Radiology and Diagnostic Imaging
Course Code: SHS 316
Instructor : Tehreem Zahra MSDU , BS RIT , CMT , DUSG
DEPARTMENT OF MEDICAL IMAGING AND ULTRASONOGRAPHY
Introduction to Mammography
Lecture no 4
Key Objectives of the Lecture on Mammography
• Understand the fundamental principles and significance of mammography in breast cancer detection.
• Identify the differences between screening and diagnostic mammography and recognize when each is
appropriate.
• Recognize the normal anatomy of the breast on mammograms and understand how abnormalities
appear.
• Describe common pathologies seen on mammograms, particularly focusing on breast cancer.
• Discuss the importance of early detection in breast cancer management and the role of mammography
in achieving this goal.
• Review current screening guidelines for mammography and understand the factors influencing
individualized screening recommendations.
• Explore advances in mammography technology, including digital mammography and 3D
tomosynthesis, and their impact on cancer detection rates.
• Understand the challenges associated with breast density and its implications for mammography
screening.
• Analyze a case study illustrating the application of mammography in clinical practice and the
subsequent diagnostic process.
• Appreciate the multidisciplinary approach to breast cancer diagnosis and management, involving
WHAT IS MAMMOGRAPHY ?
• Mammography is a dedicated radiographic technique for imaging the breast, and
the resultant images are known as mammograms.
SOFT TISSUE RADIOGRAPHY
• Radiographic examination of soft tissues requires selected techniques that differ
from those used in conventional radiography.
• These differences in technique are attributable to substantial differences in the
anatomy that is being imaged.
• In conventional radiography, the subject contrast is great because of large
differences in mass density and atomic number among bone, muscle, fat, and lung
tissue.
• In soft tissue radiography, only muscle and fat are imaged. These tissues have
similar effective atomic numbers and similar mass densities .
• Consequently, soft tissue radiographic techniques are designed to enhance
differential absorption in these very similar tissues.
• A prime example of soft tissue radiography is mammography—radiographic
examination of the Breast.
HISTORY
• As a distinct type of radiographic examination, mammography was first attempted
in the 1920s.
• In the late 1950s, Robert Egan renewed interest in mammography with his
demonstration of a successful technique that used low kilovolt peak (kVp), high
milliampere seconds (mAs), and direct film exposure.
Digital Mammography
• A digital mammogram uses the same x-ray technology as conventional
mammograms, but instead of using film, solid-state detectors are used to record
the x-ray pattern passing through the breast.
• These detectors convert the x-rays that pass through them into electronic signals
that are sent to a computer. The computer then converts these electronic signals
into images that can be displayed on a monitor and also stored for later use.
Several advantages of using digital mammography over
film mammography include:
• the ability to manipulate the image contrast for better clarity
• the ability to use computer-aided detection of abnormalities
• and the ability to easily transmit digital files to other experts for a second opinion.
• In addition, digital mammograms may decrease the need for the re-takes, which
are common with film mammography due to incorrect exposure techniques or
problems with film development.
• Digital mammography can lead to lower x-ray exposures.
BASIS FOR MAMMOGRAPHY
• The principal motivation for the continuing development and improvement of
mammography is the high incidence of breast cancer.
• In 2010, approximately 260,000 new cases of breast cancer were reported in the
United States, and this number is growing.
• Globally, 2.4 million newly diagnosed female breast cancer cases are predicted on
the basis of demographic changes only, accounting for almost 1 in 4 cancer cases
among women in 2018.
• In the past, women aged 60–64 years had the highest overall breast cancer
incidence rates, while from 2016 to 2025, large increases in breast cancer rates
among women aged 50 to 64 years are expected.
• The breast cancer incidence appeared to have been rising more rapidly among
post-menopausal women (aged 55 to 59), while a stable increase in incidence in
the youngest age group (15–29 years) of women is expected.
However, due to early detection, more than 90% of women diagnosed with early
stage disease will survive. Several factors have been identified that increase a
woman’s risk of breast cancer.
One important
consideration in the overall
efficacy of mammography
is patient radiation dose
because radiation can cause
breast cancer as well as
detect it.
Types of Mammography
Two different types of
mammographic examination are
conducted.
• Screening mammography: is
performed on asymptomatic
women with the use of a two-
view protocol, usually medial
lateral oblique and cranial
caudal, to detect an unsuspected
cancer.
• Diagnostic mammography:
• is performed on patients with symptoms or elevated risk factors. Two or three
views of each breast may be required.
References:
• https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7330-z
• https://greenimaging.net/mammogram/
