31. Imaging of the breast. Mammography, clinical mammography, ultrasound.

From greek.doctor
  • Breast cancer screening
    • Modality
      • Main modality for examination of breast: Mammography
        • Uses low-energy, soft X-rays
          • 20 – 30/40 kV
          • Soft rays are better at differentiating soft tissues of the breast
        • Molybdenum anode (instead of tungsten)
          • Produces more characteristic x-rays
        • Standard views
          • Cranocaudal (CC)
          • Mediolateral oblique (MLO)
        • Breast prosthesis (silicone/saline) behind the pectoral muscle is the best for mammography
        • Breast is compressed
          • Reduces blurring from motion
          • Reduces scattered radiation
          • Reduces radiation dose
      • Complementary roles:
        • US
          • High-frequency (7 – 12 MHz)
          • Linear probe
          • Most used in women < 30 years
          • For dense breasts
          • Axilla must also be scanned
        • MRI
          • Dynamic MRi
          • Native + contrast-enhanced
    • In Hungary
      • Normal population
        • From 45 – 65 years
        • Every 2nd year
      • High-risk patients
        • From 30 years
        • Annually
  • Benign breast tumors
    • Circumscribed on imaging
    • Fibroadenoma
      • Most common in young women
  • Breast cancer
    • Most commonly in the outer upper quadrant
    • Star-shape (stellate) on imaging
    • Invasive ductal cc = most common cancer
    • Precancerous lesion:
      • Atypical ductal hyperplasia