Carcinoma of the Breast

Publisher Website
Google Scholar
Abstract
The Approach to the diagnosis of cancer of the breast usually has omitted the x-ray examination (1, 2). This may have been justified on the basis of the inconclusive results previously reported by numerous investigators in this field, (7, 19, 20, 24, 25, 27, 29). Now, however, with improved x-ray technics (13, 14), adequately checked against pathological findings (15, 23), a reconsideration of the x-ray examination as a routine procedure in the diagnosis of early mammary carcinoma is warranted. Technic A lateral and a tangential view of each breast, either in the erect or recumbent position, probably are adequate for survey purposes (4, 6, 11), but an additional “spot film” with a small cone in either the lateral or tangential direction is required for the examination of the diseased breast (16). The application of a small lead shot to the skin over the lesion, with scotch tape, helps the radiologist select the proper area for particular scrutiny. Non-screen films are used. Type A industrial fine-grain films are slightly superior but require more critical control of exposure factors. The breast is lightly compressed between the cone and the film. A fine-focus tube is used and the film-target distance varies. The optimum factors for an adult fatty breast are: 30 to 32 kv. and 200 to 400 ma.; for a dense compact breast free of fat, the kilovoltage is raised to 36 to 38, the other factors remaining constant. The obvious advantages of this technic, based on that used by Leborgne (15, 16) are demonstrated in Figures 1, 2, and 3. For the lateral views of the breast, a special cone is used. One sector is cut out so that, when the cone is in place, the cut-out sector allows compression of the breast between the film and cone without interference by the chest wall (Fig. 7). Shorter cones with smaller apertures are used for the spot-film technic. If the film can be brought close to the lesion in the breast, a film-target distance of 30 cm. is chosen; if the lesion cannot be placed close to the film, then a film-target distance of 75 cm. is used. Changes in film-target distance, necessitated by the apparatus and the thickness of the breast, must be compensated by appropriate changes in the milliamperage. The factors suggested for spot-film exposures are: 30 kv. and 25 ma. for each centimeter of tissue at 30 cm. film-target distance. Compression of the tumor-bearing portion of the breast can be effected by using a thin plastic sheet between the cone and the breast. If the tumor lies against the chest wall, gentle traction on the nipple will sometimes bring it forward into position for a good spot-film exposure.

This publication has 0 references indexed in Scilit: