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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/F2A7/27/2019 5. Modified Mammography (2010)
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