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At the conclusion of this course, the student should be able to:
1. Explain the basic function and components of mammography equipment.
2. List the factors that affect image quality.
3. Explain how to alleviate problems that affect production of a quality mammogram.
4. List common breast anomalies.
5. Identify common forms of breast augmentation.
6. Identify examples of breast disease.
7. List the mandated mammography QC tests performed by radiologic technologists and their frequency.
8. Differentiate between screening and diagnostic mammography projections and positioning.
9. Practice the care needs of the special patient population.
10. Observe or demonstrate patient positioning.
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In a clinical setting the student will observe and / or perform mammographic imaging related to the following topics:
I. Anatomy and Physiology
A. External anatomy
1. Breast margins
2. Nipple
3. Areola
4. Montgomery's glands
5. Skin
a. Sebaceous glands
b. Pores
c. Axillary tail
d. Inframammary fold
e. Margins of pectoralis major and base
B. Internal anatomy
1. Glandular tissue
2. Parenchyma
3. Connective tissue
4. Pectoralis muscle
5. Fibrous or connective
6. Adipose or fatty
C. Male breast composition
1. Fat
2. Fibroglandular tissue
D. Breast vasculature
E. Retromammary space
F. Lymph nodes
G. Patient positioning
1. Cranio-caudal
2. Medio-lateral oblique
3. 90 degree lateral, medio-lateral and latero-medial
4. Latero-medial oblique
5. Caudal-cranial
6. Exaggerated cranial-caudal
7. Spot compression
8. Cleavage
9. Tangential
10. Axillary tail
11. Rolled lateral and medial
12. Implant displaced
13. Axillary view (Cleopatra)
14. Magnification and or spot views
H. Patients with
1. Augmented breasts
2. Breast lesion localization
3. Specimen radiograph
4. Post operative breasts
5. Irradiated breasts
6. Reconstructed breasts
7. With breast implants: Eklund projection
8. Post-mastectomy
9. Skin lesion markers
II. Pathology
A. Breast disease
1. Signs and symptoms
2. Risk factors for breast cancer
3. Early detection, breast self examination
4. Epidemiology
B. Mammographic pathophysiology
1. Benign lesions
2. Malignant lesions
3. Skin
a. Dimpling
b. Erythema
c. Edema
d. Peau d'orange
e. Discharge
4. Nipple retraction
5. Eczema
6. Erythema
7. Lump
8. Mass
a. Shape
b. Margins
9. Density
10. Calcifications
11. Spiculated lesions
12. Cysts
13. Galactocele
14. Fibroadenoma
15. Lipoma
16. Hamartoma
17. Papilloma
18. Ductal ectasia
19. Fat necrosis
20. Microcalcifications
III. Professional Ethics and Patient Care
A. Patient follow up
B. Outreach programs
C. Cultural diversity
D. Care of special patient populations
1. Patient concerns
2. Early detection
3. Patient education
E. Localization conventions: quadrant system
F. Patient preparation
G. Visual inspection: areas of interest
1. Perimeter
2. Nipples
3. Lymph nodes
H. Involution
IV. Technical Aspects of Mammography
A. Breast composition
B. Fundamental of image quality
C. Methods of improving image quality
1. Image receptor, film/screen combination
2. Cathode: purpose, effect on focal spot, orientation
3. Focal spot size
a. Anode/target
b. Purpose
c. Material
d. Anode angle
e. Line focus principle
f. Heel effect
4. Window material
5. Filtration
6. Source-to-image distance
D. Practicing ALARA concepts
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Instructor prepared materials
Mammographic Imaging: A Practical Guide. 4th ed. Lille, Shelly and Marshall, Wendy. Wolters Kluwer. 2018. (classic).