BREAST IMAGING Claudia E. Galbo,M.D.


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BREAST IMAGING Claudia E. Galbo,M.D.

  1. 1. BREAST IMAGINGBREAST IMAGING Claudia E. Galbo,M.D. USUHS Department of Radiology and Radiological Sciences
  2. 2. Breast StudiesBreast Studies  Film-Screen Mammography: Screening and Diagnostic  Ultrasound  Digital Mammography Computer Aided Diagnosis  Nuclear Medicine  MRI  CT  Galactography
  3. 3. ProceduresProcedures Needle Placement for Excisional Biopsy US-guided Aspirations US-guided Core Biopsies Stereotactic Core Biopsies
  4. 4. MammogramMammogram Standard ViewsStandard Views Cranio-caudal View (CC) Medial-lateral Oblique (MLO)
  5. 5. Digital MammographyDigital 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
  6. 6. Sensitivity of MammographySensitivity of Mammography 85% - 90% in fatty replaced breasts 65% in dense breasts
  7. 7. Mammography TechniqueMammography Technique Resolution is the important imaging parameter needed to detect microcalcifications Contrast is the important parameter needed to detect masses
  8. 8. Primary Signs of CancerPrimary Signs of Cancer on Mammographyon Mammography Mass Calcifications
  9. 9. Secondary Signs of CancerSecondary Signs of Cancer on Mammographyon Mammography Nipple Inversion Architectural Distortion Skin Thickening Axillary Adenopathy Skin Retraction Tissue Asymmetry Developing “Neodensity”
  10. 10. American College ofAmerican College of RadiologyRadiology Screening MammographyScreening Mammography GuidelinesGuidelines Baseline Mammogram by age 40 Mammogram every year after 40 Clinical Breast Examination every year after 40
  11. 11. MQSAMQSA Mammography QualityMammography Quality Standards ActStandards Act Passed 1992,Implemented 1OCT1994 Federal quality standards Must be met to legally operate in the U.S.
  12. 12. Stereotactic/US Core BiopsyStereotactic/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
  13. 13. Core BiopsiesCore 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
  14. 14. Mammography Dose LimitMammography Dose Limit The FDA dose limit for a single view mammogram is 300mRAD