Vo
lu
m
e
5,
M
ay
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
Dekhkambayeva Z.A.
Ph.D., Associate Professor, TMA
Nishanova.Y.X
PhD, Associate Professor, TMA
Toshboeva N.A
Master of the Tashkent Medical Academy
Abstract:
This article analyzes the factors that cause breast cancer, the importance of
complex radiological and ultrasound methods in early diagnosis and comparative diagnosis
of dangerous and safe tumor diseases of the breast, and the issues of teaching students and
demonstrating in practice the analysis of examination results.
Keywords:
Radionegative SBS, breast, ultrasonography, mammography, MRI, medical
education and practice, differential diagnosis, educational effectiveness
Introduction:
Breast cancer is one of the most common and widespread tumor diseases
among women. Scientists have determined that SBS is more common in women over 50
years old, have a genetic disease, drink a lot of alcohol, have not had children, have taken
hormonal drugs for more than 1 year, and have been exposed to radiation. Early detection of
breast cancer is of crucial importance in modern oncology. However, radionegative cases
pose great diagnostic difficulties. Radionegative breast cancer (RN-SBC) is a pathological
condition that is not detected on a regular mammogram but is confirmed by other
examinations, and it often occurs in women with dense breast tissue.
Studies have shown that the sensitivity of mammography decreases to 50% in dense tissue.
This reduces the possibility of early detection of the disease and delays its clinical
presentation. In cases of RN-SBC, many patients have a false negative result, which means
that the disease is not detected until it is at a late stage.
It is in such cases that an expanded diagnostic approach - the use of complex radiodiagnostic
(CNT) methods - becomes of great importance. This approach is relevant both for clinical
decision-making and for teaching complex cases in education.
Breast Cancer (BCC) According to WHO, 25% of all women worldwide are diagnosed with
breast cancer. In 2022, this disease was diagnosed in 2 million women and 627,000 deaths
were observed. This oncological process affects not only women, but also men, but much
less often than women. According to data, 6-12 men are diagnosed in Uzbekistan every year.
BCC is more common in women aged 20 to 80, after 40 years the risk of developing breast
cancer is 5-8 times higher than at the age of 60. Risk factors for the development of breast
Vo
lu
m
e
5,
M
ay
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
cancer include obesity, diabetes, hypertension, lack of physical activity, alcoholism,
radiation therapy for breast cancer, low breastfeeding, giving birth to the first child after the
age of 30, and hormone therapy after menopause. That is, the risk of developing breast
cancer is associated with impaired functioning of hormone-producing organs.
Materials and research methods
Research methodology: Today, the leading methods for diagnosing breast cancer include X-
ray mammography, ultrasound, Doppler function, MRI, and ultrasound-guided puncture
biopsy, etc.
UTT examination is also used as an independent method for detecting tumors in
combination with mammography. Ultrasound examination clearly visualizes tissues of
different densities and anatomical structures in the breast.
In addition, the advantages of this method are the absence of radiation exposure to the
patient's div and the possibility of repeated use of this method, which is considered a safe
method, especially in cases where X-ray mammography is limited, for example, during
pregnancy and lactation. According to studies conducted by Ivanov L.I., ultrasound is a
highly informative method for diagnosing SBS with a sensitivity of 92.3%, specificity of
84.1% and diagnostic efficiency of 88.9%.
Mammography plays a significant role in the early detection of SBS, and it was found that
this method of examination provides 80% of accurate information in cancer. It was found
that this method of examination is of great importance in the early detection and prevention
of not only cancer, but also precancerous diseases.
In many countries, mammography is the primary method used to diagnose breast diseases.
Mammography has several important advantages that make it an important tool for
diagnosing breast diseases:
Sensitivity to nodes:
mammography is good at detecting nodules and other changes in the
mammary glands, which allows for early detection of cancer and precancerous lesions.
Research objective;
To determine the diagnostic value of tumor detection in radionegative
tumors using complex radiological and ultrasound methods. And to develop methods for
teaching students
Main part
In the origin of SBS, the pituitary gland, thyroid gland and ovaries are of particular
importance. Another factor that increases the risk of cancer is that the presence of SBS in the
mother increases the risk of breast cancer in the offspring. In this, gene mutations BRCA1
and BRCA2 are important.
The first signs of breast cancer are breast swelling, discoloration of the skin around the
breast and around it, nipple retraction, colorless fluid or blood discharge from the nipple,
and enlargement of peripheral lymph nodes.
Vo
lu
m
e
5,
M
ay
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
SBS occurs in 4 stages
1st stage - the size of the tumor does not exceed 2 cm. Metastasis is not observed in the
lymph nodes
2nd stage - the tumor is 2-5 cm in diameter, the lymph nodes under the armpit are affected
by the tumor. Lymph node involvement is observed
Stage 3 is divided into 2 stages
Stage 3A - the diameter of the tumor is more than 5 cm, the lymph nodes are very enlarged,
they are attached to each other and to the surrounding tissues.
3B - at this stage, redness of the skin, the appearance of "orange peel", the tumor may be of
different sizes. At this stage, the skin of the chest, internal mammary lymph nodes or chest
wall are affected.
Stage 4 - the tumor reaches all lymph nodes and the spleen, liver, lungs, brain are also
affected by metastases.
More than 60% of people with SBS can detect such a lump by palpation. However, since
this method is not so effective, early detection of breast cancer is carried out by
mammography.
Diagnosis of SBS includes mammography, ultrasound, MRI and CT, analysis of CA15-3
oncomarkers in the blood, ultrasound examination of abdominal organs, lymph nodes,
biopsy, ductography, immunohistochemical examination. Mammogram takes pictures of the
entire breast. With this method, changes in the breast of any nature are visible. For
preventive purposes, it is recommended to undergo a mammography examination every year
after the age of 45.
UTT examination is an independent method of detecting tumors, and is used in conjunction
with mammography. Ultrasound examination clearly visualizes tissues of different densities
and anatomical structures in the breast.
Another examination, MRI, is used to accurately diagnose SBS, but this method is more
expensive than other methods. In this method, changes in the mammary gland tissue are
visible with high accuracy. In some cases, in the diagnosis of SBS, it is possible to make an
accurate diagnosis even without the use of a contrast agent. However, the MRI method also
depends on the period of the menstrual cycle when it is performed, and this can lead to
inaccurate information. According to a number of authors, X-ray negative breast cancer
occurs in 15-40% of cases, thereby reducing the effectiveness of mammographic screening.
Thus, it has been shown that the sensitivity of mammography in women of different ages
decreases by up to 53%. The formation of visual skills in diagnostics plays an important role
in the clinical training of students in higher medical education institutions. Teaching
complex diagnostic cases such as X-ray negative breast cancer requires a high level of
professional competence and the use of modern methods from the teacher.
Vo
lu
m
e
5,
M
ay
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
Teaching based on clinical case studies: Students are given tasks to analyze multimodal
images (MRI, UTT, PET) based on real disease histories associated with RN-SBS.
Using simulation technologies: A virtual diagnostic environment is created using special
radiological programs, in which students evaluate tissues in artificial conditions.
Transdisciplinary approach: By integrating radiology, oncology, and pathology, students not
only learn imaging but also clinical decision-making.
This approach prepares students to identify and select appropriate diagnostic strategies for
diagnostically complex diseases such as RN-SBS. As a result, the effectiveness of the
learning process increases, i.e. theoretical knowledge is transformed into practical
competence.
Conclusion
Radionegative breast cancer is one of the conditions with low sensitivity in medical practice,
and it is not enough to rely on mammography alone to detect it. Complex radiological
diagnostic methods - ultrasound, MRI, PET and digital tomosynthesis - are highly effective
in detecting RN-SBS cases.
By integrating these technologies into the medical education process, students will acquire
the skills to deeply study complex diagnostic cases, form clinical thinking and make
independent decisions. The results of practical studies have proven that this approach
increases the real educational effectiveness of this approach.
Recommendations:
1. It is necessary to include separate practical classes dedicated to complex radiological
diagnostic methods in radiology courses of higher medical education institutions.
2. Interactive simulators and methods based on real clinical case analysis should be widely
introduced in teaching visual diagnostics.
3. Young specialists can be better prepared for practice by teaching special clinical protocols
for RN-SBS.
4. Strengthen interdisciplinary integration in medical education - it is necessary to
harmonize the disciplines of oncology, pathomorphology, and radiodiagnostics.
References:
1.
American Cancer Society. Breast Cancer Facts & Figures 2023. Atlanta: American
Cancer
Society,
Inc.
2. Berg WA. "Tailored supplemental screening for breast cancer: what now and what next?"
AJR
Am
J
Roentgenol.
2022.
Vo
lu
m
e
5,
M
ay
,2
02
5
,
M
ED
IC
AL
SC
IE
N
CE
S.
IM
PA
CT
FA
CT
OR
:7
,8
9
3. Mann RM, Balleyguier C, et al. "Breast MRI: EUSOBI recommendations for women's
information."
European
Radiology,
2023.
4. Gulsun M, Demirkazik FB, Ariyurek M. "Evaluation of breast masses: comparison of
mammography, sonography, and contrast-enhanced MRI." Clinical Imaging, 2022.
5. Radiologiya va onkologiya asoslari, o‘quv qo‘llanma. Toshkent tibbiyot nashriyoti, 2021.
6. O‘zbekiston Respublikasi Sog‘liqni Saqlash Vazirligi. “Onkologik kasalliklar
diagnostikasining
klinik
protokollari”,
2023.
7. Yurtdashova G.M., Nurmatova N.K. "Vizual diagnostika bo‘yicha zamonaviy
yondashuvlar." Tibbiyotda innovatsiyalar, 2024.
8.
Декхкамбаева, З. (2024). Zamonaviy ta'limni jismoniy tarbiya va sport vositasida
takomillashtirish.
Наука и инновации
,
1
(1), 70-7
9.Zulfiya, D. (2022). SOG ‘LOM TURMUSH TARZINI SHAKLLANTIRISHDA SOG
‘LOMLASHTIRUVCI TEXNOLOGIYALAR.
Новости образования: исследование в
XXI веке
,
1
(5), 697-700.
