Screening Mammography Interpatient

Screening Mammography Interpatient

 Generally speaking of mammographic abnormalities that we're looking for on screening mammograms this is not an all-inclusive list obviously are masses asymmetries and focal asymmetries architectural distortion calcifications lymphadenopathy and skin thickening.

A standard screening mammogram includes right mlo and right cc views left me and left cc views and then there may be additional views of either breast such as nipple in profile extended ccl views or cleavage views in order to be able to obtain the entire breast screening mammograms.

Screening mammograms can only be categorized as by reds zero one or two by red's codes three four five and six should not be used for screening mammography only for diagnostic this is an overall view of what my workflow screens are on the um Hologic the mammographic unit.

Start with both breasts then  move to 

the right breast and then the left breast and we're going to be going through each of these screens individually so my first screen is a 4 over 4 view when comparing the oldest old of the mlo and the cc to the most current.

Mark mentally abnormalities going to 

analyze further on don't analyze them on this screen if  have additional views it's going to show up for me in a little box here and can look at call up those if want to the way that ensures that  completely review the mammogram is to use what  call the lawnmower technique and the next few screens are going to show you how  do that my next two screens are the bilateral current see here current mlo views and because the workflow at our institution includes both synthetic,

Mammograms 

there are many different ways of reviewing a mammogram use what call the lawnmower pattern so start at the top and my eyes scan back and forth in overlapping lines as if you were mowing a lawn go down the right mlo then go down the left and below in a similar pattern and looking for those mammographic abnormalities

the nipple area and the inframammary.

A three-zone comparison so  look at the top zone on the right  compare it to the top zone on the left looking for asymmetry the middle zone on the right compared to the middle zone on the left and then finally the bottom zone

if see any abnormalities during any 

part of this review than may mag upon them or scroll through the tomo slices in that area depending on what seeing the next screen are bilateral current cc views and going to do exactly the same process so going to start with my lawnmower type pattern then going to check areas of the extremes of the film so the extreme lateral the extreme medial and the nipple areas and then  going to compare right to left in thirds again my next screen is going to show the right mlo and the right cc views in full highest resolution and also with the cad markers on so most systems are using some form of computing count of

how many lesions that they've identified 

on each of the images you can see in this particular study, they identified one asymmetry: stars on this particular system and one triangle, which are calcifications in this particular system.

 Real abnormality or not and that there are many many many false positives of these unfortunately  magged over those areas of

calcifications and I've decided in this the the 

particular case that there are no real underlying calcifications it was just a false positive  look at the other areas that were asymmetries and decide that they're not significant and then

on the right mlo full magnification view 

standard resolution view for the right mlo system over the high-resolution right cc view.

and then the bottom third and i'm going

to go through each of the tomos

usually two or three times i'm then

going to go over to the right cc 

terms and with the right mlo just focusing on one back and forth two or three times my next screen is a comparison of the right mlo from this year with the oldest-old on top.

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