5. Modified mammography (2010)

5. Modified mammography (2010) - ‫بسم الله...

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Unformatted text preview: ‫بسم الله الرحمن الرحيم‬ Mammography By Dr. Ruba Khasawneh By And Dr. Arwa Al- kinani And 46 46 1 BREAST ANATOMY 46 2 BREAST ANATOMY 46 46 3 MAMMOGRAM What is a What mammogram? mammogram? A mammogram is an xmammogram ray of the breast, ray consisting of two .pictures pictures 46 46 4 MAMMOGRAM TWO RECENT ENHANCEMENT: TWO 1- DIGITAL MAMMOGRAPHY 2- COMPUTER AIDED DETECTION (CAD) 46 5 WHAT ARE THE BENEFITS VS. WHAT ?THE RISKS THE THE BENEFIT OF AN ACCURATE DIAGNOSIS FAR OUTWEIGHS THE RISK. RISK. 46 6 MAMMOGRAM 1- SCREENING MAMMOGRAM Recommended every year for women beginning at age of 40. beginning 2- DIAGNOSTIC MAMMOGRAM 2- 46 7 VIEWS OF MAMMOGRAM Main views: Main 1- Mediolateral oblique. 2- Craniocaudal. Additional views: 1- Compression view for areas of suspicious 1masses or asymmetric breast tissue. masses 2- Magnification view for suspicious 2calcifications. calcifications. 46 8 Views of mammogram 46 46 9 46 46 10 L 46 11 CC 46 12 Compression view 46 13 Magnification 46 14 NORMAL MAMMOGRAM CC OBL OBL 46 15 NORMAL Tow views 46 16 In general terms, what are In ?you looking for you We're looking for small breast We're cancers, which appear on the mammogram as a mass or a lump. lump 46 17 What sorts of things are described on the mammogram report mammogram BIRADS CODING CATEGORY 0 Incomplete ; needs further evaluation. CATEGORY 1 Negative mammogram CATEGORY 2 Bening findings. CATEGORY 3 Probably benign finding- short interval f/u CATEGORY is suggested. is CATEGORY 4 Suspicious abnormality- Biopsy should be CATEGORY considered. considered. CATEGORY 5 Highly suggestive of malignancy – Appropriate action should be taken 18 CATEGORY 6 Proven malignancy 46 Are denser breasts harder to Are ?screen screen The sensitivity of the mammogram is in the 90% The range. range Cancers missed by mammography are in the Cancers range of 10-30%. range Causes include: 1- Observer error. 2- Dense tissue. 3- Lobular cancer ( growth patterns 3indistinguishable from normal breast tissue). indistinguishable 46 19 BENIGN CALCIFICATIONS 1-Skin or dermal calcifications. 2- Vascular calcifications. 3-Lucent-centered calcifications ( Fat necrosis ). 4- Egg-shell or rim calcifications( Fat necrosis or 4calcification in cyst wall). calcification 5- Coarse or popcorn calcification( Fibroadenoma). 6-Large rod like calcifications or secretory calcifications. 7- Round or punctate calcification ( less than 0.5mm). 8-Milk of calcium. 9-Suture calcification. 10-Dystrophic calcifications (Trauma, surgery and 10-Dystrophic irradiation). irradiation). 46 20 Dermal calcifications 46 21 Vascular Vascular calcifications calcifications 46 22 Lucent-Centered Lucent-Centered calcifications calcifications 46 23 Egg-shell or rim Egg-shell calcifications calcifications 46 24 Pop corn calcifications calcifications 46 25 Secretory Secretory calcifications calcifications 46 26 Punctate Punctate calcifications calcifications 46 27 Milk of calcium 46 28 Suture Suture calcifications calcifications 46 29 Dystrophic Dystrophic calcifications calcifications 46 30 Breast cyst 46 31 Fibroadenoma Fibroadenoma wellwellcircumscribed oval ed shaped mass with calcification calcification 46 32 FEATURES OF MALIGNANCY 1- Speculated mass 2- Architectural distortion 3- Asymmetry of breast tissue 4- Micro calcification 5- Dense mass 6- Skin thickening 7- Pathological lymph nodes 46 33 Speculated mass 46 34 Speculated mass Magnification 46 35 Architectural distortion A focal area of breast tissue appears focal distorted with no definable central mass. distorted -Causes: A- Malignancy. B- Benign lesions as in cases of prior breast Binjury or surgery or radial scar. injury -Benign lesions don’t change overtime. 46 36 Architectural distortion 46 37 ASYMMETRY OF BREAST ASYMMETRY TISSUE TISSUE Greater volume or density of breast tissue in Greater one breast than corresponding area in the contralateral breast. contralateral 46 38 ASYMMETRY OF BREAST ASYMMETRY TISSUE TISSUE 46 39 Linear and branching micro calcification 46 40 Cluster of Cluster calcifications calcifications 46 41 46 42 Dense mass CC 46 43 Dense mass OBL 46 44 diffuse skin thickening (arrowheads), trabecular coarsening, and a diffuse trabecular speculated mass (arrows) 5.5 cm in longest diameter and dilated lymphatic channels (arrows) that are typical of the breast edema .pattern pattern 46 45 46 46 ...
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