Mammography 2

FINAL

Types of Lumps

Breast Anatomy

AA ducts ductsBB lobules lobulesCC dilated section of duct to hold dilated section of duct to hold milkmilkDD nipple nippleEE fat fatFF pectoralis major muscle pectoralis major muscleGG chest wall/rib cage chest wall/rib cage

Localization ofNon-palpable Lesions

Localization

Needle Wire Localization

Needle Wire Localizationfor Surgical Excision Biopsy

Fine Needle Aspiration Biopsy (FNAB)

Stereotactic Procedures

Mammotome

Advantages of Stereotactic

• Procedure done in office setting

• Approx. 1 hour long

• 1/4 inch long incision

• No sutures needed

• No general anesthesia

• Less internal and external scarring

• No recovery time

Contraindications

• Major blood vessels near area of biopsy.

• Breast lesion too close to chest wall.

• Patient is on blood thinners such as aspirin, heparin, Coumadin, which can result in hemorrhage.

• Patient has medical condition in which they cannot lie prone for an hour or so.

Ultrasound Guided Biopsy

Breast Specimen Radiography

Mammotome orFNAB specimen

Excisional Biopsy

Pathologies

Types of Pathologies

• Cyst

• Lipoma

• Fibroadenoma

• Fibrocystic Breasts

• Cancer

• DCIS – Ductal Carcinoma in Situ

• IDC – Infiltrating Ductal Cancer

Cysts

Cysts

Lipoma

Fibroadenoma

Fibroadenoma

Fibrocystic breasts

Cancer

Cancer

Breast Calcifications

Breast Calcifications

DCIS – Ductal Carcinoma in Situ

DCIS – Ductal Carcinoma in Situ

Infiltrating Ductal Cancer

Infiltrating Ductal Cancer

Other Invasive Breast Procedures

Galactography / Ductography

Galactography / Ductography

Indications of Galactography

• Nipple Discharge – White / Yellow/ Green / Brown / Red– Can be considered benign or malignant– Approx 2-5% bloody discharges = cancer– Other causes can be a blocked duct due to a

papilloma (shows as a filling defect on film)– Spontaneous discharge more worrisome than

if discharge must be expressed manually

Galactography / Ductography

• Filling defect

• Could be an indication of ductal papillomas

Other Imaging Modalities

Ultrasound Breast

Breast MRI

MRI vs Mammo

MRI vs. Mammo

Digital vs. Conventional

Digital vs. Conventional