CALLBACK MAMMOGRAPHY(updated 7/23/2018)
(updated 7/23/2018)
STANDARDIZED CALLBACK TERMINOLOGY:
- 1) Asymmetry or focal asymmetry (implies obscured margins)
- 2) Asymmetry with possible architectural distortion
- 3) Possible architectural distortion
- 4) Nodular asymmetry (implies circumscribed lesion: cyst, fibroadenoma)
- 5) Calcifications
- 6) Asymmetry with calcifications or possible architectural distortion with calcifications
Radiologist interpreting a screening mammo callback will:
- Circle abnormality in both Synapse and Secureview images
- Apply BI-RADS 0 code in impression
- Use standardized terminology in report impression (see choices above 1 through 6)
- Annotate image in Synapse and Secureview (circle abnormality)
- If repeat MLO or CC view is desired, write text on preferred image “REPEAT” in Synapse
- Mark case as Read in Secureview (this sends annotated images to Synapse)
Radiologist interpreting the diagnostic mammo callback will:
- Interpret callback mammo images
- Add additional mammo images as needed
- Annotate diagnostic mammography images
- Read the screening callback radiology report
- Look at screening images images in synapse
- Perform standardized default images
- Perform repeat CC or MLO if any image(s) labeled "REPEAT" in synapse
- Push case to radiologist worklist for interpretation
STANDARDIZED CALLBACK IMAGING BASED ON CALLBACK TERMINOLOGY:
(For the purpose of this system, “combo” mammo means 3D/C-view plus 2D mammo image.)
ASYMMETRY, POSSIBLE DISTORTION
Diagnostic mammogram- 90 degree (ML or LM) combo
- Spot tomographic combo image in the projection(s) annotated SPOT on the screening exam in synapse PACS -- Use this on the image where the abnormality is most conspicuous
- Tech to use discretion (eg, ok to use XCCM or XCCL magnification as needed to include region of interest)
- Additional spot tomographic image in synapse if more than one image annotated SPOT in synapse PACS
- Repeat full field of view combo image if image annotated REPEAT in synapse PACS
- Diagnostic ultrasound
- Survey US of entire breast(s), unless pt has had dense breast survey
- Be sure to document image in region of abnormality
- Include axilla
CALCIFICATIONS (ITEM 5 OF STANDARD CALLBACK TERMINOLOGY)
Diagnostic mammogram
- 90 degree (ML or LM) combo
- 90 degree (ML or LM) magnification
- CC magnification
- Tech to use discretion (eg, ok to use XCCM or XCCL magnification as needed to include region of interest)
- Survey US of entire breast(s), unless pt has had dense breast survey
- Be sure to document image in region of abnormality
- Include axilla
ASYMMETRY/DISTORTION AND CALCIFICATIONS (ITEM 6 OF STANDARD CALLBACK TERMINOLOGY)
Diagnostic mammogram
- 90 degree (ML or LM) combo
- 90 degree (ML or LM) magnification
- CC magnification
- Spot tomographic combo image in the projection(s) marked on the screening exam
- Use this on the image where the abnormality is most conspicuous
- Repeat full field of view combo image if image annotated REPEAT in synapse PACS
- Perform additional spot tomographic image in synapse if more than one image annotated “SPOT” in synapse PACS
- Tech to use discretion (eg, ok to use XCCM or XCCL magnification as needed to include region of interest)
Diagnostic ultrasound
- Survey US of entire breast(s), unless pt has had dense breast survey
- Be sure to document image in region of abnormality
- Include axilla
SYMPTOMS AT THE TIME OF SCREENING (PAIN, PALPABLE, NIPPLE DISCHARGE, ETC)
- Diagnostic mammogram
- Add 90 degree (ML or LM) combo
Diagnostic ultrasound
- Survey US of entire breast(s), unless pt has had dense breast survey
- Be sure to document image in region of abnormality
- Include axilla
If the callback patient has implants, the diagnostic images should be implant-displaced, unless otherwise specified.
Callback patients should be booked for concomitant ultrasound.
All diagnostic mammography imaging should generally be combo