mammography

Question 1

How do you position for a cranial caudal view

Question 2

How do you position for a medial-lateral oblique mammography?

Answer 2

• Xray unit rotated through 40 and 60 degrees, so the x-ray beam passes from the superior-medial to inferolateral aspect of the breast
• Breast support table is level with a sternal notch and humeral head when the patient arm is by their side
• Cassette placed in support table with correct marker lengthways
• Breast is compressed along the plane of the pectoralis muscle
• Cassette holder and image receptor should be parallel to the muscle fibres

Question 3

What are the clinical indications for a mammogram

Answer 3

• Lumps
• Skin dimpling
• Nipple inversion
• Nipple discharge
• Eczema of the nipple

Question 4

What are the advantages of mammography for breast screening ?

Answer 4

Reduction in death to cancer
Earlier diagnosis means less radical treatment
Reassurance for those with true negative result
Improved prognosis

Question 5

What are the disadvantages of mammography for screening?

Answer 5

Over treatment for questionable abnormalities
Hazards associated with screening
False reassurance for false negative
Psychological stress for patients with false positives

Question 6

What is the mammography radiographic procedure

Answer 6

• Assess both breasts for moles, skin markings/tears, inverted nipples etc.
• Mark any scar with radio opaque marker as per departmental guidelines
• For MLO assess pectoral muscle from mid-clavicular point to mid-sternum point for bumps and lumps
• Assess prominent/depressed sternum
• Ask patient about Frozen shoulder, mobility.

Question 7

After a mammograph what is the next line of image modalities

Answer 7

ultrasound, MRI and mammotome

Question 8

What are the appropriate image modalities for breast cancer staging?

Answer 8

• Chest Xray = to see lung metastases
• RNI bone scan – for staging and Mets
• CT = staging/ Mets and radiotherapy planning

Question 9

why would you send a patient for a ultrasound after a mammogram

Answer 9

Ultrasound allows us to see the nature and composition of lesion.
Ultrasound guided biopsy to gain a sample of tissue

Question 10

why would you send a patient to MRI after a mammogram

Answer 10

• makes it easier to image younger patients or people with dense breast tissue
• good for women with implants
• useful for pregnant women to see greater detail