1. HISTORY OF MAMMOGRAPHY
First proposed in 1924
Article published in 1930
1960’s Robert Egan considered the “Father of Mammography”
Also 1960’s Charles Gros developed 1st dedicated Mammo unit (Dose 8-12 rads)
1971 Xeroradiography (Dose 2-4rads)

2. IMPORTANT FACTS ABOUT MAMMOGRAPHY
Mammography is the most sensitive and accurate screening modality available for detecting early breast cancer.
It is not always diagnostically specific.
It complements but cannot replace regular physical exams and BSE.

3. STATISTICS: Breast Cancer
Most common cancer among women
Second leading cause of cancer deaths
ACS projects 212,920 new cases for women in 2006
Of these, 40,970 expected to die.

4. STATISTICS One of eight women in the U.S. will develop breast cancer.
Approximately 50% of cancers detected at a screening are impalpable
9% of breast cancers are not detected by Mammography.

5. WHAT ABOUT MEN? An estimated 1720 cases expected in men for 2006.
Approximately 460 men will die.

6. FREQUENCY Age 35 for baseline
National Institutes of Health (NIH) states screening ages every 1-2 years; every year over 50
ACS recommends every year after age 40
Patients with strong family histories should start 10 years prior to age of family member with cancer.
Cancer tends to have a rapid growth at this age. Increased incidence of breast CA at this age (40-49). Largest # of breast CA deaths in this age group.
#1 CA killer in this age
CA typically takes years to grow large enough to be palpable (1cm).
Ave CA should be found in 2-4 years before it is palpable.

7. LUMP SIZE Average size lump found by occasional BSE is 2.5cm (1”)
Ave lump found by Mammography is .5 cm (1/4”)(5yr survival 95%)
On average, lesions detected by mammography are 8 years old.
By 2 cm nodes are involved in 50-60% of the cases.
5 year survival rate is 60%

8. RISK FACTORS MAJOR RISK FACTORS MINOR RISK FACTORS Gender, Age
Personal History of Breast or other CA
Family History
MINOR RISK FACTORS
Hormonal Factors
Child-bearing
Body Shape/Type
Breast Structure
Ethinic Origin

9. DOSE 1969 Patient dose 8-12 rads 1971 Xeroradiography introduced
1986 ACR recommends <300mrad per single view with grid
view =.15 rads or 150mrads Dental = 400 mrad CA Therapy =500 rads

10. COMPARISON OF DOSE TO DAILY LIFE
The risk of death from developing breast cancer due to radiation received from a single mammographic examination is equal to the risk of:
Traveling 80 miles by air
Traveling 10 miles by car
Smoking 1/8 of one cigarette
11/2 minutes of mountain climbing
3 minutes of being a man age 60
Eating 40 TBSP peanut butter

11. EXPERIENCE INITIAL CONTINUING
Certification or 40 hours of Mammography training.
25 supervised exams
CONTINUING
15 CE every triennium
100 exams every year

12. REWARD Relaxed environment One on one patient contact Saving lives
No call or weekends

22. Collapsed Envelope

26. 11.5 Palpable Giant Fibroadenoma

30. LYMPHOMA

31. ARCHITECTURAL DISTORTION LATE STAGE PALPABLE CA

36. INSPISSATED DEBRIS AND DUCT ECTASIA

37. POST SURGICAL