Mammography Screening for breast cancer Presented by HUANG

Mammography --Screening for breast cancer Presented by: HUANG Xiao Quan 10301010095

Breast cancer The most frequently diagnosed cancer. The leading cause of cancer death among females. Death rates decreased by 1. 8% 23% of Cancer Cases per year. 14% of cancer deaths

Screening mammography • The process of using low-energy X-rays to examine the human breast • Widely used as a screening tool now. • Primary imaging modality for early detection • Detect 1. 5 to 4 years before clinically evident • Offered to women ages 50 to 69

Importance of breast compression • Necessary to obtain good quality mammograms. • Increases the image contrast and decreases the radiation dose • Causes homogeneous beast thickness, X-ray penetration is uniform through the tissues. • Reduces motion and minimizes superimposition of tissues • Improves the diagnostic quality of the study

Importance of breast compression A: Inadequate compression • Raise the question of an irregular asymmetry B: Ideal compression • Parenchyma is better visualized • No underlying abnormality

Mammographic features of breast cancer Two general categories: Soft tissue mass • The most specific mammographic feature of malignancy is a spiculated soft tissue mass; • Nearly 90 % of these lesions represent invasive cancer Clustered microcalcifications • Calcium particles of various size and shape measuring between 0. 1 to 1 mm in diameter • Numbering more than four to five per cm. • Approximately 60 % of cancers detected

Soft tissue mass Two small adjacent interconnected spiculated masses (red arrows)

Mammographic features of breast cancer Two general categories: Soft tissue mass • The most specific mammographic feature of malignancy is a spiculated soft tissue mass; • Nearly 90 % of these lesions represent invasive cancer Clustered microcalcifications • Calcium particles of various size and shape measuring between 0. 1 to 1 mm in diameter • Numbering more than four to five per cm. • Seen in approximately 60 % of cancers detected mammographically.

Clustered microcalcifications • Showing linear branching calcifications in a segmental distribution (red arrow) • Highly suggestive of carcinoma

Round mammographic calcifications • Benign • Scattered, well-defined, round calcifications

Mammographic calcifications • Classic benign • Partially calcified fibroadenoma with typical coarse, popcorn-like calcifications.

Limitation of Mammographic Assessment • The obscuring of the borders or extent of the primary tumor by dense overlying tissue. (e. g. Dense breasts can limit the sensitivity of mammography both for detection of breast cancers and for delineating disease extent. ) • In this setting, contrast-enhanced breast magnetic resonance imaging (MRI) may complement mammographic staging.

SUMMARY • The majority of breast cancers are diagnosed as a result of an abnormal mammogram. • Screening mammography is the only breast imaging modality that consistently has been found to decrease breast cancer-related death. • Breast compression improves image quality. • Increased breast density both increases the risk of breast cancer and decreases the sensitivity of mammography to detect small lesions. • Breast MRI is highly sensitive, and can identify foci of cancer that are not evident on physical examination, mammogram, or ultrasound.

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