A study to find the optimal orientation of the breast for the cranio caudal view, for screening purposes.
OBJECTIVE
It is generally accepted that the cranio-caudal (CC) view cannot image the whole breast. The aim of this study was to investigate whether emphasis should be put on imaging the medial or lateral aspect of the breast when performing the CC view.


METHODS
The mammograms of all cancers arising within a screened population were reviewed. These included 120 screen detected cancers and 41 interval cancers. Two mammographers individually assessed the CC view to ascertain if the cancer would have been excluded from the film if the patient had been rotated to emphasis the medial or lateral aspect of the breast. A radiologist acted as arbitrator in cases of discordance.


RESULTS
No cancers were excluded from the reviewed images, however five would be excluded by 5 degrees lateral rotation and eight by 10 degrees lateral rotation. Four would be excluded by 5 degrees medial rotation and two by 10 degrees medial rotation.


CONCLUSIONS
The optimal position of the breast for the CC view is with the breast straight, i.e. with the nipple pointing towards the edge of the film. More cancers would have been missed off the film if over emphasis had been given to imaging either the medial or lateral aspect of the breast.
Naylor
S M
SM
Nottingham National Breast Screening Training Centre, Nottingham City Hospital, UK.
Lee
L
L
Evans
A J
AJ
D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods* / Q000592:standards; D008403:Mass Screening / Q000379:methods / Q000592:standards; D012680:Sensitivity and Specificity