The movie touches upon several emotional aspects of day-to-day life. Unable to extend her visa, she is deported back to Pakistan. Political priorities defeat humanitarian ones. The director shows a happy ending where Mammo comes to Riyaz and her sister at the end. She pretends that she is dead so that she can continue to stay in India thereafter.
Mammography is specialized medical imaging that uses a low-dose x-ray system to see inside the breasts. A mammography exam, called a mammogram, aids in the early detection and diagnosis of breast diseases in women.
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Digital mammography, also called full-field digital mammography (FFDM), is a mammography system in which the x-ray film is replaced by electronics that convert x-rays into mammographic pictures of the breast. These systems are similar to those found in digital cameras and their efficiency enables better pictures with a lower radiation dose. These images of the breast are transferred to a computer for review by the radiologist and for long term storage. The patient's experience during a digital mammogram is similar to having a conventional film mammogram.
Computer-aided detection (CAD) systems search digitized mammographic images for abnormal areas of density, mass, or calcification that may indicate the presence of cancer. The CAD system highlights these areas on the images, alerting the radiologist to carefully assess this area.
Breast tomosynthesis, also called three-dimensional (3-D) mammography and digital breast tomosynthesis (DBT), is an advanced form of breast imaging where multiple images of the breast from different angles are captured and reconstructed ("synthesized") into a three-dimensional image set. In this way, 3-D breast imaging is similar to computed tomography (CT) imaging in which a series of thin "slices" are assembled together to create a 3-D reconstruction of the body.
Although the radiation dose for some breast tomosynthesis systems is slightly higher than the dosage used in standard mammography, it remains within the FDA-approved safe levels for radiation from mammograms. Some systems have doses very similar to conventional mammography.
Screening MammographyMammography plays a central part in early detection of breast cancers because it can show changes in the breast years before a patient or physician can feel them. Current guidelines from the American College of Radiology (ACR) and the National Comprehensive Cancer Network (NCCN) recommend screening mammography every year for women, beginning at age 40. Research has shown that annual mammograms lead to early detection of breast cancers, when they are most curable and breast-conservation therapies are available.
The ACR and the National Cancer Institute (NCI) also suggest that women who have had breast cancer, and those who are at increased risk due to a family history of breast or ovarian cancer, should seek expert medical advice about whether they should begin screening before age 40 and the need for other types of screening. If you are at high risk for breast cancer, you may need to obtain a breast MRI in addition to your annual mammogram.
Before scheduling a mammogram, the American Cancer Society (ACS) and other specialty organizations recommend that you discuss any new findings or problems in your breasts with your doctor. In addition, inform your doctor of any prior surgeries, hormone use, and family or personal history of breast cancer.
Do not schedule your mammogram for the week before your menstrual period if your breasts are usually tender during this time. The best time for a mammogram is one week following your period. Always inform your doctor or x-ray technologist if there is any possibility that you are pregnant.
A mammography unit is a box with a tube that produces x-rays. The unit is used exclusively for breast x-ray exams and features special accessories to limit x-ray exposure to only the breast. The unit features a device to hold and compress the breast and position it so the technologist can capture images at different angles.
X-rays are a form of radiation like light or radio waves. X-rays pass through most objects, including the body. The technologist carefully aims the x-ray beam at the area of interest. The machine produces a small burst of radiation that passes through your body. The radiation records an image on photographic film or a special detector.
In conventional film and digital mammography, a stationery x-ray tube captures an image from the side and an image from above the compressed breast. In breast tomosynthesis, the x-ray tube moves in an arc over the breast, capturing multiple images from different angles.
During mammography, a specially qualified radiologic technologist will position your breast in the mammography unit. Your breast will be placed on a special platform and compressed with a clear plastic paddle. The technologist will gradually compress your breast.
You will feel pressure on your breast as it is squeezed by the compression paddle. Some women with sensitive breasts may experience discomfort. If this is the case, schedule the procedure when your breasts are least tender. Be sure to inform the technologist if pain occurs as compression is increased. If discomfort is significant, less compression will be used. Always remember compression allows better quality mammograms.
While mammography is the best screening tool for breast cancer available today, mammograms do not detect all breast cancers. This is called a false negative result. On the other hand, when a mammogram looks abnormal and no cancer is present, this is called a false-positive result.
Screening mammographic images themselves are often not enough to determine the existence of a benign or malignant disease with certainty. If there are abnormalities, your radiologist may recommend further diagnostic studies.
It is very important to realize that not all breast cancers can be seen on mammography. Interpretations of mammograms can be difficult because a normal breast looks different for each woman. Also, the appearance of an image may be compromised if there is powder or salve on the breasts or if you have undergone breast surgery. Because some breast cancers are hard to visualize, a radiologist may want to compare the image to views from previous examinations.
Breast implants can also impede accurate mammogram readings because both silicone and saline implants are not transparent on x-rays and can block a clear view of the tissues around them, especially if the implant has been placed in front of, rather than beneath, the chest muscles. Experienced technologists and radiologists know how to carefully compress the breasts to improve the view without rupturing the implant.
The transfer of imaging to the digital format began two decades ago with the introduction of digital radiography. By natural progression, other imaging modalities then adopted the digital technology. The transition from conventional mammography to its digital counterpart, however, was delayed due to the difficulty of producing a full-field digital detector [4].
Objectives To conduct a computer-simulated imaging trial evaluating digital breast tomosynthesis (DBT) as a replacement for digital mammography (DM) and to compare the results with a comparative clinical trial.
Background: Film mammography has limited sensitivity for the detection of breast cancer in women with radiographically dense breasts. We assessed whether the use of digital mammography would avoid some of these limitations.
Methods: A total of 49,528 asymptomatic women presenting for screening mammography at 33 sites in the United States and Canada underwent both digital and film mammography. All relevant information was available for 42,760 of these women (86.3 percent). Mammograms were interpreted independently by two radiologists. Breast-cancer status was ascertained on the basis of a breast biopsy done within 15 months after study entry or a follow-up mammogram obtained at least 10 months after study entry. Receiver-operating-characteristic (ROC) analysis was used to evaluate the results.
Results: In the entire population, the diagnostic accuracy of digital and film mammography was similar (difference between methods in the area under the ROC curve, 0.03; 95 percent confidence interval, -0.02 to 0.08; P=0.18). However, the accuracy of digital mammography was significantly higher than that of film mammography among women under the age of 50 years (difference in the area under the curve, 0.15; 95 percent confidence interval, 0.05 to 0.25; P=0.002), women with heterogeneously dense or extremely dense breasts on mammography (difference, 0.11; 95 percent confidence interval, 0.04 to 0.18; P=0.003), and premenopausal or perimenopausal women (difference, 0.15; 95 percent confidence interval, 0.05 to 0.24; P=0.002).
Conclusions: The overall diagnostic accuracy of digital and film mammography as a means of screening for breast cancer is similar, but digital mammography is more accurate in women under the age of 50 years, women with radiographically dense breasts, and premenopausal or perimenopausal women. (ClinicalTrials.gov number, NCT00008346.)
Standard views are bilateral craniocaudal (CC) and mediolateral oblique (MLO) views, which comprise routine screening mammography. The views are usually used for all routine screening clients. That is, unless there is a contraindication, screening mammograms consist of these 4 views.
Not all 4 views are always performed in all mammogram studies. For instance, in clients under 40 only 2 MLO views may be done to limit radiation exposure, depending on local policy and the discretion of the radiologist.
The reason is that a mammogram is a two dimensional representation of a 3 dimensional structure; by the same token a map is not an accurate representation of the earth's actual geography. The ML view loses significant tissue volume in the upper outer quadrant of the breast where statistically the most breast cancers are found. By doing an MLO view you get extra tissue without extra exposure. The downside of the MLO view is it is not 90 degrees to the cc view so localization of a lesion requires some thought. The two views are not orthogonal. 2ff7e9595c
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