The Mammography Quality Standards Act (MQSA, 1992) requires marking the patient's name, unique identifier (such as medical record number or social security number; date of birth less desirable), date of examination, and the facility's name and address (city, state and zip code), the technologist who performed the examination, cassette/screen number, mammography unit number (if there is more than one at a facility) on the image receptor. Other MQSA requirements include breast [right (R)/left (L)] and projection/view [mediolateral-oblique (MLO)/craniocaudal (CC)]. It is recommended that breast and view markers be placed near the axillary edge of the film in relation to the breast.
3The unit cd m-2 is sometimes referred to as the "nit."
A flash card patient identification system is strongly recommended because it is the most permanent. An advantage of flash labels over stick-on labels is that flash labels reproduce on copy films. The identification should fit squarely in its designated space, near the edge of the film. A flash system is not acceptable if any information is illegible, does not fit, or is lopsided, causing cut-off of information. If the flash system does not meet these requirements, the radiologist should request the film manufacturer's help in putting together a satisfactory one.
Separate date stickers are recommended, as they allow for the date to be easily read with overhead light. They can be color-coded by year to facilitate the sorting of examinations.
It is also recommended that technical factors appear on the film: target-filter, operating potential (in kilovolt peak), milliampere second, exposure time, compression force, compressed breast thickness, and degree of obliquity.
Except for view and laterality, labels should be placed as far as possible from the breast so as not to distract from evaluating the breast image.
It is recommended that the angle at which the MLO view was performed be indicated. This is the angle of the x-ray beam from the vertical axis (same as the angle of the film tray to the horizontal) (Figure 2.6).
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