Indications】
1. those who are found to have breast lumps or nodules
2. those with nipple discharge who have ruled out pituitary lesions
3. screening for women at high risk of breast cancer and women over 40 years of age, usually once every 2 years for those over 40 years of age and once every year for those over 50 years of age.
3. screening for women at high risk of breast cancer and women over 40 years of age, generally every 2 years for women over 40 years of age and every 1 year for women over 50 years of age
4. follow-up of the opposite breast after surgery for breast cancer on one side
5. those who have undergone breast augmentation surgery and are suspected of having abnormalities in the implanted prosthesis.
Contraindications
Pregnancy is a relative contraindication. Pregnant women should cover their abdomen with a lead skirt if mammography is required.
Operation points
The conventional mammography positions include cephalocaudal and internal and external oblique positions, and can be added to internal and external oblique positions or other special positions depending on the location of the lesion and the size of the breast. Because both breasts are generally symmetrical, bilateral comparison can help detect lesions, so both breasts should be routinely photographed for comparison.
1. Cephalocaudal position: also called axial position, it is one of the conventional projection positions, especially helpful to detect lesions on the inner and outer side of the breast; when projecting, the projection frame is in the positive position, and the elevation column is activated to bring the film table to the fold of the lower edge of the breast, and the chest wall on the projection side is close to the outer edge of the film table, so that the breast is placed above the dark box, and the compression device is activated to compress and fix the breast from top to bottom, at which time the nipple should be in the tangent position, otherwise the elevation column should be adjusted. Otherwise, the height of the lifting column should be adjusted until it is satisfactory; when shining, the patient’s body position should be slightly inclined, such as when shining the left breast, the thorax should be rotated 10-15 degrees to the right; when shining the right breast, the thorax should be rotated 10-15 degrees to the left.
2. Internal and external oblique position: this position shows the largest range of breast tissue and can also show lesions near the chest wall and some axillary lymph nodes, and is also one of the conventional projection positions; the patient is in a semi-lateral position, and if the left breast is projected, the projection frame is rotated 45 to 55 degrees to the left, the patient’s left side is close to the machine, the upper arm is elevated with the shoulder flat and abducted 90 degrees, the left breast is placed on the film table, the compression device is activated, the breast is compressed and fixed. The nipple should also be in the tangential position; when the right breast is projected, the rotation direction is reversed and the angle is the same. The oblique film taken should include part of the chest wall tissue. 3.
When the patient is facing the machine, the left breast is projected, the projection frame is routinely rotated 90 degrees to the right, the elevator is adjusted so that the center of the table is aligned with the breast, the left breast is placed between the table and the compressor, the lateral chest wall is placed against the outer edge of the table, the compressor is activated, and the breast is fixed with pressure from left to right and immediately exposed; when the right breast is projected, the projection frame is routinely rotated 90 degrees to the left, and the other steps are the same as for the left side. For breast laxity, the other hand should be used to lift the breast while applying pressure, so that the glandular tissue is evenly distributed and the nipple is in the tangent line position to avoid the full picture not being displayed due to breast draping.
【Caution】 1.
In addition, the mammogram should be performed on the mammogram to determine the size of the lymph nodes and other metastatic adenocarcinoma; in unmarried or married patients; in patients who have been taking oral or injected estrogen drugs for a long time; and in patients with Wolfe’s P2 and Dy types.
In mammography, proper compression and fixation is important. After compression and fixation, the original conical breast tissue is compressed into a flat tissue of uniform thickness, which facilitates X-ray penetration and makes the penetration relatively uniform; after compression and fixation, the image is blurred due to the movement of the breast position can be avoided; after compression and fixation, the display area is relatively larger, which can improve the display of breast tissue and lesion details; after compression and fixation, the breast, the X-ray film and the sensitization screen are more tightly adhered to each other, which can improve The intensity of breast compression and fixation should be as strong as the patient can tolerate.
For example, in the cephalocaudal position, the film can be divided into two shots of the inner and outer parts, while in the internal and external oblique position, the film can be divided into two shots of the upper and lower parts.
4. For subtle suspicious lesions, additional spot compression magnification photography can be performed.
5. When there is an implant in the breast, in addition to the conventional position, the Eklund’s position should be added, i.e., the implant is pushed to the chest wall so that the implant avoids the compression area and the anterior breast tissue is photographed under pressure.