Podcast
Questions and Answers
What is the primary purpose of mammography?
What is the primary purpose of mammography?
Which X-ray tube kVp value is typically used in mammography?
Which X-ray tube kVp value is typically used in mammography?
What is a key characteristic used to assess masses in mammograms?
What is a key characteristic used to assess masses in mammograms?
What type of calcification is characterized by a teacup shape on oblique projection in mammography?
What type of calcification is characterized by a teacup shape on oblique projection in mammography?
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Which type of lesion tends to be irregular in shape and often hyperdense, indicating potential malignancy?
Which type of lesion tends to be irregular in shape and often hyperdense, indicating potential malignancy?
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Which component of a mammography system is responsible for controlling exposure to radiation?
Which component of a mammography system is responsible for controlling exposure to radiation?
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What projection angles are recommended for mammographic imaging?
What projection angles are recommended for mammographic imaging?
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Why is it critical to maintain consistency in radiographic technique during screening mammography?
Why is it critical to maintain consistency in radiographic technique during screening mammography?
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What characteristics are typically associated with malignant calcifications?
What characteristics are typically associated with malignant calcifications?
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Architectural distortion can indicate the presence of which conditions?
Architectural distortion can indicate the presence of which conditions?
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What is the primary role of ultrasound in breast imaging?
What is the primary role of ultrasound in breast imaging?
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Which symptom may indicate malignancy but has low specificity without other features?
Which symptom may indicate malignancy but has low specificity without other features?
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What advantage does ultrasound have over X-ray in breast assessment?
What advantage does ultrasound have over X-ray in breast assessment?
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What is a significant drawback of magnetic resonance imaging (MRI) for breast assessment?
What is a significant drawback of magnetic resonance imaging (MRI) for breast assessment?
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What is the standard angle for mammographic equipment in a basic setup?
What is the standard angle for mammographic equipment in a basic setup?
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What additional features may be assessed alongside the main indicators of malignancy?
What additional features may be assessed alongside the main indicators of malignancy?
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What position should the woman's arm be in during the examination?
What position should the woman's arm be in during the examination?
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During the 45-degree medio-lateral oblique projection, what should the radiographer do with the breast?
During the 45-degree medio-lateral oblique projection, what should the radiographer do with the breast?
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What is essential to check for once the compression of the breast is almost complete?
What is essential to check for once the compression of the breast is almost complete?
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Which anatomical structures should be demonstrated in the mammographic images?
Which anatomical structures should be demonstrated in the mammographic images?
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What positioning should the woman be in for the cranio-caudal projection?
What positioning should the woman be in for the cranio-caudal projection?
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What is the appropriate level for the breast-support table during the examination?
What is the appropriate level for the breast-support table during the examination?
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What should be ensured for proper imaging of the nipple?
What should be ensured for proper imaging of the nipple?
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What should both medio-lateral oblique projections exhibit when viewed together?
What should both medio-lateral oblique projections exhibit when viewed together?
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Study Notes
Radiographic Techniques
- Mammography is a radiographic examination of breast tissue.
- It visualizes normal breast structures and pathologies.
- Low kVp (typically 28 kVp) is used for mammography.
- Radiation dose must be minimized due to breast tissue sensitivity.
- Mammography is performed on symptomatic women with a known history or suspected abnormality, and as a screening procedure for asymptomatic women.
- Consistent technique and image quality are crucial, particularly in screening mammography.
- Other techniques like MRI and ultrasound also play roles in breast imaging.
Mammography Techniques
- Mammography is a type of soft-tissue radiography.
- It's used to diagnose or treat patients through recording images of internal body structures to evaluate the presence or absence of diseases, foreign bodies and damage or anomalies.
- A mammography system consists of a high-voltage generator, X-ray tube, tube filtration, compression device, image-recording system, and an automatic exposure control (AEC).
Mammography: Recommended Projections (Basic)
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Basic Projections:
- 45-degree medio-lateral oblique (MLO)
- Craniocaudal (CC)
- Used in the diagnosis or treatment of patients by recording images of the internal structure of the body.
Radiological Considerations
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Lesion Characteristics:
- Four main types: masses, calcifications, architectural distortion, and density.
- Masses are assessed by shape, margin, and density.
- Benign masses tend to be round, oval, and well-defined.
- Malignant masses tend to be irregular in shape and often hyperdense.
- Low-density lesions suggest fat and are usually benign.
Calcifications
- Calcification variations: size, shape, number, and orientation.
- There are several benign forms like popcorn and milk-like calcifications, and various shapes/types of calcifications, like rod- or ring-like.
- Malignant calcifications are often grouped, linear, and irregular in size and shape.
Architectural Distortion
- Architectural distortion is a feature of many carcinomas and may also occur with benign conditions, such as sclerosing adenosis.
- Typically, this is diagnosable only by histology.
- Focal increased density may be a sign of malignancy, but low specificity unless combined with other features.
Other Techniques (e.g. Ultrasound, MRI)
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Ultrasound:
- Most widely used, readily available alternative imaging technique.
- Best for determining if a lesion is a cyst; also useful in detecting other fluid-filled diseases like abscesses.
- Provides different tissue information, such as homogeneity, acoustic shadowing, and vascularity.
- Aids in assessing mammographically indeterminate masses and guiding biopsies.
- Important in younger patients with dense breasts and lower suspicion for malignancy because it minimizes radiation exposure.
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MRI (Magnetic Resonance Imaging):
- Expensive, time-consuming, and not widely available.
- Some patients cannot tolerate it due to claustrophobia.
- Demonstrates morphological features.
45-degree Medio-lateral Oblique (MLO) Projection
- The equipment is angled at 45 degrees from the vertical.
- The patient's position, arm placement, and table adjustments are important to prevent confusion with other mammographic projections.
Essential Image Characteristics
- Axilla, glandular tissue, and pectoral muscle should be visible.
- Projections (images) should be symmetrical (mirror images).
- No overlying structures, folds in the breast tissue, or nipple misalignment should exist.
Cranio-Caudal (CC) Projection
- The mammography equipment is positioned with the X-ray beam vertically downwards.
- The patient faces the equipment with arms at her side.
- The patient is ideally rotated 15–20 degrees to align the side of the breast under examination with the horizontal breast-support table.
- The radiographer positions and holds the breast.
- Clear images show the breast's axillary side and nipple midline.
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Description
This quiz covers essential aspects of mammography, a specialized radiographic examination of breast tissue. Learn about the techniques used, the importance of image quality, and the role of mammography in diagnosing breast pathologies. The quiz also touches upon the equipment involved and considerations for minimizing radiation exposure.
