Breast Imaging Flashcards
What are the two purpose of breast imaging?
The first purpose is to screen asymptomatic women for early breast cancer.
The second purpose is to evaluate breast abnormalities in symptomatic patients or patients with indeterminate screening mammograms.
What is the ACS guidelines for breast cancer screening in average-risk women?
For 20 to 39 years = Clinical examination every 3 years; Mammography is not recommended
For 40 years and older = Annual clinical examination and mammography
This is the only imaging modality that has been proven to reduce breast cancer mortality when used to screen asymptomatic women.
Mammography
This is being used for breast cancer screening in conjunction with mammography in high-risk women.
MR
This should be the first imaging study performed in patients older than 30 year who present with breast masses that are suspicious for carcinoma.
Bilateral mammography
This mammographic view, when properly positioned, depicts the greatest amount of breast tissue.
It is the most useful view in mammography.
Mediolateral oblique view (MLO)
To perform MLO view, the x-ray tube and image receptor, which are fixed with respect to one another, are moved to an angle that parallels the orientation of the patiet’s _______ muscle.
Pectoralis major muscle
The angle is generally between 40 to 60 degrees from the horizantal.
A properly positioned MLO mammogram should show what structures/landmark?
The pectoralis major muscle down to the level of a line drawn perpendicular to the muscle through the nipple (posterior nipple line).
The nipple should be in profile so that the subareolar area can be adequately evaluated.
The inframmary fold should be visible to ensure that the inferior portion of the breast has been imaged.
For this view, the unit is placed in the vertical position so that the x-ray tube is perpendicular to the floor.
Photons will travel from the anode, located superior to the breast, to the image receptor underneath the breast.
The craniocaudal (CC) view
When evaluating a CC mammogram, optimal positioning can be assured when __________.
When the pectoralis muscle is seen centrally on the film and the nipple is in profile.
An alternative method of assuring appropriate visualization of posterior tissues is to measures the distance from the _____ to the edge of the film through the central axis of the breast.
Nipple
This distance should be within 1 cm of the length of the posterior line as seen on the MLO view.
What is the purpose of a 90 degree lateral view (ML or LM)
Localizing lesion seen in one view
Demonstrate milk of calcium due to its gravity dependency
What is the purpose of a spot compression view?
Determine whether lesion is real or is a summation shadow
What is the purpose of a spot compression with magnification view?
Better definition of margins of masses and morphology of calcifications
What is the purpose of an exaggerated craniocaudal view?
Show lesions in outer aspect of breast and axillary tail not seen on CC view
