| Abstract | Dojka je parni organ građen od žljezdanog i masnoga tkiva. U mlađoj dobi, žljezdano je tkivo zastupljenije, dok starenjem dojka involuira, odnosno, udio masnog tkiva znatno se povećava.
Najveći broj lezija u dojkama benigne je prirode, a od njih su najčešće ciste i fibroadenomi. Karcinomi su rjeđi od benignih promjena, no, prvi su po učestalosti i smrtnosti od svih malignih bolesti u žena. Uvođenjem nacionalnog programa za rano
otkrivanje raka dojke mamografskim pregledom, mortalitet je smanjen za oko 20%. Radiološka dijagnostika tumora dojke obuhvaća mamografiju, ultrazvuk te magnetsku rezonanciju dojki. Pod kontrolom navedenih metoda izvode se različiti zahvati –
citološka punkcija tankom iglom, biopsija dojke širokom iglom te vakuumom potpomognuta biopsija dojke, koje omogućavaju određivanje prirode promjena u dojci. Magnetska rezonancija dojke uz primjenu kontrasta najosjetljivija je radiološka metoda
u otkrivanju patologije dojke. No, specifičnost metode je ograničena, a, samo snimanje je dugotrajno, kompliciranije te manje dostupno od mamografskog i ultrazvučnoga pregleda.
Biopsija dojke pod kontrolom magnetske rezonance indicirana je u slučaju lezije koja je okultna na mamografiji i ultrazvuku. Provodi se pomoću zatvorenog magneta koristeći zavojnice posebno namijenjene za dojke. Zbog manje mogućnosti pogreške
i preciznije dijagnoze, najčešće se izvodi vakuumom potpomognuta biopsija.
Kontraindikacije za zahvat uključuju sve kontraindikacije za pregled magnetskom rezonancijom te alergiju na gadolinij ili lokalne anestetike, dok su moguće komplikacije zahvata stvaranje hematoma, infekcija te ozljeda kože.
Ova metoda izuzetno je precizna, minimalno invazivna te se pacijenticu ne izlaže ionizacijskome zračenju. S druge strane, izvođenje zahvata je dugotrajno, skupo, slabo dostupno te zahtijeva dobro obučeno osoblje i specifičnu opremu. |
| Abstract (english) | The breast is a paired organ composed of glandular and adipose tissue. In younger women, glandular tissue predominates, whereas, with aging, the breast undergoes involution, resulting in a significant increase in the proportion of adipose tissue.
The majority of breast lesions are benign, with cysts and fibroadenomas being the most common. Carcinomas are less frequent than benign changes, but rank first in incidence and mortality among all malignant diseases in women. The implementation of a national breast cancer early detection program through mammographic screening has reduced mortality by approximately 20%.
Radiological diagnosis of breast tumors encompasses mammography, ultrasound, and breast magnetic resonance imaging. Various procedures are performed under the guidance of these imaging methods, including fine-needle aspiration, core needle biopsy, and vacuum-assisted breast biopsy, which facilitate the determination of the nature of breast changes.
Breast magnetic resonance imaging with contrast enhancement is the most sensitive radiological method for detecting breast pathology. However, the specificity of this method is limited, and the imaging process is time-consuming, more complex, and less accessible compared to mammographic and ultrasound examinations. Breast biopsy under magnetic resonance imaging guidance is indicated for lesions that are occult on mammography and ultrasound. This procedure is performed using a closed magnet and coils specifically designed for the breasts. Vacuum-assisted biopsy is most commonly performed due to its lower error rate and more precise diagnosis.
Contraindications for the procedure include all contraindications for magnetic resonance imaging, as well as allergies to gadolinium or local anesthetics. Potentialcomplications of the procedure include hematoma formation, infection, and skin injury. This method is extremely precise, minimally invasive, and does not expose the patient to ionizing radiation. Conversely, the procedure is time-consuming, expensive, less accessible and requires highly trained personnel and specific equipment. |
