Mammography Flashcards
What is the purpose of compression?
- Reduces breast thickness for even tissue distribution
- Reduces patient motion
- Prevents tissue overlap
What is the difference between a screening and diagnostic mammo?
Screening Mammogram:
- 2 projections of each breast must be
obtained
Diagnostic Mammogram:
- Additional views
What is the machine angulation for MLO view?
30-60 degrees
What direction is the breast imaged in MLO?
axilla to IMF
What information does MLO provide about a mass?
estimation of location superior or inferior to nipple
How is the machine positioned for CC view?
beam is perpendicular with floor
Where is the marker placed for CC view?
toward axilla
What information does a CC view provide us about a mass?
estimation of location medial or lateral to nipple
What is a lateral view?
true lateral, beam is parallel with floor, can be ML or LM
What is a lateral view best for imaging?
lesions in sup or inf quads
What is spot compression?
used to image small regions with greater compression, can be used w or w/o magnification
What is a cleavage view?
images medial aspects of both breasts simultaneously
What is a cleavage view best for imaging?
masses in most medial or sternal region
What is an axillary tail view?
similar to MLO, focused on Tail of Spence
What is a rolled view?
displaces mass or nipple
What is an Eklund view?
implant displaced
Where are medial and lateral located in CC view?
From nipple to marker: lateral
From nipple away from marker: medial
What aspect of the breast is located higher in MLO view?
Since MLO is not a true lateral, medial portion located slightly higher and lateral portion located slightly lower
MULD – Medial Up Lateral Down
How much has breast cancer detection increased with the use of CAD?
8-15%
What are the pros of using CAD?
- Detects small microcalcs
- Detects small spiculated masses
- Reliable and consistent
- Decreased human error
- Technology is continuing to improve
What are the cons of using CAD?
- Should not be used as a diagnostic tool alone
- Radiologist needs to interpret images first
- CAD markings need to be reevaluated and imaged again
What is tomosynthesis?
- Provides a volume reconstruction of an image by obtaining 2 projections
- Instead of 2 still images, radiologists can scroll through sliced images of the breast
What is a benefit of using tomosynthesis?
allows for displacement of obstructing tissue
What is MRI best used for in regards to breast imaging?
- Useful in cancer staging and the evaluation of lymph node involvement
- MRI is the most accurate modality for evaluating augmented breasts and implant rupture
What are pros of using MRI?
- Image slices from any plane
- Landscape image
- Both breasts simultaneously
- Sensitive to small lesions
- Sensitive to malignant lesions with use of contrast
- Breast implant ruptures
- Residual cancer after lumpectomy
What are cons of using MRI?
- Difficultly distinguishing benign vs malignant
- Cannot evaluate microcalcs
- Use of contrast injection
- Claustrophobia
- Time-consuming
- Expensive
What is breast imaging in nuclear medicine called?
scintimammography
What is scintimammography?
- Images the physiologic response to breast disease
- A radioactive element is injected into the contralateral arm
- This tracer locates and highlights cancer cells in the breast
What is nuc med helpful in diagnosing?
- Disease in patients with dense breasts
- Palpable abnormalities not well visualized on US/Mammo
- Multifocal/Multicentric cancer invasion
What is BIRADS cat 0?
incomplete, needs additional imaging
What is BIRADS 1?
negative
What is BIRADS cat 2?
benign
What is BIRADS cat 3?
probably benign
What is BIRADS cat 4?
suspicious
4A: low suspicion
4B: moderate suspicion
4C: high suspicion
What is BIRADS cat 5?
highly suggestive of malignancy
What is BIRADS cat 6?
known biopsy-proven malignancy
What are categories A-D in mammo?
A: almost entirely fatty
B: scattered areas of fibroglandular density
C: heterogeneously dense
D: extremely dense
What are categories A-C in US?
A: homogenous echotexture- fat
B: homogenous echotexture- fibroglandular
C: heterogenous echotexture
What are categories A-D in MRI?
A: almost entirely fat
B: scattered fibroglandular
C: heterogenous fibroglandular
D: extreme fibroglandular
