MAMMO

• Mammogram


  An x-ray image of the breast
• Mammogram


  • Differences in breast tissue generally show as different shades of grey in the image
  • Fat appears as black on the film
  • Tumors appear as shades of gray
  • Calcifications appear as white
• Radiolucent


  Permits the penetration and passage of X-rays
• Radiopaque


  Blocks the penetration of X-rays
• Benign lesions


  Most often circumscribed and in regular contours
• Tumors


  Often appear as speculated masses (needle-like shapes)
• 30% to 50% of mammographic cancers appear as pleomorphic microcalcifications
• Pleomorphic


  Having many different shapes
• Mammography usually reveals about 85% of the breast content
• Mammography usually detects microcalcifications typical of malignant tissue
• Mammography views


  • Cranial-Caudal (CC)
  • Mediolateral-oblique (MLO)
  • Mediolateral (ML)
• Cranial-Caudal (CC) view


  • View from above
  • Depicts the entire breast
  • Fat tissue closest to the breast muscle appears as a dark strip
  • Clearly depicts the nipple
• Mediolateral-oblique (MLO) view


  • Angled view
  • Allows imaging of more of the breast in the upper-outer quadrant
  • Allows imaging of the axilla (armpit area)
  • Radiologists prefer this view
• Mediolateral (ML) view


  • View from the center of the chest outward
  • Best view of the lateral side of the breast
  • Chest muscle (pectoral) shows as a narrow light band
  • Imaging of the nipple is clear in profile
• Digital mammography


  The mammogram converts the x-ray image photos into an electrical charge, which becomes a digital value
• Digital mammography is starting to be used, but it is not yet clear as to whether the digital image reveals more than a conventional analog x-ray
• Breast MRI


  Magnetic resonance imaging, used at times in mammography but not as much as one might think
• Breast MRI scanning gives the most detail and sensitive diagnostic scanning technology, but has limitations such as being very expensive and having results open to more variable interpretation
• Screening mammography has proven to be a beneficial and life saving technique, which may reduce mortality from breast cancer by up to 35% in women 50 to 69 years of age, and up to 20% in women in their 40's
• Even with the advent of computer aided detection systems and breast MRI, conventional mammography is sure to serve the purpose of early breast cancer detection and saving lives for years to come
• How are mammograms done?

  1. Breasts are compressed between two firm surfaces to spread out the breast tissue

  2. An x-ray captures black and white images of the breasts that are displayed on a computer screen and examined by a doctor
• Screening mammogram


  Used for screening purposes
• Diagnostic mammogram


  Used for diagnostic purposes
• The frequency of mammograms depends on the woman's age and risk of breast cancer
• Guidelines for when to begin screening mammography

  • Women with an average risk of breast cancer
  • Women with a high risk of breast cancer
• Risks and limitations of mammograms

  • Exposure to low-dose radiation
  • Inaccuracy
  • Difficulty interpreting in younger women
  • May lead to additional testing
  • Cannot detect all cancers, and not all tumors found can be cured
• How to prepare for a mammogram appointment

  1. Choose a certified mammogram facility

  2. Schedule the test for a time when breasts are least likely to be tender

  3. Bring prior mammogram images

  4. Do not use deodorant before the test

  5. Consider an over-the-counter pain medication if the test is uncomfortable
• Possible findings on a mammogram

  • Calcium deposits
  • Masses or lumps
  • Distorted tissues
  • Dense areas appearing in only one breast or one specific area
  • New dense areas that have appeared since the last mammogram