Mammography Positioning (Removals) Flashcards
• Exposure made on suspended respiration.
• Image receptor (IR) positioned at the level of the raised inframammary crease.
• The patient’s head is turned away from the side being examined.
• The patient’s feet are apart with weight equally distributed, for stability.
• The patient’s arm closest to breast being examined is placed by the patient’s side.
• The contralateral arm is raised—holding the bar on the unit will provide support.
• Dense areas of the breast are well penetrated.
• The nipple imaged in profile, centered on the IR.
• The medial and lateral aspects of the breast included in the collimated area. (The pectoralis major
muscle is seen approximately 20% of the time.)
Craniocaudal (CC)
• Exposure made on suspended respiration.
• The tube angulation will vary between 30 and 60 degrees depending on patient size; thin patients
require steeper angulation than heavier patients.
• Arm closest to the breast being imaged is draped over the top of IR. The upper border of the IR
fits in the armpit.
• Compression must adequately support the anterior breast tissue to prevent sagging and distortion
of the ductal architecture.
The mammographer supports the anterior breast with one hand during compression and uses the
other hand to adjust the skin over the sternum and clavicle to reduce the “pulling sensation.”
• The convex-shaped pectoral muscles demonstrated to level of the nipple.
• Appropriate markers and labeling as required by the ACR.
Mediolateral Oblique (MLO)
What does drooping breast mean?
Anterior breast poorly compressed
Posterior breast is not imaged or poorly imaged
insufficient pectoral muscle
should be included on the mammogram?
Abdominal Tissue
become useful when the standard projections or are difficult to obtain.
Supplemental Projections
• To locate a lesion not seen on a CC projection if lesion is seen only on the MLO projection medial
lesions move up on the lateral from their position on the MLO lateral lesions move down on the lateral
from their position on the MLO central lesions do not move significantly from the MLO to the ML
Mediolateral (ML) 90 degree
• To verify a finding or localize a lesion in another dimension (necessary during needle localizations)
• To prove benign breast calcifications (eg, “teacup”-shaped calcifications)
Mediolateral (ML) 90 degree
• To image small breast
• To image the kyphotic patient
• To image patients with pacemakers
• To better visualize lesions in the superior or upper quadrants of the breast
Caudocranial or From Below (FB)
• To improve detail of a lesion located in the medial aspect of the breast
• To perform preoperative localization of an inferior and/or lateral lesion
• To image the nonconforming patient
Lateromedial (LM)
The beam is directed from superior lateral aspect to the inferior medial aspect.
• Demonstrates the upper-inner and the lower- outer quadrant
• Especially useful in imaging encapsulated implants
Superior-Inferior Oblique (SIO)
• To improve imaging of fine detail, especially when analyzing calcifications
Magnification (M)
The breast is rolled laterally or medially from the CC position.
• This image removes superimposed tissue when imaging dense breast (the lesion is “rolled” off or
away from the dense tissue).
Rolled Lateral (RL) or Rolled Medial (RM)
The breast is rolled superiorly or inferiorly from the lateral position.
• This image removes superimposed tissue when imaging dense breast (the lesion is “rolled” off or
away from the dense tissue).
Rolled Superior (RS) or Rolled Inferior (RI)
• Applies more compression to a localized area of interest using a smaller compression paddle
• Localization of suspected abnormality
• To evaluate a suspicious area
• Imaging performed in any projection, with or without magnification
Spot Compression
