Mammography Imaging Protocols
Screening mammograms…
Standard CC and MLO views of each breast.
Additional films as necessary to show all breast tissue.
Diagnostic Mammograms
Symptomatic patient (over 30 years of age) with palpable abnormality.
Mark palpable area with Triangle.
Standard CC and MLO views of each breast (unless it has been less than 1 year
since her last normal mammogram then just do side of concern)
Spot compression CC and MLO views over palpable area. (Try to make one of
the views a tangential)
90 degree lateral of affected breast.
Symptomatic patient (under 30 years of age) with palpable abnormality .
Women under 30 who have a palpable abnormality (and no family history of
pre-menopausal breast cancer) should initially have a breast US. If a cyst is seen
by US and explains the palpable abnormality, then in general a mammogram does
not have to be done. However, if the breast US is negative or shows a solid lesion
of any type, then a diagnostic mammogram should be performed as directed by
the radiologist.
In patients under 30 years of age, diagnostic mammography may be indicated if
there is a strong family history. The current recommendations for a woman
whose mother had pre-menopausal breast cancer is the young woman begin
mammography 10 years earlier than the age at which her mother developed
breast cancer. Diagnostic studies in these high risk patients should begin with a
diagnostic mammogram and follow the same protocol as for patients age 30
and older, with possible US to follow.
Symptomatic patient (over 30 years of age) with generalized pain.
Standard CC and MLO views of each breast (unless it has been less than 1 year
since her last normal mammogram then just do side of concern)
90 degree lateral of affected breast.
Additional imaging at radiologist discretion.
Symptomatic patient (under 30 years of age) with generalized pain
Get patients history and begin imaging at radiologist’s direction.
Symptomatic patient with specific area of pain.
Standard CC and MLO views of each breast (unless it has been less than 1 year
since her last normal mammogram then just do the side of concern)
Spot compression CC and MLO views over area of pain.
90 degree lateral of affected breast.
Symptomatic patient (under 30 years of age) with specific area of pain.
Follow the same protocol for patient under 30 with palpable abnormality.
Symptomatic patient (over 30 years of age) with nipple discharge.
Standard CC and MLO views of each breast (unless it has been less than 1 year
since her last normal mammogram then just do side of concern)
Spot compression CC and MLO views retroareolar.
90 degree lateral of affected breast.
Additional imaging at radiologist discretion.
Symptomatic patient (under 30 years of age) with generalized pain
Get patients history and begin imaging at radiologist’s direction.
Additional views for densities.
Spot compression views in CC and MLO.
Full 90 degree lateral.
Additional views for calcifications.
Spot magnification views in CC and 90 degree lateral.
Full non-magnified 90 degree lateral.
6 month follow up for density and follow up to biopsy/lumpectomy done
for density.
Standard CC and MLO
Spot compression views CC and MLO
90 degree lateral
6 month follow up for calcifications and follow up to a
biopsy/lumpectomy done for calcs.
Standard CC and MLO
Spot magnification CC and 90 degree lateral
Full non-magnified 90 degree lateral.
Implants:
Standard CC and MLO views with Implant in place with minimal compression.
No pounds of compression should register on the the compression readout.
Implant displaced CC and MLO views.
If implants are encapsulated do 90-degree laterals of each
breast instead of implant displaced views.
Skin Markers:
Lumps: Triangle-spot marker over any palpable lump.
Pain: X-spot marker over any area of specific pain. (not generalized pain).
Moles: O-spot marker on any mole that could be visualized on the mammogram.
Scars: S-spot maker on any new scar, first mammogram following surgery.