Breast Imaging

• Mammography uses ionizing radiation of low voltage (28-35 Mega-volts) to evaluate the breast.
• The technique is designed to demonstrate soft tissues of the breast (fibroglandular tissue).
• The glandular tissue of the breasts, or breast density, shows up as white areas on a mammogram film (figure 9-1).

A.     Calcifications: macro- and microcalcifications.

B.     Mass densities (opacities).

C.     Lymph nodes opacities.

D.     Distortion of breast architecture.

Benign lesions: (solid or cystic) are usually of variable size, solitary or multiple, regular shape, smooth well-defined border and not associated with microcalcifications or distortion of breast architecture .

1. Macrocalcifications: Macrocalcifications are coarse (large) calcium deposits that are often associated with benign fibrocystic changes or with degenerative changes in the breasts, and do not usually require a biopsy

 2. Microcalcifications:

Microcalcifications are categorized to one of three groups:

1.      Typically benign, Few, discrete, has the same shape 

2.      Intermittent type, lies between benign and malignant type

3.      Highly suspicious of malignancy (figure 9-4): which has the following features:

a.       Numerous: at least five to eight in number.

b.      Clustered; aggregated in one part of the breast.

c.       Polymorphic: differing from each other in size and shape: branched or V- or Y- shaped calcifications.

q      Microcalcifications may or may not be associated with breast mass opacity.

Malignant tumors: are usually solitary, has irregular shape, ill-defined or speculated border, of high density and may or may not associated with microcalcifications and/or architectural distortion of the breast. 

Lymph nodes opacities are usually found in clusters and have kidney- or bean-shaped appearance with central or peripheral area of translucency representing the hilum of lymph nodes