Mammo Technique and Artifacts Flashcards
What indicates an acceptable MLO view?
- When both MLO are mirrored, pectolaris makes a V or U shape.
- The LOWER edge of pectoralis must be at the level of the posterior nipple line (PNL) (see 460) Pectoral muscle should be seen to the level of the nipple
- Nipple should be in atleast one profile.
- Pec should be relaxed (CONVEX anterior border). When I’m vexed I need to relax.
What indicates acceptable CC view?
- Nipple in profile and points straight ahead
- PNL on CC must be within 1 cm of PNL on MLO
- Should have small amount of skin at the most medial aspect to confirm adequate coverage
Other features of adequate technique
- Breast should be up and out, not camel nosed (see 461)
- Inframammary fold should be visualized
- ConVEX is good as pect will be relaxed
- When do you get an LMO view
- When do you get an ML view
- When do you get an LM view
- Which views would you want in a magnification view
- When to use ML vs LM (screener vs diagnostic)
- MLO
- Kyphosis or pectus excavatum
- Avoid a medial pacemaker or central line
- ML:
To catch milk of calcium. This is a true lateral. Useful for identifying things on the single view only. - LM: To get a medial view- posterior medial view is hardest to get and can be seen on ML
- mag view: CC and ML
- If screener says lateral use ML on diagnostic;
If screener says medial use LM on diagnostic
Which view contains most breast tissue?
Which view contains maximized visualization of the axillary and posterior tissue
Which view maximizes the posterior medial tissue
MLO
MLO again!
What should you do with the collimator when doing a spot compression?
When to use small vs/ large paddles?
- Leave it open, this gives a larger view/field
- Small paddles give better focal compression
Large paddles allow visualization of landmarks
If you see an area of interest on MLO only (not CC) should you get LM or ML?
Pick ML as 70% of cancers occur laterally.
Which area has motion artifact in an MLO and what can be done to prevent this
Inferior part ; sweep up and out.
What does the CC maximize
Maximizes the posterior medial tissue (this can be missed on MLO)
When should you get an exaggerated lateral CC view
XCCL: If you lack adequate coverage of the posterior lateral edge or axillary tail (see more laterally)
ML vs LM for triangulation (pg 462 text seems incorrect but pg 464 diagram makes perfect sense!)
Muffins rise: if the lesion appears in a higher position on the lateral than MLO, then it is located medially (on the CC)
Lead falls: if the lesion appears in a lower position on the lateral than MLO, then it is located laterally (on the CC)
If you see :
- a lesion only in CC view
- a lesion favored to be in skin
- a lesion favored to be milk of calcium
- Lesion in far posterior medial breast
- Breast Implants
- Calcifications
Never use or pick the word “nodule” on an exam
get a:
- Rolled CC
- Tangential (TAN)
- True lateral
- Cleavage view
- Eklund views or implant displaced (MLOID, CCID)
- Magnification view
Which area can be excluded or high risk for missing cancer on MLO / CC?
- MLO : medial breast
- CC: Inferior post breast
pics on 464
Localizing a lesion on MLO vs CC
Read on pg 465 and 466, very clear!
How would you localize a lesion seen (as superior or inferior) on CC only?
Get a rolled CC view
Using the top of the breast as reference, roll medially or laterally
Superior tumor moves in the direction you roll: A superior tumor when rolled medially will move the cancer medial on rolled CC ; lateral roll will move it laterally
Inferior tumors will move in the opposite direction: Medial roll moves it on the lateral part of rolled CC; a lateral roll will move it medially
