Mammography

Mammography is one of the major part of a senology consultation: however this examination does not reduce the importance of clinical examination.

Mammography is performed with a specifically designed radiographic device : X-Ray source designed for soft tissue imaging, and a breast compression device. The patient stays then the technician spreads the mammal gland on the film plate, and smoothly and regularyl compresses the breast with an automatic pedal, thus bringing some discomfort but without pain. If the technician quietly and progressively performs this compression after a reassuring information, the patient generally does not expect pain for a further examination.

For screening mammography, two views are shot from each breast: medio-lateral oblique view and craniocaudal view.

In some circumstances, other views may be used, noticeably lateral views (horizontal position of the X-Ray source) in order to precise the situation of a suspicious opacity seen only on the mediolateral oblique view (not on the craniocaudal view), either in the lateral direction (external or internal) and vertical direction (superior or inferior), thus distinguishing a supero-internal localization from an infero-external localization.

Other specific views (tangent views) may be used to confirm calcifications or skin thickening or retraction, and magnification (with specific compression) to detail a spot of microcalcifications or analyze false constructed images.

Cranio-caudal view	Medio-lateral oblique view	Lateral view

If necessary (noticeably for very dense breast to distinguish between solid and cystic masses), an ultra-sound examination may be performed, by moving a specific transducer in various directions around the suspicious lesion and near the nipple, with a direct real-time examination on a screen. Prints are produced for legal reasons.

Two very interesting websites should be mentionned:

• An interactive paedagogical website (in French) realized by medical students from Mc Gill University, (Montreal) with specific clinical cases.

• A more scientific website by Professeur Claude COLIN (in French and English) from the Free University of Liège (Belgium).

• Another incredible website is the Digital Database for Screening Mammography (DDSM) from the University of South Florida,
  
• Another website (easier to work with) was found as BI-RADS tutorial system, by G. Pfarl and T.H. Helbich, from the University of Vienna,
  

Many thanks for them to have allowed us to use their iconography for our website.

The next pages are devoted to:

Breast anatomy,

Histogenesis of mammary lesions,

Interpreting mammograms,

Asymmetric densities (with mammograms),

Breast masses,

Regular breast masses (with mammograms),

Masses with irregular limits (with many mammograms),

Irregular masses (with many mammograms),

Mammary calcifications (Le Gall's classification),

Benign calcifications (with many mammograms),

Malignant calcifications (with many mammograms),

Mammogram analysis (the ACR classification)

Needle biopsy of the breast (with many pictures about the mammotome procedure).