BREAST IMAGING

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BREAST IMAGING

• Claudia E. Galbo,M.D.
• USUHS
• Department of Radiology and Radiological Sciences

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Breast Studies

• Film-Screen Mammography
  Screening and Diagnostic
• Ultrasound
• Digital Mammography
  Computer Aided Diagnosis
• Nuclear Medicine
• MRI
• CT
• Galactography

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Procedures

• Needle Placement for Excisional Biopsy
• US-guided Aspirations
• US-guided Core Biopsies
• Stereotactic Core Biopsies

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MammogramStandard Views

• Cranio-caudal View (CC)
• Medial-lateral Oblique (MLO)

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Digital Mammography

• More inherent contrast than film-screen
• Post-processing will save on patient dose
• Telemammography option is an advantage
• Optical disc storage of images eliminates film
  loss
• At present time, resolution is better for film
  screen

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Sensitivity of Mammography

• 85 - 90 in fatty replaced breasts
• 65 in dense breasts

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Mammography Technique

• Resolution is the important imaging parameter
  needed to detect microcalcifications
• Contrast is the important parameter needed to
  detect masses

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Primary Signs of Canceron Mammography

• Mass
• Calcifications

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Secondary Signs of Canceron Mammography

• Nipple Inversion
• Architectural Distortion
• Skin Thickening
• Axillary Adenopathy
• Skin Retraction
• Tissue Asymmetry
• Developing Neodensity

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American College of RadiologyScreening
MammographyGuidelines

• Baseline Mammogram by age 40
• Mammogram every year after 40
• Clinical Breast Examination every year after 40

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MQSAMammography Quality Standards Act

• Passed 1992,Implemented 1OCT1994
• Federal quality standards
• Must be met to legally operate in the U.S.

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Stereotactic/US Core Biopsy

• Less invasive, more economical, more efficient
  than excisional biopsy of the breast
• 11 and 14 guage needle core samples obtained
• As accurate as excisional biopsy

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Core Biopsies

• Patient is supine for US core biopsies
• Patient is prone for most stereotactic core
  biopsies
• Stereo procedures usually are used to sample
  calcifications US cores are used to sample masses

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Mammography Dose Limit

• The FDA dose limit for a single view mammogram is
  300mRAD