mammography lecture part 1 & 2
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Transcript mammography lecture part 1 & 2
1
MAMMOGRAPHY
LECTURE #1
rev 2010
Positioning & Anatomy
RADIOGRAPHIC IMAGING OF THE BREAST
RTEC 255 -Week # 3
D. Charman, M.Ed.,R.T.(R,M)
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Mammograms
don’t look fun
but they can
save a life!
Man – o - gram
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A mammogram can find breast cancer when
it is very small -- 2 to 3 years before you
can feel it.
No screening tool is 100% effective. Good
quality mammograms can find 85-90% of
cancers
Some cancers are not found
until they reach this size
A mammogram can find
cancer when it is only this size
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Do it for those you love….
And who love you
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POSITIONING
Routine Images aka “screening mammo”
(not screaming)
CC
- cranio caudad
MLO – mediolateral oblique
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More on MAMMO Equipment – week 8
With Xray & Mammo QC
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Compression Important:
Evens Density of Breast
Reduces Motion
AEC choice depends of size
and composition of breast
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CC
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Marker? Which side is axilla?
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MLO – RT BREAST
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POSITIONING
CC – CRANIOCAUDAD
MLO – MEDIAL LATERAL OBLIQUE
“TRUE” LATERAL
ETC
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TRUE LAT
CONE-MAG
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Magnification = increase OID
Anatomy of the Breast
Vary in shape & size
Cone shaped with the post
surface (base) overlying the
pectoralis & serratus muscles
Axillaries tail extends from lat.
base of the breasts to axillaries
fossa
Tapers ant. from the base
ending in nipple, surrounded
by areola
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Female Breast
Consists of 15-20 lobes
Divide into several
lobules
Lobules contain
acini, draining ducts
and interlobular
connective tissue.
By teenage years
each breast contains
hundreds of lobules
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See Mammo Study Guide
TDLU ?
COOPER’S Ligaments
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Breast profile:
A ducts
B lobules
C dilated section of duct to hold
milk
D nipple
E fat
F pectoralis major muscle
G chest wall/rib cage
Enlargement:
A normal duct cells
B basement membrane
C lumen (center of duct)
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Lymph node areas
adjacent to breast area.
A pectoralis major muscle
B axillary lymph nodes:
levels
C axillary lymph nodes:
levels
D axillary lymph nodes:
levels
E supraclavicular lymph
nodes
F internal mammary
lymph nodes
Lymph Nodes
Lymphatic vessels of the
breast drain laterally and
medially
Laterally into the axillary
lymph nodes (C & D)
75& drain toward
axilla
Medially into the
mammary lymph nodes
25% toward
mammary chain (F)
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Breast Scintomotography
Isotope matches tumor to node involvement
More on Breast Pathology & Procedures next lecture…..
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Quadrants of the breast
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TYPES OF
BREAST TISSUE
GLANDULAR
DUCTS
LOBES
LOBULES
TDLU
MOSTLY SEEN UPPER
OUTER QUADRANT
STROMAL
FATTY TISSUE
CONNECTIVE
TISSUE
(COOPER’S
LIGAMENTS –
SUSPENSATORY
LIGAMENTS
3 Tissue Types
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Breast Classifications
Breast Changes with Age
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Fibro-glandular Breast
Fibro-glandular
Dense with very
little fat
Females 15-30
years of age
Or 30 years or
older without
children
Pregnant or
lactating
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Fibro-fatty Breast
Fibro-fatty
Average density
50% fat & 50%
fibro-glandular
Women 30-50
years of age
• Or women
with 3 or
more children
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Fatty Breast
Fatty
Minimal density
Women 50 and
older
(postmenopausal),
men and children
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THE MALE BREAST
Male Mammography and Cancer
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Male Breast Cancer Statistics:
According to the American Cancer Society,
about 0.22 percent of men’s cancer deaths
are from breast cancer.
This disease is 100 times more common in
women than it is in men.
Thanks to greater awareness and better
treatments, the survival rates for both men
and women are on the rise.
Gynecomastia
Benign excessive development of male mammary gland
Occurs in 40% of male cancer pt’s
Survival rates with treatment are 97% for 5 years
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Gynecomastia:
Prominent Male
Breasts
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Most Common Causes :
Puberty (hormonal growth and changes during
adolescence)
Estrogen exposure (female hormone present in the
body and the environment)
Androgen exposure (body-building hormones)
Marijuana use
Medication side effects (older men)
One symptom of Klinefelter's syndrome, a
condition in which a male has an extra X
chromosome
Gynecomastia
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is a benign male breast (non-cancerous)
condition
Some men who have prominent breasts, or
uneven breasts, often feel some embarrassment
about their body image.
This condition can also cause
emotional conflict over
sexual identity.
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Position?
Best Seen ?
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male breast
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Male Mammography
1300 men get breast cancer per year
1/3 die
Most are 60 years or older
Nearly all are primary tumors
Symptoms include:
Nipple retraction
Crusting
Discharge
Ulceration
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male mastectomy
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THE AUGMENTED
BREAST
Difficulty with IMPLANTS
Breast Implants
Is it worth the risk?
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Complication with Breast
Augmentation
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Mammography has a 80-90% true positive rate
for detecting breast cancer in those women
without implants
Decreases to 60% with implants
Because 85% of breast tissue is obscured
More images are needed than the standard two
projections
There is a risk of rupturing the implant
Loss of sensation from surgical scars
Elkland Method for Imaging with
Breast Implants
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“PUSH BACK” TECHNIQUE
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Other Imaging of the Breast
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Xero mammography (early years
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OTHER CHALLENGES TO
MAMMOGRAPHY
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