I am here with Dr. Laszlo Tabar and he and his colleagues have written a book titled
Understanding the Breast in Health and Disease.
So, Dr. Tabar, why is it so important for women to understand their breasts?
Lisa, the breast has a very complex structure.
Unlike other organs in the body, it varies from woman to woman and also it may vary a
lot from decade to decade.
I can demonstrate this by showing you mammograms.
Here are the mammograms of five different women and you see the composition, the structure.
This is what we call a dense breast.
This one we call a dense breast too and this one too, but these are three versions of this
so called dense breast.
And this one is totally fatty replaced and it's partly dense and partly fatty replaced.
So, the varieties are enormous.
Unlike, for example, the lungs, one chest x-ray doesn't differ very much from another
chest x-ray.
One woman's kidneys are not very different from another woman's kidneys.
Why is it so, that the mammograms have composition of normal breasts so different?
I think women should know about it.
In addition, the benign and malignant breast diseases are extremely heterogeneous.
So what we want to accomplish by informing women about these varieties is that they should
be aware of which mammographic parenchymal patterns they belong to.
Because here in this entirely fatty replaced breast, I can find the tiniest benign or malignant
lesion, but I can not provide the same service here and I have a very difficult task in finding
for example 1 cm cancer in this breast.
I would very much like women to understand this variation and I would like to show you
also this compared with 3-dimensional histology.
Every woman would understand that this breast has a lot of glandular tissue where the milk
is produced.
And this is actually the blue print of this mammogram.
I am just imaging the underlying beautiful nature.
This is a milk duct.
This is a milk duct full of fluid and let me call it a spring time, that is these milk
factories are hormone sensitive.
They are really reacting, producing fluid and this results in the dense tissue, but
this one is a winter time.
That is the milk factories are already regressed, they disappeared, just the skinny branches
of the duct or the tree and its branches are seen.
So it's very easy for me to find any benign or malignant lesion in it.
So you are talking about winter time versus spring time.
Is there an age difference between these women?
Yes and no.
This woman can be a 25-year-old woman, but when she becomes pregnant then spring time
comes.
So it's a very interestingly dynamic and complex organ.
It changes a lot, our lungs do not change.
Our other organs don't change to this level.
Thus, we can demonstrate the change.
So that's why it is an extremely difficult task to read mammograms and I just want to
let women know these varieties of the normals.
So they can understand why one woman has a breast pain and the other woman doesn't even
understand what breast pain is.
Why one woman's mammogram is easy to read, why a woman with dense breast has a problem,
both of them concerning breast pain and their physicians have problem in finding very small
cancers in those breasts as well.
Thank you so much for joining us here at Breast Cancer Answers, doctor.
Every woman should purchase this book and again the name of it is Understanding the
Breast in Health and Disease.
You can pick it up at amazon.com or you can also get it at mammographyed.com.
Now in addition to the book, there is more.
There are also video commentaries that can give you more information and why it's very
important to understand your breast.
For Breast Cancer Answers, I am Lisa Schneider-Cipriano.