mammodiagnostic basic examinations, screening

MammodiagnosticMammodiagnosticbasic examinations, screeningbasic examinations, screening

MUDR. Daniel ZoubekMUDR. Daniel Zoubek

Klinika zobrazovacích metodKlinika zobrazovacích metod

FN MotolFN Motol

1913 Salomon - 1913 Salomon - x-ray of specimenx-ray of specimen

1930 Waren 1930 Waren

1966 Gros1966 Gros

HistoryHistory

Mammodignostic basic examinationsMammodignostic basic examinations

mammographymammography sonographysonography

magnetic rezonancemagnetic rezonance

computer tomographycomputer tomography

Examination methodExamination method


Soft technics Soft technics 25 – 35 kV25 – 35 kV

AnodeAnode molybdenmolybden

wolframwolframPrimary filtrationPrimary filtration

molybden f.molybden f.rhodium f.rhodium f.

Technics – x-ray tubeTechnics – x-ray tube


Pressure 7-15 kgPressure 7-15 kg

ContrastContrastReduction of Reduction of

summationsummation

exposureexposuremotion artefactmotion artefact

Technics - compresionTechnics - compresion


Special cassetteSpecial cassette

18x24, 24x30 cm18x24, 24x30 cm

Single intensifying Single intensifying screenscreen

Single emulsion filmSingle emulsion film

Technics – cassette, exp. automatTechnics – cassette, exp. automat


Technics – viewing boxTechnics – viewing box


Technics – projectionTechnics – projection

craniocaudal (CC)craniocaudal (CC)

mediolateral mediolateral oblique (MLO)oblique (MLO)

magnificationmagnification

spot compresionspot compresion

mediolateral (ML)mediolateral (ML)

……


AnatomyAnatomy


Tabar parenchymal pattermTabar parenchymal pattermTabár I.Tabár I.

Tabár II.Tabár II.

Tabár III.Tabár III.

Tabár IV.Tabár IV.

Tabár V.Tabár V.


Shape Shape

MarginsMargins

DensityDensity

CalcificationCalcification

Typical finding - MassesTypical finding - Masses


MorphologyMorphology

DistributionDistribution

NumberNumber

Typical finding - CalcificationsTypical finding - Calcifications


Typical finding – Assymetrical patternTypical finding – Assymetrical pattern


Linear transducerLinear transducer

Hihg-frequency tranducerHihg-frequency tranducer

7,5 – 10 – 13 MHz7,5 – 10 – 13 MHz

Sonography - technicsSonography - technics


MassesMasses

Cysts / solid massesCysts / solid masses

SizeSize

ContourContour

EchostruktureEchostrukture

Acoustis absorptionAcoustis absorption

Architectural distortionArchitectural distortion

Sonographic findingsSonographic findings

MammodignosticMammodignostic basic examinationsbasic examinations

TrueCut / CoreCut biopsyTrueCut / CoreCut biopsy

Presurgical localization – dye marking, localization wiresPresurgical localization – dye marking, localization wires

US guided navigationUS guided navigation

Stereotactic mammography navigationStereotactic mammography navigation

Breast interventionsBreast interventions


True Cut biopsyTrue Cut biopsy


US-guided True Cut biopsy US-guided True Cut biopsy


CystsCysts

FibroadenomaFibroadenoma

PapilomaPapiloma

LipomaLipoma

……

Benign DisordersBenign Disorders


CystsCysts

39 y., palpable masses39 y., palpable masses


FibroadenomaFibroadenoma

28-29 let28-29 let

Palpable Palpable masses in masses in left breastleft breast

After 12 After 12 month month increaseincrease


in situ / invasivein situ / invasive

DuctalDuctal

LobularLobular

TubularTubular

MedullaryMedullary

MucinousMucinous

Paget carcinoma,…Paget carcinoma,…

CarcinomaCarcinoma


CarcinomaCarcinoma59 y.59 y.

Without palp.Without palp.

AssymetryAssymetry

DC + Inf.DCDC + Inf.DC


CarcinomaCarcinoma47 let47 let

Palpable masses in Palpable masses in HZQ sin.HZQ sin.

Stp. Ca mammae dx.Stp. Ca mammae dx.

T1N0M0 2,5 year backT1N0M0 2,5 year back

DC + meta LUDC + meta LU


The male breastThe male breast

GynecomastiaGynecomastia

PseudogynecomastiaPseudogynecomastia

CarcinomaCarcinoma


Primary prevention – Primary prevention – prevention of developmentprevention of development

Secondary prevention – Secondary prevention – early detectionearly detection

Efficient treatmentEfficient treatment

ScreeningScreening


NOT lower incidenceNOT lower incidence

LOWER mortalityLOWER mortality

small agresiv treatmentsmall agresiv treatment

better prognosisbetter prognosis

ScreeningScreening


57 screening centers 57 screening centers (1/180tis. ob.)(1/180tis. ob.)

45 – 69 let, asymptomatic 45 – 69 let, asymptomatic

Two year intervalTwo year interval

Screening – Czech republicScreening – Czech republic


Screening – Czech republicScreening – Czech republic


mammodiagnostic basic examinations, screening

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