Mammography.ppt
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Transcript of Mammography.ppt
![Page 1: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/1.jpg)
Mammography # 1
Week 2
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Mammography Facts
• 1 in 8 women who live to 95 will develop breast cancer
• Most common malignancy in women, only lung cancer kills more women– One of the most treatable cancers
• Before Mammo fewer than 5% of pt’s survived 4 years after diagnosis with a 80% recurrence– With a radical mastectomy survival increased to 40% with a
10% recurrence
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Goal of Mammography
• Detect cancer before it is palpable
• Early detection, diagnosis and treatment is the key to a favorable prognosis
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How would your family feel with you missing from the family picture?
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How would you feel about your father, brother or mother missing
from the family picture?
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Breast Self Exam
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Breast Dimpling
![Page 8: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/8.jpg)
Breast Cancer
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Peau d’orange
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Anatomy of the Breast
• Vary in shape & size• Cone shaped with the post
surface (base) overlying the pectoralis & serratus muscles
• Axillaries tail extends from lat. base of the breasts to axillaries fossa
• Tapers ant. from the base ending in nipple, surrounded by areola
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Female Breast• Consists of 15-20
lobes– Divide into several
lobules– Lobules contain acini,
draining ducts and interlobular connective tissue.
– By teenage years each breast contains hundreds of lobules
![Page 12: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/12.jpg)
Lymph Nodes
• Lymphatic vessels of the breast drain laterally and medially– Laterally into the
axillary lymph nodes (C & D)
• 75& drain toward axilla
– Medially into the mammary lymph nodes
• 25% toward mammary chain (F)
![Page 13: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/13.jpg)
Quadrants of the Breast
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3 Tissue Types
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Breast Changes with Age
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Breast Classifications
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Fibro-glandular Breast
• Fibro-glandular– Dense with very little
fat– Females 15-30 years
of age• Or 30 years or older
without children
– Pregnant or lactating
![Page 18: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/18.jpg)
Fibro-fatty Breast
• Fibro-fatty– Average density
• 50% fat & 50% fibro-glandular
• Women 30-50 years of age
– Or women with 3 or more children
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Fatty Breast
• Fatty– Minimal density– Women 50 and older
(postmenopausal), men and children
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Positioning
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Various Mammographic Positioning
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Ouch! Why Compression?
• Two Reasons:
– Decrease thickness of breast tissue
– Reduce OID
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Cranio- caudad :CC
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Diagram of Proper CC Positioning
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CC Images
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Multiple Bilateral Benign Calcifications
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Breast Cancer
![Page 28: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/28.jpg)
Carcinoma
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Microcalcifications
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CC positioning
• CR Perpendicular• Film tray brought to
level of inframammary crease
• Wrinkles and folds smoothed out
• Compression applied• Markers on axillary
side
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CC Criteria
• No motion• Nipple in profile• All pertinent anatomy
demonstrated• Dense areas penetrated• High contrast & optimal
resolution• Absence of artifacts• Marker & patient ID
visible
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Medio-lateral Oblique:
MLO
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MLO Diagram for Proper Positioning
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MLO Properly Positioned
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Bilateral MLO
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MLO positioning
• CR & cassette (IR) angled 45 degrees
• Top of cassette (IR) at axilla
• Compression applied
• Nipple in profile• Marker at axilla
![Page 37: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/37.jpg)
MLO criteria
• No motion• Pectoral muscle to level
of nipple visualized• Breast pulled away from
chest wall• Nipple in profile• Dense areas of breast
penetrated• High contrast & optimal
resolution• Absence of artifacts• Marker & PT ID visible
![Page 38: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/38.jpg)
What position is this?
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What position is this?
![Page 40: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/40.jpg)
Breast ImplantsAre they worth it?
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Complication with Breast Augmentation
• Mammography has a 80-90% true positive rate for detecting breast cancer in those women without implants– Decreases to 60% with implants
• Because 85% of breast tissue is obscured
• More images are needed than the standard two projections
• There is a risk of rupturing the implant
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Elkland Method for Imaging with Breast Implants
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Image ComparisonWhich is the Push back (Elkland)?
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Male Mammography and Cancer
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Male Mammography
• 1300 men get breast cancer per year– 1/3 die
• Most are 60 years or older• Nearly all are primary tumors• Symptoms include:
– Nipple retraction– Crusting– Discharge– Ulceration
![Page 46: Mammography.ppt](https://reader036.fdocuments.net/reader036/viewer/2022081603/55cf8c6b5503462b138c25e4/html5/thumbnails/46.jpg)
Gynemastia
• Benign excessive development of male mammary gland• Occurs in 40% of male cancer pt’s• Survival rates with treatment are 97% for 5 years
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Old and New Equipment
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Cone Magnification
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Cone magnification
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Mammography Equipment
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Digital vs. Film