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Mammography

Mammography. Chapter 17. Mammography. Gold standard for breast cancer detection Most common in women other than skin cancer 2 nd leading cause of cancer death in women 1 in 8 chance of getting breast cancer 1 in 35 chance of dying from it. . Mammography. Highly regulated

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Mammography

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  1. Mammography Chapter 17

  2. Mammography • Gold standard for breast cancer detection • Most common in women other than skin cancer • 2nd leading cause of cancer death in women • 1 in 8 chance of getting breast cancer • 1 in 35 chance of dying from it.

  3. Mammography • Highly regulated • Mammography Quality Standards Act (MQSA) • All Mammography units must meet federal standards. ACR accredited. • State of Nevada requires annual inspections

  4. External Breast Anatomy • Inframammary fold • Inferior breast to the chest wall • Axillary Tail • Superiolateral aspect

  5. External Breast Anatomy • Areola • Dark area surrounding nipple. • Montgomery’s gland or Areolar glands (are Sabaceous glands) • Nipple • Protrusion containing duct openings

  6. Boundaries of the Breast Superiorly: 1st or 2nd rib (clavicle) Inferiorly: 6th or 7th (IMF-Inframammary fold) Medially: Sternum Laterally: Mid-axillary line at the junction of the latissimus dorsi muscle.

  7. Internal Breast Anatomy • Pectoralis Major • Chest muscle posterior to breast. • Retromammary Space • Connective tissue attaching breast to pectoralis major.

  8. Parenchyma (Breast) Tissue • Glandular Tissue • Milk production and duct system • Adipose Tissue • Fatty tissue surrounding glandular tissue • Fibrous (Connective) Tissue • Surround and support the glandular structures (Cooper’s Ligament)

  9. Glandular Tissue • 15 – 20 lobes surrounding the nipple • Alveoli (Acini) • Milk producing units • Lobules • Groups of alveoli

  10. Glandular Tissue • Duct • Transports breast milk • Ampula • Reservoir at the end of ducts

  11. Mammo Compression • Decrease breast thickness • Brings breast structures close to the IR • Decrease dose and scatter • Holds the breast tissue away from the chest wall

  12. Compression • Decreases motion unsharpness • Increase contrast • Separate breast structures

  13. Positioning • Craniocaudal (CC) • Mediolateral Oblique (MLO) • Others are possible

  14. Craniocaudal (CC) • IR raised for 90º chest wall angle. • Compression applied • Correct placement of the photocell in film screen mammography is under the most glandular tissue • Typically the anterior third of the breast • Pectoral muscle should be seen

  15. Mediolateral Oblique • CR angled 45º-50º and enters medially. • IR raised to the height of the axilla • Compression applied • Film Screen mammography-position of photocell is under the most glandular tissue typically the anterior third of the breast • Pectoral muscle and inframammary fold should be seen.

  16. Mammography Advancement • Full Field Digital Mammography • Computer Aided Detection (CAD) • Ultrasound • MRI and MR Spectroscopy • Nuc Med • BSGI Breast Specific Gamma Imaging (Caution-residual radiotracers have been linked to Colon Cancer) • 3 D Mammography or Breast Tomosynthesis (Standard mammographic views with approximately 50 individual images. Same compression and positioning.)

  17. BREAST TOMOSYNTHESIS BENEFITS • Improves radiologists' ability to screen for and detect potential breast cancers. • Helps radiologists pinpoint size, shape, and location of abnormalities. • Can help distinguish harmless abnormalities from real tumors, leading to fewer callbacks and less anxiety for women. http://www.massgeneral.org/imaging/services/3D_mammography_tomosynthesis.aspx

  18. Getting Registered New Mandates from ARRT Effective July 2009 40 Hours of Initial Training Approx cost -$625 4 day program • Candidates must be in compliance with MQSA requirements for • technologists, and are required to complete: (a) a specified number of mammographic • examinations; (b) quality control procedures; (c) selected special procedures; (d) mammographic • review and critique. All procedures must be completed within the 24 months immediately before • application for certification. www.achievingqi.com- Las Vegas, Multiple dates 2011

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