M AMMOGRAPHY Spring 2011

M AMMOGRAPHY F ACTS ____ in _____ women who live to _____ will develop breast cancer Most common malignancy in women, only lung cancer kills more women _______________________________________________ Before Mammo fewer than_____ of pt’s survived ___years after diagnosis with a ________recurrence With a radical mastectomy survival increased to______ with a _______________recurrence

G OAL OF M AMMOGRAPHY Detect cancer before it is ________________ Early detection, __________________ and treatment is the key to a favorable ________________

H OW WOULD YOUR FAMILY FEEL WITH YOU MISSING FROM THE FAMILY PICTURE ?

H OW WOULD YOU FEEL ABOUT YOUR FATHER, BROTHER OR MOTHER MISSING FROM THE FAMILY PICTURE ?

A NATOMY OF THE B REAST Vary in ________________ Cone shaped with the post surface (base) overlying the _______& _______ muscles Axillaries tail extends from ________ to ____________ Tapers ant. from the base ending in ______________ surrounded by areola

F EMALE B REAST Consists of _______ lobes Divide into several lobules Lobules contain _____ draining ducts and ______________ By _______________ years each breast contains hundreds of lobules

L YMPH N ODES Lymphatic vessels of the breast drain laterally and medially ______ into the axillary lymph nodes (C & D) ______drain toward axilla _________ into the mammary lymph nodes _______toward mammary chain (F)

Q UADRANTS OF THE B REAST

3 T ISSUE T YPES

B REAST C HANGES WITH A GE

B REAST C LASSIFICATIONS

F IBRO - GLANDULAR B REAST Fibro-glandular Dense with very little fat Females ___________ years of age Or ______ years or older without children __________________

F IBRO - FATTY B REAST ________________ Average density _______ fat & _______fibro-glandular Women ________years of age Or women with ________ or more children

F ATTY B REAST Fatty ____________ density Women __________________ (postmenopausal), men and children

P OSITIONING

O UCH ! W HY C OMPRESSION ? Two Reasons: Decrease __________ of breast tissue Reduce ____________

C RANIO - CAUDAD :CC

D IAGRAM OF P ROPER CC P OSITIONING

CC I MAGES

M EDIO - LATERAL O BLIQUE : MLO

MLO D IAGRAM FOR P ROPER P OSITIONING

MLO P ROPERLY P OSITIONED

B ILATERAL MLO

B REAST I MPLANTS A RE THEY WORTH IT ?

C OMPLICATION WITH B REAST A UGMENTATION Mammography has a__________ true positive rate for detecting breast cancer in those women without implants Decreases to _________with implants Because__________________ of breast tissue is obscured More images are needed than the standard two projections There is a risk of ______________________ the implant

E LKLAND M ETHOD FOR I MAGING WITH B REAST I MPLANTS

I MAGE C OMPARISON W HICH IS THE P USH BACK (E LKLAND )?

M ALE M AMMOGRAPHY AND C ANCER

M ALE M AMMOGRAPHY ___________ men get breast cancer per year __________die Most are _________________ years or older Nearly all are primary tumors Symptoms include: ___________________

_______________________________ Benign excessive development of male mammary gland Occurs in ___________________ of male cancer pt’s Survival rates with treatment are_______ for ___years

C ONE M AGNIFICATION

D IGITAL VS. F ILM

L OCALIZATION OF N ON - PALPABLE L ESIONS

L OCALIZATION

__________________________________

__________________________

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A DVANTAGES OF S TEREOTACTIC Procedure done in __________________________ Approx. 1 hour long ___________________________inch long incision No _______________________________ needed No general anesthesia Less _____________________________ scarring No recovery time

C ONTRAINDICATIONS _________________________ near area of biopsy. Breast lesion ____________________to chest wall. Patient is on blood thinners such as ___________, ______, ________ which can result in hemorrhage. Patient has medical condition in which they cannot lie prone for an hour or so.

__________________________________

B REAST S PECIMEN R ADIOGRAPHY ______________________ _______________

O THER I NVASIVE B REAST P ROCEDURES

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G ALACTOGRAPHY / D UCTOGRAPHY

I NDICATIONS OF G ALACTOGRAPHY Nipple Discharge ______, ________, __________, _________&___________ Can be considered benign or malignant Approx ________________bloody discharges = cancer Other causes can be a ______________________ (shows as a filling defect on film) _________________discharge more worrisome than if discharge must be expressed manually

______________________________________ ____________ defect Could be an indication of ________________

O THER I MAGING M ODALITIES

__________________________________

B REAST ___________________

MRI VS M AMMO

MRI VS. M AMMO

D IGITAL VS. C ONVENTIONAL