anatomy of breast
- cone shaped with posterior surface (base) overlying the pectoralis and serratus muscles
- axillary tail extends from lateral base of the breast to axillary fossa
- tapers anteriorly from base, ending in nipple, surrounded by areola
- consist of 15-20 lobes, each dividing into several lobules
- lobules containing acini, draining ducts and interlobular connective tissue
3 types of tissue in the breast
- glandular
- fibrous or connective tissue
- adipose
characteristics of a benign lesion
well defined
characteristics of malignant lesion
- margins not well defined
- spiculated
what are the different margins
- circumscribed
- obscured
- microlobulated
- indistinct
- spiculated
what are the different asymmetries
- asymmetry
- focal asymmetry
- global asymmetry
- developing asymmetry
non modifiable risk factor for breast cancer
- age
- length of fertile period
- certain inherited genes
- family history of breast cancer
- having dense breast tissue
modifiable risk for breast cancer
- age at first completed pregnancy
- hormone replacement therapy
- alcohol consumption
- being overweight or obese
- not being physically active
- not breastfeeding
4 radiographic examination performed to detect unsuspected breast CA in asymptomatic women
- right craniocaudal (RCC)
- LCC
- right mediolateral oblique (RMLO)
- LMLO
additional views performed to evaluate patients with S&S of breast disease
- magnification view
- spot compression view
- rolled view
- cleavage view
- tangential view
which layer in the breast does breast disease common occur
glandular parenchyma, separated from the underlying muscle fascia by the retroglandular fat
how to achieve maximum and optimal visualisation of tissue
breast must be:
- pulled away from chest wall
- appropriately compressed
- immobilised before obtaining image
mobile aspects of the breast
lateral and inferior margins
fixed aspects of the breast
medial and superior margins
why is compression used
- uniformly reduce thickness of breast
- decrease superimposition of tissue
- separates glandular tissue
- reduces scatter radiation
- decrease radiation dose
- reduces motion
- improves improves resolution of image
- increases contrast to visualise subtle differences in tissue
what to look our for in pre-mammo visual and physical observation
- lump
- pulled nipple
- dimpling
- dripping
- redness/ rash
- skin changes
plane of digital receptor in MLO view
- 30-60deg from horizontal, typically 45deg used
- plane parallel to pec muscle
tall and thin patients: 50-60deg
short and heavy patients: 30-40deg
failure to do “up and out” manoeuvre will result in what appearance
- droopy breast –> fold at IMF
- “camel nose” appearance
