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Mammographic detection of breast cancer at the earliest possible stage requires optimal radiographic technique and a full knowledge of the subtle features with which very small cancers can present. Although some early cancers are identified as characteristic clusters of calcifications or as spiculated or multinodular (knobby) masses, others demonstrate less typical and sometimes much less obvious mammographic signs: the single dilated duct, focal architectural distortion, asymmetry, and the developing density sign. Although these indirect signs are nonspecific, they provide mammographers with the important opportunity to discover breast cancer at a very early stage, when the likelihood for cure is great.
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