Transcript Mammography - University of Nevada, Las Vegas

Chapter 17
Mammography
 Gold standard for breast cancer detection
 Most common in women other than skin cancer
 2nd leading cause of cancer death in women
 1 in 8 chance of getting breast cancer
 1 in 35 chance of dying from it.
Mammography
 Highly regulated
 Mammography Quality Standards Act (MQSA)
 All Mammography units must meet federal standards.
ACR accredited.
 State of Nevada requires annual inspections
External Breast Anatomy
 Inframammary fold
 Inferior breast to the chest wall
 Axillary Tail
 Superiolateral aspect
External Breast Anatomy
 Areola
 Dark area surrounding nipple.
 Montgomery’s gland or Areolar glands (are Sabaceous
glands)
 Nipple
 Protrusion containing duct openings
Boundaries of the Breast
Superiorly: 1st or 2nd rib (clavicle)
Inferiorly: 6th or 7th (IMF-Inframammary fold)
Medially: Sternum
Laterally: Mid-axillary line at the junction of the
latissimus dorsi muscle.
Internal Breast Anatomy
 Pectoralis Major
 Chest muscle posterior to breast.
 Retromammary Space
 Connective tissue attaching breast to pectoralis major.
Parenchyma (Breast) Tissue
 Glandular Tissue
 Milk production and duct system
 Adipose Tissue
 Fatty tissue surrounding glandular tissue
 Fibrous (Connective) Tissue
 Surround and support the glandular structures
(Cooper’s Ligament)
Glandular Tissue
 15 – 20 lobes surrounding the nipple
 Alveoli (Acini)
 Milk producing units
 Lobules
 Groups of alveoli
Glandular Tissue
 Duct
 Transports breast milk
 Ampula
 Reservoir at the end of ducts
Mammo Compression
 Decrease breast thickness
 Brings breast structures close to the IR
 Decrease dose and scatter
 Holds the breast tissue away from the chest wall
Compression
 Decreases motion unsharpness
 Increase contrast
 Separate breast structures
Positioning
 Craniocaudal (CC)
 Mediolateral Oblique (MLO)
 Others are possible
Craniocaudal (CC)
 IR raised for 90º chest wall angle.
 Compression applied
 Correct placement of the photocell in film screen
mammography is under the most glandular tissue
 Typically the anterior third of the breast
 Pectoral muscle should be seen
Mediolateral Oblique
 CR angled 45º-50º and enters medially.
 IR raised to the height of the axilla
 Compression applied
 Film Screen mammography-position of photocell is
under the most glandular tissue typically the anterior
third of the breast
 Pectoral muscle and inframammary fold should be
seen.
Mammography Advancement
 Full Field Digital Mammography
 Computer Aided Detection (CAD)
 Ultrasound
 MRI and MR Spectroscopy
 Nuc Med
 BSGI Breast Specific Gamma Imaging (Caution-residual
radiotracers have been linked to Colon Cancer)
 3 D Mammography or Breast Tomosynthesis
(Standard mammographic views with approximately 50
individual images. Same compression and positioning.)
BREAST TOMOSYNTHESIS
BENEFITS
1. Improves radiologists' ability to screen for and detect
potential breast cancers.
2. Helps radiologists pinpoint size, shape, and location
of abnormalities.
3. Can help distinguish harmless abnormalities from
real tumors, leading to fewer callbacks and less
anxiety for women.
http://www.massgeneral.org/imaging/services/3D_mam
mography_tomosynthesis.aspx
Getting Registered
New Mandates from ARRT
Effective July 2009
40 Hours of Initial Training
Approx cost -$625 4 day program
 Candidates must be in compliance with MQSA requirements for
 technologists, and are required to complete: (a) a specified number of
mammographic
 examinations; (b) quality control procedures; (c) selected special
procedures; (d) mammographic
 review and critique. All procedures must be completed within the 24
months immediately before
 application for certification.
www.achievingqi.com- Las Vegas, Multiple dates 2011