recommendations for the examination depend on the individual risk of breast cancer and the general state of health.

Further procedures in breast diagnostics

Breast sonography

Ultrasound examination of the breast

Sonography (ultrasound) of the breast is usually the primary examination method for women under the age of 40. Only the latest generation of high-resolution devices are used for the examination in our centers. It should also be used as a supplement to mammography. The examination can also be carried out during pregnancy without any problems.

Sonography is ideal for clarifying palpable findings. Cysts can be easily differentiated from solid focal findings. In addition to the examination of the mammary gland tissue, the lymph nodes, e.g. in the armpit, can also be visualised.

Breast MRI

MRI examination of the breast

Breast MRI is a complementary specialised method of breast diagnostics for certain indications. Our examination protocols are optimised to the maximum for outstanding image quality and diagnostic significance.

The examination is carried out in a magnetic resonance tomograph (MRT) with a special surface coil for the breast. It should take place between the 6th and 12th day of the menstrual cycle.

When used appropriately, breast MRI is a very good complementary method.

Breast biopsy

A biopsy (tissue sample removal) may be performed to clarify suspicious breast findings. This is used to take a biopsy sample. The pathologist uses this to carry out a microscopic analysis (histopathology). In most cases, the biopsy is conducted under sonographic control (ultrasound) using a thin needle with a diameter of just 1.1 – 2.2 mm. The biopsy takes only slightly longer than a blood sample.

Routine application is the most important prerequisite for the highest quality. It goes without saying that we take plenty of time to discuss the indication, explain the individual approach and the results.

Stereotactic biopsy is used for suspicious findings that are only visible on mammography. This method is also painless and quick to perform. Including the necessary planning images and the imaging check after the biopsy, the examination takes about 15 minutes.

Under special conditions, we also perform biopsies under MRI control. The biopsy itself only takes 2-5 minutes. However, a series of MRI images must be taken for planning, so that the entire examination takes just under an hour.

Sonographic punch biopsy

The demand for sonographically guided biopsies has risen sharply. We perform these in the proven high quality.

Stereotactic vacuum biopsy

We now offer the bioptic clarification of mammographic findings under X-ray control. An experienced team is available to look after your patients.

MRI vacuum biopsy

We offer MRI-guided vacuum biopsy in Munich-Pasing.

Frequently asked questions about breast density

A woman’s breast consists of glandular, fatty and connective tissue. If the proportion of glandular and connective tissue in the breast is very high and the proportion of fatty tissue is comparatively low, this indicates a high breast density. This can influence the risk of breast cancer. It can also make it more difficult to detect breast cancer in an analogue X-ray image.

The ratio of glandular, fatty and connective tissue in the female breast is not always the same. It changes depending on hormone levels. For this reason, breast density can even fluctuate during the menstrual cycle. When women go through the menopause, the glandular tissue often recedes to a greater extent, which can lead to a decrease in breast density. However, it can be increased again by taking oestrogen supplements. Women who are overweight generally have a lower breast density.

Your individual breast density can only be assessed using imaging techniques such as mammography. If the breast density is very high, we can see a lot of white areas on the resulting X-ray image. These show the glandular and connective tissue. Fatty tissue, on the other hand, looks dark. Many dark areas on the X-ray image therefore indicate a higher proportion of fat and therefore a lower breast density.

Category 1: Very low breast density

The breast consists mainly of fatty tissue.

Category 2: Low breast density

The proportion of fatty tissue in the breast is high. However, there are isolated areas with dense glandular and connective tissue.

Category 3: High breast density

The breast contains more glandular and connective tissue. The proportion of fatty tissue is lower.

Category 4: Very high breast density

In this case, the breast consists almost entirely of glandular and connective tissue. This means that the breast tissue is extremely dense.

Women who have a high breast density have a higher risk of developing breast cancer. However, the individual risk of breast cancer also depends on other factors, such as age and genetic influences.

With a very high breast density (category 4), it is more difficult for radiologists to detect a tumor in the X-ray image – unless a non-digital procedure is used. This is due to the fact that dense breast tissue appears just as white as a tumor on a conventional X-ray image and can therefore obscure it. A change is generally more noticeable with a lower breast density, as fatty tissue is shown as dark.

At our Radiological Centre in Munich, you can benefit from digital mammography. This procedure is suitable for checking all degrees of breast density. Even with extremely dense breast tissue, we can recognise abnormalities such as architectural disorders of the breast or microcalcifications using the digital procedure. We can also carry out an ultrasound examination.

Switchboard:

089 / 896 000 – 0

Private consultation:

089 / 896 000 – 33

RZM fax number:

089 / 896 000 – 19

E-mail requests:

terminvergabe@rzm.de