Step-oblique mammography

Last revised by Ammar Haouimi on 28 Dec 2020

Citation, DOI, disclosures and article data

Citation:

Skandhan A, Haouimi A, Thurston M, et al. Step-oblique mammography. Reference article, Radiopaedia.org (Accessed on 18 Apr 2024) https://doi.org/10.53347/rID-28203

DOI:

https://doi.org/10.53347/rID-28203

Permalink:

https://radiopaedia.org/articles/28203

rID:

28203

Article created:

14 Mar 2014, Avni K P Skandhan

Disclosures:

At the time the article was created Avni K P Skandhan had no recorded disclosures.

View Avni K P Skandhan's current disclosures

Last revised:

28 Dec 2020, Ammar Haouimi ◉

Disclosures:

At the time the article was last revised Ammar Haouimi had no recorded disclosures.

View Ammar Haouimi's current disclosures

Revisions:

7 times, by 6 contributors - see full revision history and disclosures

Systems:

Breast

Sections:

Approach, Radiography

Tags:

breast, mammographic views

Synonyms:

Step oblique mammography
Step oblique mammographic technique
Step-oblique mammographic technique

Step-oblique mammography is an accurate technique for determining whether a mammographic finding visible on multiple images on only one projection (but not elucidated using standard additional mammographic projections) represents a summation artifact or a true mass and for precisely localizing the true mass for further evaluation.

Projections are obtained every 15° beginning with the view in which the density is visible. If the density is still not visible with this technique, it can be considered a summation artifact, and no further evaluation is needed.

all step-oblique images should be taken with the breast in the same orientation (i.e. all mediolateral oblique or all lateromedial oblique)
the nipple should be in profile on all step-oblique exposures and there should be no rolling of the breast .
the patient should stand up straight during all step-oblique exposures.
projections are obtained every 15° beginning with the view in which the density is visible

Clinical applications

frequently used to assess the non-calcified density identified on only one standard mammographic projection
helpful in evaluating grouped microcalcifications seen on only one standard view
helpful in establishing the presence of truly clustered calcific particles
permitted accurate three-dimensional localization of the lesion
step-oblique mammography is also useful in indicating the three-dimensional locations of more than one lesion in the same breast, especially if two or more lesions display similar mammographic features and are similar in distance from the nipple; confirmation of the precise three-dimensional location of each lesion by step-oblique mammography permits planning of the optimal approach for imaging-guided biopsy.
if the density is not visible with this technique, it can be considered a summation artifact, and no further evaluation is needed