Gynecological examination is an important screening for women from the age of 16. However, hardly any other examination in medicine is associated with such fears and inaccurate ideas as the smear test, which should be carried out once a year. It is used for the early detection of breast cancer (using mammography) and cervical cancer (cancer smear). The sooner a serious disease (e.g. breast cancer) is detected, the higher the chances of recovery.univ. doz. dr. michael medl
→ The smear test
Every woman from the age of 20 should have an annual smear test of the cervix (PAP smear) carried out by her gynecologist. This precautionary examination, according to Dr. George PAPanicolaou, is an important method for the early detection of cervical cancer. A cellulosic material is taken from the vagina using a measuring instrument (e.g. brush, cotton wool) to be evaluated in a laboratory. Most PAP-findings are “normal”. If, however, the smear is “abnormal” a colposcopy is carried out for further clarification, in which changes in the cervix can be determined with a magnifying glass.
→ The mammography
The mammography is an early detection examination, to be undertaken every two years, which is recommended for every woman from the age of 40. For women with genetic predispositions it makes sense to have a yearly examination. In 90-95% of cases mammography findings are normal.
At present a breast cancer screening program is being implemented throughout Austria. With a two year interval women between the ages of 45 and 70 are invited to a screening. The age can be extended for women from the age of 40 to over 75 on request. The gynecologist’s name as an independent medical examiner must be given to the radiologist.
The mammography can detect small tumors or changes in the breast which may not be palpable at the given time. Whether these nodes are benign or malignant can not always be detected by means of mammography. A node will never become malign because of a mammography. An ultrasound of the breast is more informative and a biopsy (tissue sampling)will obtain even more accurate indications.
In the course of pregnancy, the ultrasound is an important method for the position and development of the fetus. It is a completely pain-free examination.
→ The ultrasound examination
Compared to X-Rays, ultrasound waves are completely harmless.
Some changes in the breast can be better judged by mammography, others by ultrasound (sonography), therefore one examination method complements the other. Especially in young women, whose mammary gland tissues are often so dense that hardly anything can be seen in a mammography, sonography is much more highly diagnostic. In older women, mammography provides better images due to the glandular tissue being less dense. Additionally, an ultrasound examination of the breast provides more clarity, can distinguish nodes from cysts and better depict lymph nodes.