Mammography

1. MAMMOGRAPHY
Presented by: Dr Manoj Agrawal
Radiologist Mumbai
Agrawal Diagnostic Centre

2. BREAST CANCER
 Breast cancer accounts for 32% of cancer
incidence and 18% of cancer deaths in women ?
India.
 Approximately 1 in 8 or 9 women ? India will
develop breast cancer over her lifetime.
 Patients in the early stages respond well to
extensive surgery
 Patients with advanced disease do poorly
 The earlier the diagnosis, the better the chance of
survival

3.  The standard techniques used for breast imaging
are:
1. Screen film x-Ray mammography.
2. Real-Time ultrasound.
3. Other new techniques include:
 MRI
 Color Doppler
 Elastography

4. What is mammography..??
 Mammography is the tool for early detection
 Mammography is a radiographic modality to detect
breast pathology and cancer.
 A mammogram can find breast cancer when it is
very small -- 2 to 3 years before we can feel it.

5. Modern Equipment
 Dedicated
Mammography
Equipment
 Specialized X-ray
Tubes
 Optimized
Screen/Film detector
systems
 Breast Compression
Devices

6.  No screening tool is 100% effective. Good
quality mammograms can find 85-90% of
cancers.
Some cancers are not found
until they reach this size
A mammogram can find
Cancer even when it is micro in
size

7. Indication of mammography
 pain/tenderness
 Swelling
 Nipple discharge (mild)
 Calcification
 Benign or malignant tumor
 Lymph node enlargement

8. contraindication
 Breast implant
 Severe nipple discharge
 Large palpable mass
 Inflammation
 Women within reproductive age
15-40 (benefit over risk)
Lactating
Pregnancy

9. Risk Factors
 Age
 Incidence increases with age
 Hormonal History- External supplements
Family History
 Women with positive family members
are more prone to breast cancer
 Failure of lactation

10. Patient preparation
 The patient is requested to take proper bath before
coming for the procedure
 Patient should not wear deodorant, talcum powder
or lotion under her arms or on her breasts as these
may appear on the mammogram and interfere with
correct diagnosis.
 She is suggested to wear loose clothing so that it is
easier for her to change for the procedure
 She is asked to bring along all reports done before
mammography for clinical co-relation

11. Breast Cancer Screening
 American Cancer Society(ACS) and American College of
Radiology(ACR) suggest that all women over 50 years should
undergo annual mammography.
 Women between 40 and 49 should do every alternate year.
 A baseline mammogram should be done at the onset of
menopause.

12. Routine Images -
 CC - cranio caudad
 MLO – mediolateral oblique
Additional view
 “True” Lateral view
 Latero-medial oblique view
 Paddle compression view
 Magnification view
 Tangenital view
 Cleavage view
 Axillary view
POSITIONING

14. Lundgren’s oblique view

15. Compression
 Compression is achieved with a low attenuating lexan paddle
attached to a compression device
 10 to 20 Newtons (22 to 44 pounds) of force is typically
used
 Parallel to the breast support table
 Spot compression uses small paddles
 Principal drawback of compression is patient discomfort

16. Compression
 Breast compression is necessary
 Spread the anatomy out to minimise overlaying
structures (improve contrast)
 Equalise thickness to ensure homogenous density
on the radiograph
 Bring the structures closer to the detector to
reduce geometric unshaprness
 less scatter, more contrast, less geometric
blurring of the anatomic structures, less motion
and lower radiation dose to the tissues

18. BI-RADS mammographic
assessment categories
 Categ.0 : incomplete
 Categ.1 : negative / normal
 Categ.2 : benign finding
 Categ.3 : probably benign
 Categ.4 : suspicious abnormality
 Categ.5 : highly suspicious of malignancy
 Categ.6 : known biopsy with prone
malignancy

19. THE MALE BREAST
Male Mammography and Cancer

20. 20
Male Breast Cancer Statistic:
 According to the American Cancer Society, about 0.22
percent of men’s cancer deaths are from breast cancer.
 This disease is 100 times more common in women than
it is in men.
 Benign excessive development of male mammary gland
 Occurs in 40% of male cancer pt’s
 Survival rates with treatment are 97% for 5 years

21. Gynecomastia:
Prominent Male
Breasts
Most Common Causes :
 Puberty (hormonal growth and changes during
adolescence)
 Estrogen exposure (female hormone present in the
body and the environment)
 Androgen exposure (body-building hormones)
 Marijuana use
 Medication side effects (older men)
 One symptom of Klinefelter's syndrome, a
condition in which a male has an extra X
chromosome

22. THANK YOU…..!!!!!