MRI /Breast Implant TechnologyQ1. The changes of the breast tissues during the cycle of menstruation is influenced by both Progesterone and estrogen hormones in the female body. These changes occur in two phase luteal and follicular phase. The latter is the first phase which is imposed by presence of estrogen hormone while the former is the second phase of the 28 days during the menstruation cycle and is caused by the progesterone hormone. During the menstruation period the histological changes of the breast goes through five phases of change (Vogel et al. , 1981).
These changes are characterized by: - Phase 1- proliferative (early follicular): This is usually the first stage which runs from the third up to the seventh day. This phase characterized by well formed connective tissues, non-well defined Lumina which are compacted by alveoli. On observation the breast shows one cell of epithelial containing salient nucleoli in a rounded nucleus and a light cytoplasm. During this stage the apoptotic and mitoses cells also increase. Phase 2- follicular phase This period runs from the eighth day to the fourteenth day of the cycle.
This phase is characterized by presence of myopithelial, the intermediate pale and luminal basophilic cell. In this stage the lumen can be well distinguished and has cellular collagenous stroma which is quite dense. The mitoses cells clear out and are less detected in this stage. Phase 3- luteal phase This phase runs from the 15th to 20th day of the whole period. This stage is defined by alveoli-Lumina expansion, stroma loss, myoepithelial cell are easily seen and the lobular size increases due to production of some secretion. Phase 4-secretory phase This phase runs from the 21st to 27th day of the female human cycle.
During this stage, the luminal cells actively secrete apocrine. There is high level of mitotic activity and basal cells are clearly seen as vacuolized. Phase 5-menstrual phase This period brings the ultimate end of the menstrual cycle and occurs as from the 28th day to the 2nd day of the following month of the cycle. The breast tissues still appear dense and sort of swollen lumen which in turn results in reduction of apocrine secretion. During this stage the cells of the basal are seen to be highly vacuolized while on the other hand the cytoplasm in the cells of lumina is scarce. The way these two reproductive hormones influence the physiological change of the breast during the 28 days, is critical for the radiographers in the imaging centers for it is used to give a clear period of when to carry out an MRI among the premenopausal women so as to diagnose the presence or absence of malignant cell in the breast tissue (Vogel et al. , 1981).
Research has shown that, the long the female menstruates the higher the risk of Vogel developing cancer.
This has been charged from the point that long menstruating women are highly exposed to endogenous estrogen. For effective results MRI should be carried in the follicular stage since the progesterone is quite low. This is because the hormonal interaction and fluctuation during the cycle affect how gadolinium used in the MRI produces results of a normal breast tissue. As a result the accuracy of the MRI is also affected and may as well give bogus outcome especially during the luteal phase when the progesterone is high.
This is because during this stage the breast tissues is enlarged and tender with increased blood flow giving the same appearance as that of breast MRI with malignant cells. The diagnosis therefore brings a greater challenge of differentiating between the normal cells and abnormal cells of the breast hence calling for another MRI procedure repeat. To mitigate this challenge the radiographers together with the client are encouraged to schedule the procedure during the period of follicular (Ellis, 2009).