A mammogram is an x-ray of the breast used to detect breast cancer. The document discusses the equipment used for mammography including the x-ray tube, compression device, and digital systems. It also covers positioning of the breast, types of mammograms, limitations, and various breast imaging modalities like digital mammography and breast MRI. Mammography remains the standard screening tool for breast cancer detection, though false negatives can occur and imaging is limited in women with dense breasts.

1. FPPT.com
IMAGING BREAST
MAMMOGRAM
1/29/2020 4:43:06 PM 1Imaging breast mammogram

2. Digital X-Ray Imaging and Computer Tomography
course code :1202
Submitted by
Mahfuzur Rahman
Semester : MSc 2st
Class roll:04
Batch: 25th
Year: 1st
Department of MPBME
GONO BISHAWABIDYALAY
SAVAR,DHAKA
Submitted to
Mokhlesur Rahman
Lecturer of MPBME Department
1/29/2020 4:43:06 PM 2Imaging breast mammogram

3. over view
 Mammogram
 Brief History
 MAMMOGRAPHY EQUIPMENT
 Principles Of Breast Cancer
 BI-RADS mammographic
 Type of mammographic examination
 Anatomy of the Breast
 POSITIONING of breast
 Imaging modalities
 Male Breast Cancer Statistics
 Limitations of Mammograms
 References
•1/29/2020 4:43:06 PM 3Imaging breast mammogram

4. What is a mammogram?
• Mammography is a specific type of breast imaging that uses low-dose x-rays to
detect cancer early – before women experience symptoms – when it is most
treatable.
• Mammography is a radiographic modality to detect breast pathology and cancer.
• No screening tool is 100% effective. Good quality mammograms can find 85-90%
of cancers.
• A mammogram can find breast cancer when it is very small -2 to 3 years before we
can feel it.
1/29/2020 4:43:06 PM 4Imaging breast mammogram

5. Type of mammographic examination
Screening mammogram
• Mammogram of the breast for the women who have no sign or symptom of
breast cancer, usually with two x-ray views
• Finding breast cancer early greatly improves a woman’s chance for
successful treatment.
Diagnostic mammogram
• X-ray of the breast for a woman with breast problem like lump or nipple
discharge or an abnormal area found in screening by taking spot view or
magnification view
1/29/2020 4:43:06 PM 5Imaging breast mammogram

6. MAMMOGRAPHY EQUIPMENT
• Generator
• X-ray tube – fine focus of 0.2-0.5 mm with an additional 0.1 mm
focus for magnification .
• Target – Molybdenum and Rhodium
• Beryllium window – Minimises absorption of radiation within the
tube .
• Molybdenum filter – By transmitting only characteristic radiation
,absorbs unwanted radiation and forms a monoenergetic beam.
• Compression device : 1-4 mm thick plastic plate.
1/29/2020 4:43:06 PM 6Imaging breast mammogram

7. X-ray tube configuration
1/29/2020 4:43:06 PM 7Imaging breast mammogram

8. Principles Of Breast Cancer
• 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
• Mammography is the tool for early detection
1/29/2020 4:43:06 PM 8Imaging breast mammogram

9. Indication
• pain/tenderness
• Swelling
• Nipple discharge (mild)
• Calcification
• Benign or malignant tumor
• Lymph node enlargement
1/29/2020 4:43:06 PM 9Imaging breast mammogram

10. contraindication
• Breast implant
• Severe nipple discharge
• Large palpable mass
• Inflammation
• Women within reproductive age 15-40 (benefit over
risk)
1/29/2020 4:43:06 PM 10Imaging breast mammogram

11. BI-RADS mammographic
1/29/2020 4:43:06 PM 11Imaging breast mammogram

12. Risk Factors
• Age
• Incidence increases with age
• Hormonal History
• More sensitive to carcinogens during menarche
• Family History
• Women with positive family members are more prone to breast cancer
1/29/2020 4:43:06 PM 12Imaging breast mammogram

13. 1/29/2020 4:43:06 PM 13Imaging breast mammogram

14. Anatomy of the Breast
• Vary in shape & size
• Cone shaped with the post
surface (base) overlying the
pectoralis & serratus muscles
• Axillaries tail extends from lat.
• base of the breasts to axillaries
fossa
• Tapers ant. from the base
ending in nipple, surrounded by
areola
1/29/2020 4:43:06 PM 14Imaging breast mammogram

15. Female Breast
• Consists of 15-20 lobes
• Divide into several
lobules
• Lobules contain acini,
draining ducts and
interlobular connective
tissue.
• By teenage yearseach
breast contains
hundreds of lobules
1/29/2020 4:43:06 PM 15Imaging breast mammogram

16. Lymph node:
• Lymphatic vessels of the
breast drain laterally and
medially
• Laterally into the axillary
• lymph nodes (C & D)
• Medially into the mammary
• lymph nodes
1/29/2020 4:43:06 PM 16Imaging breast mammogram

17. POSITIONING
• 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
1/29/2020 4:43:06 PM 17Imaging breast mammogram

18. Breast positioning
1/29/2020 4:43:06 PM 18Imaging breast mammogram

19. Lundgren’s oblique view
1/29/2020 4:43:06 PM 19Imaging breast mammogram

20. 1/29/2020 4:43:06 PM 20Imaging breast mammogram

21. Imaging modalities
• Although film screen mammography were effective, according to various
studies up to 20-30% of malignancies were missed by the regular film
screen mammography.
• One of the drawbacks of SFM is its contrast resolution. The breast is a
difficult organ to image as it consists of tissues of contrasting densities;
glandular tissue interspersed with fat.
• It has been found that women with dense breasts have a four to six times
higher risk of breast cancer compared to women with little or no glandular
tissue. This is postulated to be due to the masking of existing lesions by
the overlying breast tissue.
1/29/2020 4:43:06 PM 21Imaging breast mammogram

22. Digital mammography
• also called full-field digital mammography
(FFDM),
• in which the x-ray film is replaced by
electronics that convert x-rays into
mammographic pictures of the breast.
• These detectors convert the x-rays that pass
through them into electronic signals that are
sent to a computer.
• The computer then converts these electronic
signals into images that can be displayed on
a monitor and also stored for later use.
1/29/2020 4:43:06 PM 22Imaging breast mammogram

23. Full Field Digital Mammography
1/29/2020 4:43:06 PM 23Imaging breast mammogram

24. Computerized Tomography Laser Mammography
• Is an optical tomographic
technique for breast imaging.
• This medical imaging technique
uses laser energy in the near
infrared region of the spectrum,
to detect angiogenesis in the
breast tissue
• It is optical molecular imaging for
hemoglobin both oxygenated
and deoxygenated.
1/29/2020 4:43:06 PM 24Imaging breast mammogram

25. Automated Breast Ultrasound
• Also known as Automated 3D US
Breast Volume Scanning (ABVS).
• Cross-correlation between
multiplanar reconstructions
• Optimizes assessment and
correlation with mammography and
MRI.
• Disconnection of image acquisition
and assessment: suitable for double
reading, screening and CAD.
• Facilitates preoperative surgical
planning: Lesion distance to nipple
and skin; Indication and lesion
position.
1/29/2020 4:43:06 PM 25Imaging breast mammogram

26. Breast MRI
• Also known as MR
MammDedicated bilateral breast
surface coil (simultaneous
examination of both breasts)
• Preoperative MRI more accurate
in assessing tumor extent and
multi-focality (incl. DCIS)
• MRI lowest FN rate in detecting
ILC, highest accuracy in
measuring the size.
1/29/2020 4:43:06 PM 26Imaging breast mammogram

27. Male Breast Cancer Statistics:
• 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
1/29/2020 4:43:06 PM 27Imaging breast mammogram

28. Limitations of Mammograms
• Mammograms are the best breast cancer screening tests we have at this time. But
• mammograms have their limits. For example, they aren’t 100% accurate in showing if a
• woman has breast cancer:
• * A false-negative mammogram looks normal even though breast cancer is present.
• * A false-positive mammogram looks abnormal even though there’s no cancer in the
• breast.
• False-negative results.
• A false-negative mammogram looks normal even though breast cancer is present.
• Overall, screening mammograms do not find about 1 in 5 breast cancers.
• * Women with dense breasts have more false-negative Limitations of Mammograms
1/29/2020 4:43:06 PM 28Imaging breast mammogram

29. conclusion
• Mammography still remains the basic breast imaging examination
• Digital mammography provides better visualization in dense breast
• DBT is an exciting prospect which will definitely improve the diagnosis
• MR Mammography is recommended in women with Lifetime risk of higher than
20%
• Breast Cancer is a common but mostly treatable disease
• Screening mammography can detect precancerous changes in breast.
• Early detection results in a high cure rate of breast cancer.
1/29/2020 4:43:06 PM 29Imaging breast mammogram

30. 1. THE ESSENTIAL PHYSICS OF MEDICAL IMAGING,
THIRD EDITION.
2. CHESNES’ EQUIPMENT FOR STUDENT
RADIOGRAPHERS FOURTH EDITION.
1/29/2020 4:43:06 PM Imaging breast mammogram 30
Reference

31. .
1/29/2020 4:43:06 PM 31Imaging breast mammogram