© 2017 Mammography Educators - www.mammographyeducators.com

!

!The Miller Method™

CC QUICK STEPS

The following steps should be performed after the proper compression paddle size is chosen, machine is at 0-degree angulation and the patient is facing the machine with feet, hips and shoulders forward and level. Stand on the medial side of the breast to be imaged. (Steps below describe positioning for the LCC) ___ 1. Elevate breast/IMF (until the PNL is perpendicular to the chest wall)

___ 2. Adjust IR height (so top edge is parallel with elevated IMF)

___ 3. Pull breast onto IR with both hands (left hand on top; right hand on bottom)

___ 4. Anchor breast with the base of your thumb (after switching hands)

___ 5. Lift other breast onto IR (turn patient forward, if needed)

___ 6. Guide the patient’s head forward and around

___ 7. Relax shoulder on side being imaged with your hand

___ 8. Pull on lateral breast tissue and compress

!

50 SECTION 06 POSITIONING TECHNIQUES

CC QUICK STEPS

The following steps should be performed after the proper compression paddle size is chosen, machine is at 0 degree angulation and the patient is facing the machine with feet, hips and shoulders forward and level. You should be standing on the medial side of the breast to be imaged.

1. Stand perpendicular to patient2. Elevate breast/IMF3. Adjust IR height4. Pull breast on IR with both hands5. Anchor breast6. Lift other breast onto IR7. Guide the patient’s head forward and around8. Relax shoulder with hand9. Pull on lateral breast tissue

10. Compress

Diagram

Page 43

78

1 - 4

5

6

SHOULDER

OVERHEAD VIEW

HEAD

Figure 49: Overhead view of patient.

Back Front

© 2017 Mammography Educators - www.mammographyeducators.com

The Miller Method™

IMAGE CHECKLIST FOR THE CC Self-evaluation

In order to ensure maximum inclusion of breast tissue, the technologist and radiologist should consider the following criteria:

___ Visualization of central, subareolar and medial aspects of the breast. �

___ Visualization of pectoral muscle on approximately 40% of cases. � ___ PNL must measure within 1.0 cm of PNL measurement on the

MLO. � ___ Retroglandular fat is visualized behind glandular breast tissue. �

© 2017 Mammography Educators - www.mammographyeducators.com

The Miller Method™

MLO QUICK STEPS

The following steps should be performed after choosing the proper degree of angulation, the proper compression paddle is chosen and shifted (as needed) and the patient is facing the machine with both feet, hips and shoulders forward and level. You should be standing on the medial side of the breast to be imaged. Determine angle and adjust machine height. (Steps below describe positioning for the LMLO) ___ 1. Stand perpendicular to the patient

___ 2. Lift patient’s arm up over IR

___ 3. IR placed in back of axilla (just interior to latissimus dorsi)

___ 4. Patient’s hand resting on bar, elbow bent

___ 5. Place your left hand on patient’s left shoulder

___ 6. Your right hand slides down lateral side of breast

___ 7. Hold breast up and out and compress

46 SECTION 06 POSITIONING TECHNIQUES

MLO QUICK STEPS

The following steps should be performed after choosing the proper degree of angulation (Figure 5), the proper compression paddle is chosen and shifted (as needed), and the patient is facing the machine with feet, hips and shoulders forward and level. You should be standing on the medial side of the breast to be imaged. Determine angle and adjust machine.

1. Stand perpendicular to the patient2. Lift patient’s arm up over IR3. IR placed in back of axilla4. Patient’s hand resting on bar, elbow bent5. Left hand on left shoulder6. Right hand slides down lateral side of breast7. Hold breast up and out8. Compress

Diagram

Page 44

2-56

7

1

SHOULDER

OVERHEAD VIEW

HEAD

Figure 40: Overhead view of patient.

Back Front

© 2017 Mammography Educators - www.mammographyeducators.com

The Miller Method™

IMAGE CHECKLIST FOR THE MLO Self-evaluation

In order to ensure maximum inclusion of breast tissue, the technologist and radiologist should consider the following criteria:

___ Visualization of all breast tissue within the perimeter of breast margins. �

___ The position of the breast is supported up and away from the thorax (not drooping) and as close to perpendicular to the chest wall as possible. �

___ Retromammary fat is visualized. �

___ Inframammary fold is visualized and open. �

___ Nipple is in profile. �

___ Visualization of pectoral muscle: from axilla down to the level of the PNL, wide margin at axilla, convex or straight configuration and radiolucent appearance. �