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Senologie - Zeitschrift für Mammadiagnostik und -therapie 2016; 13(02): 76-81
DOI: 10.1055/s-0042-106030
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Zur Problematik der mammografisch dichten Brust – Positionspapier des AK Mammasonografie der DEGUM[*]

The problem of mammographic breast density – the position of the DEGUM working group on breast ultrasound
M. P. Mueller-Schimpfle
1   Radiology, Neuroradiology and Nuclear Medicine, Frankfurt Höchst Hospital, Frankfurt am Main
,
V. C. Brandenbusch
2   Radiology, Diagnostic Breast Center Turmcarree, Frankfurt am Main
,
F. Degenhardt
3   Gynecology, Franziskus Hospital, Bielefeld
,
V. Duda
4   Gynecology, University of Marburg
,
H. Madjar
5   Gynecology, DKD, Wiesbaden
,
A. Mundinger
6   Breast Center, Marienhospital, Osnabrück
,
R. Rathmann
7   Radiology, Schwarzer Baer Practice, Hannover
,
M. Hahn
8   Gynecology, University of Tübingen
› Author Affiliations
Further Information

Publication History

Publication Date:
10 May 2016 (online)

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Zusammenfassung

Die mammografisch dichte Brust ist mit einem erhöhten Risiko einerseits für die Entstehung von Brustkrebs und andererseits für die Maskierung von Karzinomen in der Mammografie korreliert. Dies hat in einer zunehmenden Zahl von Staaten der USA zur gesetzlichen Verpflichtung geführt, die mammografische Brustdichte an die Frau wie auch an den behandelnden Arzt weiterzugeben. Der Arbeitskreis Mammasonografie empfiehlt die Mitteilung der Brustdichte und die Aufklärung der betroffenen Frauen über die Vorteile individualisiert ergänzender Verfahren in Abhängigkeit vom Gesamterkrankungsrisiko der Frau; aufgrund der deutschen Gesundheitsstruktur mit Erfahrung und Qualitätssicherungsprogrammen insbesondere die ergänzende Durchführung einer Mammasonografie unter Sicherung von Struktur-, Prozess-, und Ergebnisqualität. Die Probleme möglicher Überdiagnostik, zusätzlicher Kosten und erhöhten emotionalen Stress sind bei der Aufklärung zu berücksichtigen. Bei familiärer Hochrisikokonstellation sollte eine humangenetische Beratung durchgeführt, eine genetische Testung und intensivierte Früherkennung unter Einbeziehung der MR-Tomografie erwogen werden.

Abstract

Mammographic breast density correlates with breast cancer risk and also with the number of false-negative calls. In the USA these facts lead to the "Breast Density and Mammography Reporting Act" of 2011. In the case of mammographically dense breasts, the Working Group on Breast Ultrasound in Germany recommends explaining the advantages of adjunct imaging to women, depending on the individual breast cancer risk. Due to the particular structure of German healthcare, quality-assured breast ultrasound would be the first choice. Possible overdiagnosis, costs, potentially increased emotional stress should be addressed. In high familial breast cancer risk, genetic counselling and an intensified early detection program should be performed.

Key words

breast - mammography - ultrasound - neoplasms - screening

* English version online.


 

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