Special patients

Question 1

Pectus carinatum

Answer 1

Challenge: Exclusion of medial/lateral tissue
Solutions:
CC: XCCL, XCCM, CV
MLO: AT, MLO

Question 2

Pectus excavatum

Answer 2

Challenge: Exclusion of medial tissue
Solutions: CC: XCCM
MLO: LM

Question 3

Post surgical breast

Answer 3

Challenges: Tenderness, scar tissue, posterior surgical beds, distortion, fat necrosis
Solutions: CC: FB, XCCL
MLO: LM
MLO of missing tissue, AT

Question 4

Reduction mammoplasty

Answer 4

Challenges: medial tissue excluded. Nipple not in profile.
Solutions: XCCM, CV, NP, LM, ML

Question 5

Male mammography

Answer 5

Challenges: Chest hair
CC: miss sup/pos tissue
Solutions: position with spatula paddle. FB instead of CC add XCCL.
LMO instead of MLO

Question 6

Kyphosis

Answer 6

Challenge: limit medial tissue on MLO
Solution: CC: XCCL, XCCM, CV, FB
MLO: LMO, ML

Question 7

Protruding abdomen

Answer 7

Challenges: CC/MLO tissue exclusion may occur with posterior/inferior tissue
Solution: CC: lean pt forward to exclude abdomen. May need 1
MLO: pt pushes hips/pelvis away from IR, may need 2

Question 8

Small breasts

Answer 8

Challenges: tissue can slip from compression, superior tissue missed.
Solutions: can use spatula paddle. XXCL, LM. May need to use manual technqiue

Question 9

Large breasts

Answer 9

Challenges: excluded tissue, uneven compression, skin folds, drooping
Solutions: AC views, mosaic/filing vws

Question 10

Lactating breast

Answer 10

Challenges: engorged breasts
Solutions: pump prior to exam

Question 11

Implanted devices

Answer 11

Challenges: complete adequate compression
Solutions: CC: AC, FB
MLO: AC, LM, ML, LMO