0:00

Okay, in this case, uh, we have a

0:02

screening mammogram from a 40-year-old

0:04

female sitting for a baseline mammogram.

0:07

First, looking at image quality, we have, uh, full

0:10

field MLO views on top, CC views on the bottom.

0:15

We can see in the MLO views, the

0:16

pectoralis muscle is a little bit short.

0:18

We would expect that pectoralis to maybe go

0:22

to approximately this nipple line here, using

0:25

That's true on both sides, right and left.

0:29

And on the CC view, um, we can see that the right CC

0:35

looks like it might be a little bit short, meaning

0:38

that we're not getting enough posterior tissue.

0:40

And indeed, when we measure, we can see that

0:42

this is greater than a centimeter difference,

0:44

or it's approximately a centimeter different.

0:46

So this CC is a little bit short.

0:48

We'd expect it to be a little bit more,

0:50

measuring about, um, 80 millimeters or greater.

0:53

For the purposes of this, we won't get too much

0:54

into that, but this patient could potentially

0:56

be recalled for a technical repeat, just

0:58

for a little bit more posterior tissue and

0:59

potentially addressing the MLO pectoralis muscles.

1:04

So, focusing on the pectoralis muscles here

1:06

in this case, um, we can see that there

1:09

are some high-density material in both

1:11

axillae. Some of it looks a little bit linear.

1:13

We might call these calcifications.

1:15

They might look a little bit amorphous.

1:17

Certainly something we might wanna explore a little

1:19

bit more and try to prove what exactly we're seeing.

1:22

We switch over to the DBT slices, we'll start in

1:24

the lateral aspect of both breasts, and immediately

1:26

we can see that some of that, uh, dense material

1:28

that we see is projecting over on the skin at

1:31

the very edges, uh, in the last or first tomo slice.

1:36

Now, since we're on the first tomo slice, if we're

1:38

in that first three and we have some finding, we can

1:41

demonstrate that that's very likely skin-associated.

1:45

And in this case, the expected thing that we're

1:47

seeing here is artifact related to, uh, deodorant.

1:52

The technologists, or at least our institution,

1:54

always verify the patients are not wearing deodorant

1:57

during the performance of their exams.

2:00

Um, and so we try to mitigate this kind of finding.

2:03

Um, and if they are, we ask them to sort of

2:05

clean the axilla, take the images again.

2:08

In this case, um, we might even ask the technologist

2:10

to say, you know, did you check here, um, the

2:12

patient clean off and they couldn't get it all?

2:14

Or what, what sort of happened?

2:16

That being said, um, we can be very confident

2:19

that this really is just related to artifact,

2:21

and we're not getting confused by some sort of

2:23

axillary calcifications or something like that.

2:25

Since we can prove that it's already,

2:27

uh, in the skin, um, we probably don't

2:29

really need to do anything more about it.

2:32

Um, other than noting that there

2:33

is some deodorant artifact.

2:34

Uh, and moving on to the next case.

2:36

We can also see, interestingly, that we do

2:38

see some artifact related to probably the

2:40

patient's chin, uh, in the imaging stack here.

2:44

Um, and this is, uh, one of the

2:46

artifacts that we reviewed earlier.

2:48

Now, um, you might see it if we look very

2:50

closely at the very superior margin of

2:53

this image, where there is a little bit of a

2:55

line, and this is that so-called bright line

2:57

artifact related to, um, something obscuring

3:01

of the projection images shown in.