1. DR (MRS) AUGUSTINA BADU-PEPRAH MB Ch B, FWACS RADIOLOGIST KATH

2. Breast cancer 10/8/2015 GMA CPD 2009 2 MAMMOGRAM DUCTOGRAPHY MRI ULTRASOUND

3. Ultrasound equipment

4. Linear probe Freq of 7.5-9MHZ

5. ULTRASONOGRAPHY  RT/LT  RADIAL/ANTIRADIAL  DISTANCE FROM NIPPLE;CM FN 1. Breast composition 2. Symmetry 3. Focal masses 4. ?Calcification 5. Axillary LN

6. Screening Guidelines for the Early Detection of Breast Cancer, American Cancer Society 10/8/2015 GMA CPD 2009 6  Yearly mammograms are recommended starting at age 40.  A clinical breast exam should be part of a periodic health examination, about every 3 years for women in their 20s and 30s. Asymptomatic women aged 40 and older should continue to undergo a clinical breast exam, preferably annually*.  Beginning in their early 20s, women should be told about the benefits and limitations of breast-self examination. Women should know how their breasts normally feel and report any breast changes promptly to their health care providers.  __________  * Beginning at age 40 years, annual CBE should be performed prior to mammography

7. Usg preferred below 30yrs Due to breast composition Carcinogenic nature of x-rays

8. BENIGN FEATURES  MASS 1. Well defined 2. Smooth margins 3. Fatty content  CALCIFICATION 1. Tramline and tortuous; arterial 2. Smooth and round with lucent centre 3. Thick rod-like 4. Egg-shell 5. Pop corn 6. Large calcific opacity

9. MALIGNANT FEATURES  MASS 1. Spiculated margins 2. Ill defined 3. ?Architectural distortion 4. Skin thickening 5. ?Nipple retraction 6. ?Retraction of pectorialis muscle

10.  CALCIFICATION 1. Micro calcification 2. Mixture of sizes and shapes 3. Cluster 4. Haphazard arrangement 5. Linear branching patterns

11. BI-RADS Category 0 (needs additional imaging evaluation) Category 1 (negative- nothing to comment on) Category 2 (Benign finding) Category 3 (Probably benign finding) Category 4 (Suspicious abnormality) Category 5 (Highly suggestive of malignancy) Category 6(histologically known malignancy)

14. BENIGN

18. Ultrasound features of malignancy 10/8/2015 GMA CPD 2009 18

19. Inflammatory breast disease

20. SUBTLE CHANGES THAT CAN BE MALIGNANT

21. Group of calcification

22. THANK YOU