mammography for mammographers

1. PRESENTING BY:
SUMANJALI N.
MANIPAL HOSPITAL
WHITE FIELD
BENGALURU.

2. over view:
 Introduction to mammography.
 Anatomy.
 Breast cancer.
 Imaging modalities.
 Role of a mammographic technologist.
 Mammographic views.
 Reporting system.
 Additional information for a mammography
technologist.
 Artifacts.
 Male mammography .
 Conclusion.

3. INTRODUCTION
to mammography
Mammography is a special x-ray
of breasts with compression in order to
recognize any abnormalities of breast,
with dedicated mammography unit.

4. ANATOMY

5. ANATOMY

6. CANCER IS A WORD NOT A SENTENCE.

7. Imaging modalities
Mammogram

8. Ultrasound

9. Tomosynthesis

10. PET Mammogram

11. MR Mammogram

12. Breast thermography

13. Mammography technologist
 The Mammography Technologist, under
direct supervision, performs specialized
examinations of the breast to help in the
diagnosis and treatment of breast disease
in women patients.

14. Role of a Mammography technologist
 Educate patients.
 Promote privacy and comfort of the
patient.
 Perform breast and axilla palpation.
 Take proper history of a patient.
 Produce high quality films for the
radiologist to evaluate.
 Informing the radiologist regarding any
suspicious lesion.

15. Screening diagnostic
 Performed in
asymptomatic
women in order
to pick up early
and potentially
curable cancers.
 Helps in early
detection.
 Performed in
symptomatic
women, who
complain of a lump,
nipple discharge,
skin changes etc.. In
order to diagnose
or rule out an
underlying cancer.

16. Standard views:
Craniocaudal view (CC view)
45* Medio lateral Oblique (MLO view)/ Lundgren’s
view
RCC RMLOLCC LMLO

17. LAT
Left Axillary Tail
LCV
Left Cleavage
LFB
Left From Below
LLMO
Left Lateromedial
LML
Left Medio lateral
LRL
Left Roll Lateral
LRM
Left Roll Medial
LLM
Left Lateromedial
Supplementary views:

20. Extended CC view
medially rotated
Extended CC view
laterally rotated

22. Magnification view

26. Breast implant Mammogram

27. Reporting System:
 BI-RADS: BREAST IMAGING-REPORTING
AND DATA SYSTEM
 System which includes a standardized format
to guide patient care and improve physician
communication.
 BI-RADS includes specifics for
mammography, ultrasound and MRI
reporting.
 ALL breast imaging should be performed
according to BI-RADS guidelines

28. BI-RADS CATEGORIES: 1-6
 BI-RADS: 0. FURTHER EVALUATION OR
PRIORS NEEDED
 BI-RADS: 1. NEGATIVE
 BI-RADS: 2. BENIGN FINDINGS
 BI-RADS: 3. PROBABLY BENIGN (implies <2%
chance of malignancy)
 BI-RADS: 4. SUSPICIOUS OF MALIGNANCY
(requires biopsy. May be subdivided as A,B,C: low,
intermediate, moderate)
 BI-RADS: 5. HIGHLY SUSPICIOUS (requires
biopsy. Implies 95% likelihood of malignancy)
 BI-RADS: 6. KNOWN MALIGNANCY (prior to
treatment)

29. BI-RADS
 BI-RADS: 1 and 2. No action needed
 BI-RADS: 3. Short term follow-up, usually
in 6 months or consider biopsy (decision
may be based on patient’s preference)
 BIRADS: 4 and 5. Take action. Needs
biopsy

30. BI-RADS Breast Density Types
 Type 1: “Almost Entirely Fat” or “Mostly
Fatty Replaced” (0-25%)
 Type 2: “Scattered Fibroglandular” (25-
50%)
 Type 3: “Heterogeneously Dense”. (50-
75%)
 Type 4: “Extremely Dense” (>75%)

31. Breast Density Images

32. Mammographic abnormalities
which may indicate breast
cancer
Spiculated
mass

33. Micro
calcifications

34. Architectural
distortion

35. Asymmetric
density

36. artifacts
Belly fold
artifact

37. Pectoral
muscle fold
artifact

38. Hand
artifact

39. Chin
artifact

40. Axillary skin
fold artifact

41. Motion blur

42. Chest wall
skin fold
artifact

43. Powder artifact
mimicking micro
calcifications

44. Male mammogram

45. Male mammogram

46. What’s best for your patients?
 Digital imaging preferred
 Experienced Radiologists and Techs
 Proper imaging protocols
 Timely reporting to physicians using BI-
RADS format and easy to understand
patient information

47. conclusion
 Screening mammography can detect
precancerous changes in breast.
 Early detection results in a high cure rate of
breast cancer.
 Mammography is the only tool which has
reduced death rates due to breast cancer.
 Even basic screening can be terrifying to
patients. Sometimes the most important
service we provide is REASSURANCE

48.  Breast Cancer is a common but mostly
treatable disease
 Screening is the key to early diagnosis but
only works if patients trust that it is safe and
effective (and it is!)
 It is our job to: Educate patients, order
appropriate imaging, provide consistent
follow-up and communicate.
 This is a team effort!

49. thank you