5. Modified Mammography (2010)

7/27/2019 5. Modified Mammography (2010)

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MammographyBy Dr. Ruba Khasawneh

And Dr. Arwa Al- kinani


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BREAST ANATOMY


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BREAST ANATOMY


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MAMMOGRAM

What is a

mammogram?

Amammogram is an x-ray of the breast,

consisting of twopictures.


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MAMMOGRAM

TWO RECENT ENHANCEMENT:

1- DIGITAL MAMMOGRAPHY

2- COMPUTER AIDED DETECTION (CAD)


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WHAT ARE THE BENEFITS VS.

THE RISKS?

THE BENEFIT OF AN ACCURATEDIAGNOSIS FAR OUTWEIGHS THE

RISK.


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MAMMOGRAM

1- SCREENING MAMMOGRAM

Recommended every year for women

beginning at age of 40.

2- DIAGNOSTIC MAMMOGRAM


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VIEWS OF MAMMOGRAM

Main views:

1- Mediolateral oblique.

2- Craniocaudal.

Additional views:

1- Compression view for areas of suspiciousmasses or asymmetric breast tissue.

2- Magnification view for suspiciouscalcifications.


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Views of mammogram


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L


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CC


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Compression view


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Magnification


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NORMAL MAMMOGRAM

CC OBL


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NORMAL

Tow views


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In general terms, what are

you looking for?We're looking for small breast

cancers, which appear on themammogram as a mass or a

lump .


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What sorts of things are described on the

mammogram report

BIRADS CODING

CATEGORY 0 Incomplete ; needs further evaluation.

CATEGORY 1 Negative mammogram

CATEGORY 2 Bening findings.CATEGORY 3 Probably benign finding- short interval f/u

is suggested.

CATEGORY 4 Suspicious abnormality- Biopsy shouldbe considered.

CATEGORY 5 Highly suggestive of malignancy

Appropriate action should be taken

CATEGORY 6 Proven malignancy


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Are denser breasts harder to

screen?

The sensitivity of the mammogram is in the 90%

range.

Cancers missed by mammography are in the

range of 10-30%.

Causes include:

1- Observer error.

2- Dense tissue.3- Lobular cancer ( growth patterns

indistinguishable from normal breast tissue).


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BENIGN CALCIFICATIONS

1-Skin or dermal calcifications.

2- Vascular calcifications.

3-Lucent-centered calcifications ( Fat necrosis ).

4- Egg-shell or rim calcifications( Fat necrosis or

calcification in cyst wall).5- Coarse or popcorn calcification( Fibroadenoma).

6-Large rod like calcifications or secretory calcifications.

7- Round or punctate calcification ( less than 0.5mm).

8-Milk of calcium.

9-Suture calcification.

10-Dystrophic calcifications (Trauma, surgery andirradiation).


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Dermal calcifications


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Vascularcalcifications


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Lucent-Centered

calcifications


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Egg-shell or rimcalcifications


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Pop corncalcifications


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Secretory

calcifications


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Punctate

calcifications


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Milk of calcium


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Dystrophic

calcifications


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Breast cyst


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Fibroadenoma

well-

circumscrib-

ed ovalshaped

mass with

calcification


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FEATURES OF MALIGNANCY

1- Speculated mass

2- Architectural distortion

3- Asymmetry of breast tissue4- Micro calcification

5- Dense mass

6- Skin thickening7- Pathological lymph nodes


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Speculated mass


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Speculated mass

Magnification


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Architectural distortion

A focal area of breast tissue appears

distorted with no definable central mass.

-Causes:

A- Malignancy.

B- Benign lesions as in cases of prior breast

injury or surgery or radial scar.

-Benign lesions dont change overtime.


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Architectural distortion


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ASYMMETRY OF BREAST

TISSUE

Greater volume or density of breast tissue inone breast than corresponding area in the

contralateral breast.


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ASYMMETRY OF BREAST

TISSUE


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Linear and branching micro calcification


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Cluster of

calcifications


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Dense mass

CC


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Dense mass

OBL

diffuse skin thickening (arrowheads), trabecular coarsening, and a


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g ( ) g

speculated mass (arrows) 5.5 cm in longest diameter and dilated

lymphatic channels (arrows) that are typical of the breast edema

pattern.
http://radiology.rsnajnls.org/cgi/content/full/223/3/829/F2Ahttp://radiology.rsnajnls.org/cgi/content/full/223/3/829/F2Ahttp://radiology.rsnajnls.org/cgi/content/full/223/3/829/F2Ahttp://radiology.rsnajnls.org/cgi/content/full/223/3/829/F2A


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5. Modified Mammography (2010)