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Mammo ARRT Exam Solved Correct
Solutions
The biggest risk factor for breast cancer disease is (a) a family history of breast cancer (b) a personal history of breast cancer (c) gender (d) not breast feeding Answer - (C) Gender One of the minor risk factors for breast cancer could include (a) gender (b) aging (c) genetic risk factors (d) Not breast Feeding Answer - (d) Not breast feeding What is the approximate risk of developing breast cancer for a women whose fathers sister has the disease (a) higher than normal risk (b) no significant change in risk' (c) lower than normal risk (d) none of the above Answer - (a) higher than normal risk Seventy seven percent of breast cancers are discovered in women in which age group (a) age 30 or below (b) above age 50 (c) between 30 and 40 (d) above 20 but below the age of 30 Answer - (b) above the age of 50 Symptoms of benign breast disease not seen mammographically can include
- nipple discharge
- skin thickening 3.circumscribed tumors
(a) 1 only (b) 3 only (c) 2 and 3 only (d) 1 and 3 only Answer - (a) nipple discharge Symptoms of malignant breast cancer include 1.skin thickening 2.nipple discharge 3.calicfications (a) 1 only (b) 2 and 3 only (c) 1 and 3 only (d) 1,2, and 3 Answer - (d) 1,2, and 3 skin thickening nipple discharge calcification Skin thickening can be malignant but could also be caused by 1.a breast abscess
- a calcified fibroadenoma
- postradiation (a) 1 only (b) 2 only (c) 1 and 2 only (d) 1 and 3 only Answer - (d) 1 and 3 only a breast abscess post radiation The two main classifications of breast cancer are
- ductal
- lobular
- medullary
A CBE can be performed by which of the following Answer - -the radiologist -a health-care professional a BSE should be done regularly by Answer - -the patient All women about the age should perform a BSE regularly Answer -
- 20 The two-step method of BSE is to Answer - -look and feel for changes in the breast When visually inspecting the breast the changes that should be recorded include Answer - -changes in size and shape -changes in texture or color -indentations The patients medical history and documentation will Answer - - provide the radiologist with information on the patients risk factors for breast cancer -provide information about the possible benign breast conditions of the patient The importance of the BSE and the CBE is stressed because Answer
- -both with help in the detection of the malignant breast conditions -a mammogram is not 100% effective Which of the following are methods used in BSE Answer - -using the pads of the 3 middle fingers to palpate the entire breast -palpating around the breast in a vertical pattern -using up varying degrees of pressure while palpation of the breast For a menstruating women, when is the best time of the month to perform a BSE Answer - When the breast is least tender -Breast cancer death rates in United States are going down -The second leading cause of cancer death in women in United States is breast cancer
T/F Answer - True Postmenopausal obesity is associated with? Answer - - circulating estrogen that is produced in fat tissue A process of removing tissue, muscle, and fat from the belly and transferring that tissue to reconstruct the breast is called Answer - - TRAM flap Anti estrogen drugs such as tamoxifen can be used to Answer - - slow or stop the cancers growth -prevent breast cancer in high risk women -prevent the recurrence of breast cancer In routine mammo the radiation dose per projection is generally about Answer - 0.1- 0.2 rad Which age group is likely to get the most radiation dose from a mamm Answer - - 20- 35 The 5 year survival rate for a patient with a stage 0 breast cancer is about? Answer - 100% During a mammo, which of the following will affect the average glandular dose per breast? Answer - -degree of breast compression -the half value layer (HVL) of the xray beam -breast size and composition In general the optimal duration of tamoxifen treatment is? Answer - 3 years Lumpectomy describes the process of? Answer - removal of the breast cancer tumor and surrounding margins of normal breast Radiation therapy can be used? Answer - -combined with other
The intensity of the x-ray beam from the cathode side of the tube is generally higher because Answer - The heel effect causes variation on the intensity of the x-ray beam The design of the lip of the compression paddle (both height and angle along the chest wall) affects all of the following except that it? Answer - Ensures greater compression of the anterior breast tissue The primary goal of compression is to Answer - Allow uniform penetration of structures within the breast AEC failure, resulting in an underexposed radiograph, can be caused by Answer - Improper placement of the dense breast tissue/size over the detector Most AEC circuitry in modern mammo-graphic imaging at least three detectors. Three or more detectors are recommended because? Answer - Multiple detectors allow for maximum variations in breast size and tissue density The major difference between the general radiography grid and the grid used in mammography is that the? Answer - grids used in general radiography have higher ratios The grid ratio can vary in modern mammography units. A common grid ratio used is? Answer - 4: As the size of the x-ray field decreases, to maintain a constant image density, the exposure will? Answer - Increase The chest wall edge of the compression paddle should be aligned just beyond the chest wall edge of the IR to? Answer - avoid projecting the chest wall edge of the paddle on the mammogram Which of the following affects the focal spot size? Answer - Angle of the anode In mammography, the commonly used focal spot size for routine
work is? Answer - 0.3mm Which of the following characteristics are unique to mammography cassettes? Answer - Generally have a single intensifying screen Two main disadvantages of extended processing are? Answer - Increased processing artifact and increased film fog In digital mammography, both the film and cassette can be replaced by? Answer - A detector and electronic system The greatest difference between digital technology and conventional mammography imaging is Answer - In digital technology, the final image can be manipulated. all of the following are characteristics of double emulsion film/screens combination. Which characteristics makes these systems undesirable in mammography use? Answer - The system has a lower spatial resolution tha the singel emulsion systems. Which of the following quality control tests does not require a densitometer Answer - screen cleanliness The criteria to pass the ACR mammography Accreditation on conventional phantom imaging require a minimum of masses Answer - three In establishing processing quality control levels, the speed index is designed as the density Answer - closest to but not less than 1. For the daily quality control testing, the base plus-fog level should remain within Answer - +0.03 of the established levels The screen cleaning test should be carried out whenever Answer - the mammographer notices dust artifacts on the image
In imaging the phantom, the technical factors used should be the same as those used clinically for a -cm-thick breast of medium glandularity If after examining a phantom image, the number of visualized fibers or mass has changed significantly, the next step is to Answer
- check the mammography unit or the image processor Repeated films are Answer - films that involve exposure to the patient If the patient volume at the mammography site is 200 patients per week, the repeat/reject analysis should be done every Answer - 3 months all the fluorescent tubes in the mammography view box should be replaced at the same time because Answer - fluorescent tubes decrease in brightness with age Mammography facilities can receive certification from Answer - FDA SAC state MQSA certificate is issued when a mammography facility has been accredited. This certification is valued for Answer - 3 years If any of the visual checks fail, the step is to Answer - correct or replace the item Digital images can be viewed on a computer monitor or printed using Answer - Dry laser technology Hard copy viewing of the digital imaging describes Answer - The image that is sent for interpretation A lesion located in the upper outer quadrant of the right breast is located in the? Answer - 10 o'clock position Morgani tubercles are usually found Answer - on the skin of the
areola Compression of the breast is most effective and most comfortable when applied against the Answer - inferior and lateral aspects The normal breast may have how many lobes? Answer - 15-20 lobes The structure that gives the breast its support and shape is called Answer - cooper ligament The breast extends vertically from the Answer - second through sixth rib the thickest portion of the breast is the Answer - tail of spence cooper ligaments attach anteriorly to the Answer - fascia of the skin fatty tissue is generallyand on the mammogram seen as areas of optical densities Answer - radiolucent/higher Typically, a patient with dense fibrous and glandular tissue throughout the entire breast on a baseline mammogram is what age? Answer - below 45 Glandular tissue is usually found in the of the breast Answer
- central upper quadrant lymph drainage from the medial half of the breast is generally directed to the Answer
- lactiferous sinus The portion of the breast that holds the milk producing element is the Answer - lobule veins are normally located Answer - in the periphery of the breast
Characteristics of a malignant stellate tumor include Answer - the presence of a central tumor mass the larger the tumor the longer the spicules the radial scar or sclerosing duct hyperplasia can sometimes be mistaken for carcinoma fyi Answer - can sometimes be mistaken for carcinoma a mammogram shows a low density radiopaque tumor. it is oval, lobulated, and a halo is seen along one border only. the next step should be Answer - ultrasound a galactocele is associated with Answer - nursing it can be a huge encapsulated lesion occupying the entire breast Answer - lipoma a rare form of cancer that represents with swelling, warmth, or erythema and mammographically with skin thickening is Answer - inflammatory carcinoma somethimes describes as an oil cyst, this lesion represents an encapsulated area on the mammogram and can be caused by surgery, biopsy, trauma, or radiation therapy Answer - fat necrosis a benignn self limiting breast tumor that is the result of new disorganized cell growth Answer - hamartoma an infusa port can be used to Answer - allow repeated access to the venous system see page 56 figures Answer - which projection is used to determine if a lesion is medial or lateral to the nipple Answer - cc if any breast tissue is poorly imaged or missed on the MLO
projection it is likely to be Answer - medial breast tissue the posterior nipple line (PNL), visualized on the MLO, should be within how many centimeters of the PNL on the CC Answer - 1. which of the following conditions must be be bet whtn imaging the breast in the MLO Answer - -the pectoral muscle should extend to or below the PNL -Visualized fat should be posterior to all the fibrogladular tissues -The inframammary fold (IMF) should be open In positioning for the CC projection, if the C-arm of the mammography unit is raised too high the IMF is overrelevated, resulting in loss of Answer - -inferior breast tissue -posterior breast tissue The Single projection that will best visualize the maximum amount of breast tissue is the Answer - MLO In general, when imaging tall, thin patients the angulation is adjusted close to how many degrees? Answer - close to 60 degrees The position used to determine whether an abnormality is superior or inferior to the nipple is the Answer - MLO The principle of mobile versus fixed tissue is used in mammography positioning to image the maximum Answer - medial breast on the MLO projection In the CC projection of the breast, the IR is positioned Answer - at the level of the raised inframammary crease when positioning for the right cc, where is the patients left arm places Answer - brought forward. The patient can hold the handle bar of the unit your patient has had recent chest surgery and has a scarred and
Manual compression in mammography depends on? Answer - depends on breast size and the patient's pain tolerance Some considerations that could be given to women with painful breasts include Answer - -Having the patient take IBU prior to the exam -Scheduling the mammogram just after the menstrual cycle -Explaining, before the examination, the importance of compression Compression will not decrease spatial resolution Answer - fyi Compression reduces radiation to the breast by Answer - Decreasing breast thickness What principle does compression use to visualize the borders of circumscribed lesions Answer - -It brings the lesion closer to the image receptor -It spreads apart the overlapping tissue -It separates superimposed areas of glandular tissue Ideally breast compression is maximized when Answer - - accompanied by a thorough explanation to increase pt. cooperation -the pt. recognizes the advantage of compression in reducing radiation dose Patients who are allowed to play an active role in applying the compression are usually Answer - -more likely to tolerate the compression -more relaxed during the compression Magnification can be used to assess Answer - margins of a lesion The cleopatra view is an old term given to the projection similar to the current AT. All projection in mammo are compression or compressed projections. Answer - involve looking and feeling for changes in the breast.
the most common cause of undercompression is Answer - inadequate compression by the mammographer
The retormammary space is filled with Answer - adipose tissue The fatty versus fibroglandular nature of breast tissue is affected by which of the following Answer - age, hormone use, number of preganacies In compression on the XCCL projection, the affected arm should Answer - be raised, with hand resting/holding on the bar of unit In the CC position the pectoral muscle is seen what % of the time? Answer - about 30%-40% of the time Between ages 20- 39, a women should have a CBE every Answer - 3 years The lesion is not palpable and is not associated with nipple or skin changes it is likely to be Answer - nonspecific, further testing is indicated Regardless of the reason, if the proper amount of compression cannot be applied which of the following must apply Answer - it must be noted on the patients history form Magnification is contraindicated as a normal routine screening tool Answer - as normal routine routine screening tool if no previous mammograms are available for comparison, the AEC detector should be places Answer - in the central aspect of the compressed area of the breast which section of the breast is poorly visualized on the cc projection Answer - lateral Manual technique is sometimes is necessary when imaging implants because Answer - the implant covers the AEC detector Which projection could be used to demonstrate a deep medical lesion not seen on the CC Answer - CV
after a routine four projection mammo series the nippple is not seen in profile on any images. Additional projections are done if Answer - -the nipple is indistinguishable from a mass -a subareolar abnormality is suspected -the nipple is not marked with a BB The XCCL projection best images the posterolateral breast. the beam is directed superiority to inferiority, similar to a standard CC projection. The TAN image of the area in question, the FB image directs the beac caudocranially and the ML is a 90 degree lateral projection Answer - fyi your patients sister had breast cancer. your patient is considered to have Answer - a greater risk for breast cancer The MQSA mandates that the average glandular dose received per projection/position during routine screen-film mammo cannot exceed Answer - 300mrad when imaging an extremely dense breast using AEC, the exposure sometimes terminates, resultiing in an underexposed image because of the action of the Answer
- backup timer the operating level density difference (DD) for the phantom should be at least Answer - 0. a film was accidentally bent prior to loading into the mammo cassette. if this film is used in mammo screening, an artifact would appear as Answer - a minus-density artifact Montgomery glands are specialized Answer - sebaceous gland a women taking estrogen replacement therapy may notice changes in the breast such as Answer - -breast enlargement -lumpy breast -cysts
