Welcome to your Mammography Name: Email: [In magnification, what immediate role does the large object-to-image receptor distance (OID) play in reducing scattered radiation?] The compressed breast allows lower kVp values. Exposure is reduced because a grid is not needed. Most of the scattered radiation misses the image receptor. The larger source-to-image receptor distance (SID) utilizes the inverse square law. None . [The darkroom fog test is performed] semiannually monthly weekly daily None . [A lipoma] is generally seen as a high-density radiopaque lesion on the mammogram can be a huge encapsulated lesion occupying the entire breast may have irregular borders typical of malignant lesions is usually difficult to image mammographically None . [Between ages 20 and 39, a woman should have a CBE every] year 2 years 3 years 4 years None . [Delaying the processing of films will affect the 1. speed of the film 2. film contrast 3. density of the film] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [One of the minor risk factors for breast cancer could include] gender aging genetic risk factors not breast-feeding None . [A lesion located in the upper outer quadrant of the right breast is located in the] 5-o’clock position 2-o’clock position 10-o’clock position 7-o’clock position None . [The standard projection taken on patients with breast implants requires compression 1. for immobilization only 2. to separate the breast tissue 3. to assess areas of lumps] 1 only 2 only 1 and 3 only 2 and 3 only None . [During needle localization, breast positioning should provide the shortest skin-to-abnormality distance in order to 1. minimize trauma to the breast 2. ensure minimal excursion of the biopsy needle into the breast 3. reduce the possibility of needle deflection] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [Increased kVp during mammography is sometimes necessary to penetrate dense fibroglandular tissue. Increased kVp, however,generally causes] increased subject contrast decreased subject contrast motion unsharpness less scatter None . [The absorbed dose in mammography is generally _______ the entrance skin exposure (ESE).] significantly higher than significantly lower than about the same as slighter higher than None . [Radiation therapy is a treatment that utilizes] drugs to treat cancer that may have spread high-energy radiation to destroy cancer cells radioactive tracers to track the path of cancer to the lymph nodes potent pain medication to treat the severe pain from cancer None . [Unlike conventional x-ray tubes, some mammography tubes are tilted 7.5–12 degrees from the horizontal. The effect of this is to 1. allow the use of smaller focal spot size 2. minimize the heel effect 3. increase resolution] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Compression will do all of the following except] bring tissue closer to the image receptor reduce patient dose improve image subject contrast decrease spatial resolution None . [The thickest portion of the breast is the] areola nipple tail of Spence inframammary crease None . [Although it often means losing some of the lateral breast tissue, in imaging for the craniocaudal (CC) projection, most experts advise a slight rotation of the patient’s body to maximize imaging of the medial breast tissue. Why?] Medial breast is imaged best on the CC. Medial breast is imaged only on the CC. Slight rotation avoids distorting the medial breast. The slight rotation enables ease in positioning. None . [The 5-year survival rate for a patient with a stage 0 breast cancer is about] 49% 76% 88% 100% None . [In digital mammography, a grossly underexposed image] appears excessively noisy is too light is too dark appears correctly exposed None . [The fatty versus fibroglandular nature of breast tissue is affected by which of the following? 1. age 2. hormone use 3. number of pregnancies] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [A lesion is superimposed by breast tissue in the CC projection. A projection used to demonstrate the lesion in the same projection and free of superimposition is the] MLO ID XCCL RM None . [What is the approximate risk of developing breast cancer for a woman whose father’s sister has the disease?] higher than normal risk no significant change in risk lower than normal risk none of the above None . [If any breast tissue is poorly imaged or missed on the MLO projection it is likely to be] medial breast tissue lateral breast tissue inferior breast tissue superior breast tissue None . [Hardcopy viewing of the digital imaging describes] displaying the image on the mammographer’s workstation for further enhancement the only image viewed by the mammographer the image that is sent for interpretation the ability to reduce the cost associated with repeats None . [When is imaging of the irradiated breast recommended?] immediately after treatment 1–2 months after treatment 6–12 months after treatment 1–2 years after treatment None . [Why is the MLO preferred to the ML as a routine projection?] The MLO visualizes the medial breast. The ML does not visualize the medial breast. The ML poorly visualizes the posterior and lateral breast. The MLO does not distort the anterior structure of the breast. None . [Mammography is more accurate in] premenopausal women postmenopausal women women with fibrocystic breast women with dense breast tissue None . [Figure indicates ?] mammographically benign calcifications malignant calcifications keratosis fibroadenomas None Comment . [Which of the following affects focal spot size?] angle of the anode a decrease in the SID decreasing the size of the collimated beam changing the relationship between the OID and the SID None . [Proving that a darkroom fog failure is a result of safelight problems involves] moving the safelight at least 6 ft from the work surface repeating the test with the safelights checking for light leaks around the doors and passbox changing the filter on the safelight None . [The tumor seen in Figure is characteristic of] invasive ductal breast carcinoma a mammographically malignant tumor a mammographically benign tumor a low-density tumor typical of benign None Comment . [Regardless of the reason, if the proper amount of compression cannot be applied which of the following must apply?] the patient must be told the patient’s doctor must be told the radiologist must be told it must be noted on the patient’s history form None . [Densities on the sensitometric strip and phantom image were recorded as follows: density inside the disk = 1.23, the middensity = 1.25, the background density = 1.68, the density adjacent to the disk = 1.66, and the highest density = 1.69. What is the density difference (DD) on the phantom image?] 0.42 0.43 0.44 0.45 None . [Identify the lactiferous sinus in Figure.] site A site B site C site D None Comment . [Fibrous tissues are presented radiographically as] black or radiolucent areas gray and less dense areas white or denser areas black and less dense areas None . [Symptoms of a malignant breast cancer can include 1. skin thickening 2. nipple discharge 3. calcifications] 1 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Figure shows] invasive ductal breast carcinoma mammographically malignant calcifications mammographically benign calcifications numerous oil cysts None Comment . [In addition to the routine CC and mediolateral oblique (MLO), a routine series for a postmastectomy patient could also include the] axillary tail (AT) mediolateral (ML) TAN lateromedial oblique (LMO) None . [To select a 12% increase in mAs before exposure, the mammographer could] use the density compensation circuit double the selected mAs activate the backup timer readjust the AEC selector None . [On a reject/repeat analysis, the rate was lower than 5% but one category of the reject/repeat analysis is significantly higher than others. What should be done?] Although the overall rate is less than 5%, that one area should be targeted for improvement. If the other categories are within normal limits, that area can be disregarded. Because the rate was more than 2%, the entire department needs to be reassessed. With an overall rate lower than 5%, one high rate is statistically meaningless. None . [When imaging a small breast, scattered radiation can be minimized by 1. increasing compression 2. reducing kVp 3. reducing field size] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The area of minus density in the upper part of Figure best represents] a pacemaker the patient’s chin a hematoma port-a-cath None Comment . [Chemotherapy] involves the use of drugs to treat cancer that may have spread is the destruction of cancer cells using high-energy radiation involves mapping the area around a tumor with the injection of a radioactive tracer involves the use of drugs to treat cancer that may have spread None . [Which of the following conditions must be met when imaging the breast in the MLO? 1. The pectoral muscle should extend to or below the PNL. 2. Visualized fat should be posterior to all the fibroglandular tissues. 3. The inframammary fold (IMF) should be open.] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The projection best used to demonstrate the true representation of medial breast structures in relation to the nipple is the] LM AT ML TAN None . [MRI can be used to 1. map the extent of a tumor 2. image patients with implants 3. evaluate patients with dense breast] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The mammogram of a woman age 50 who has recently started estrogen replacement therapy is likely to be] more fibroglandular than her past mammographic study more fatty that her previous mammogram less fibrous and less glandular than her previous studies unchanged from her previous mammograms None . [The greatest disadvantage of magnification is] increased OID increased patient dose decreased subject contrast increased risk of motion unsharpness None . [In the CC position the pectoral muscle is seen] all the time rarely if ever about 30%–40% of the time about 50% of the time None . [A rare form of cancer that presents with swelling, warmth, or erythema and mammographically with skin thickening is] inflammatory carcinoma invasive ductal carcinoma lobular carcinoma in situ papillary carcinoma None . [In compression on the XCCL projection, the affected arm should] not be raised, but rest along the top of the image receptor be raised, with hand resting/holding bar of unit be place on the patient’s hips be placed according to the wishes and comfort of the patient None . [Paget disease of the breast is a(an)] infiltrating carcinoma generally limited to the breast form of carcinoma associated with changes of the nipple benign breast condition that is relatively common malignant form of breast carcinoma involving the lobules None . [In the darkroom fog test, the optical density difference between fogged and unfogged areas of the film should not exceed] 1.20 0.15 0.05 0.02 None . [In digital imaging a repeat analysis test is] unnecessary—digital imaging automatically corrects exposure mistakes necessary—digital imaging cannot correct for overexposure unnecessary—digital imaging corrects unsharpness by altering the spatial display necessary—digital imaging cannot correct factors such as motion unsharpness None . [In conventional imaging, the characteristic curve of a particular film describes the relationship between the] exposure the film receives and the density after processing x-ray beam quality of the mammographic unit and film speed speed of the film and the density at different exposure levels screen-film combination as it relates to the selected mAs None . [In the dedicated mammography unit, the single intensifying screen is positioned in contact with the film emulsion on] the side of the IR away from the x-ray source the side of the film facing the x-ray source the side of the IR facing the x-ray source either side—the placement does not matter None . [Identify Cooper ligament in Figure.] site A site B site C site D None Comment . [The specimen is compressed to] reduce motion unsharpness reduce radiation exposure reduce tissue thickness reduce the magnification factor None . [Fatty tissue is generally _______ and on the mammogram is seen as areas of _______ optical density.] radiolucent/lower radiopaque/higher radiolucent/higher radiopaque/lower None . [AEC failure, resulting in an underexposed radiograph, can be caused by] processing deficiencies such as fluctuating developer temperature improper placement of the dense breast tissue/size over the detector decreased radiographic contrast inadequate breast compression None . [If the patient volume at a mammography site is 200 patients per week, the repeat/reject analysis should be done every] week 2 weeks 2 months 3 months None . [Veins are normally located] in the periphery of the breast central areas of the breast in the axilla area of the breast in the medial areas of the breast None . [Film fog is best demonstrated on the characteristic curve as] the straight-line portion of the graph the toe of the graph the shoulder of the graph the shift of the graph to the left None . [Extended processing increases the amount of time the film is immersed in the] developer solution fixer solution dryer both the developer and fixer solutions None . [Some considerations that could be given to women with painful breasts include 1. having the patient take ibuprofen prior to the mammogram 2. scheduling the mammogram just after the menstrual cycle 3. explaining, before the examination, the importance of compression] 1 only 1 and 2 2 and 3 1, 2, and 3 None . [For a menstruating woman, when is the best time of the month to perform a BSE?] 1 week before the start of menstruation on the first day of the month on the last day of the month when the breast is least tender None . [What does the glandular dose measure?] the average dose to the patient’s skin the absorbed dose to the skin the absorbed dose at the tissue level the same as the entrance skin dose None . [Core biopsy techniques developed as an alternative to surgical biopsy because this technique provided a larger sample of the area of suspicion and thus more information than] ductography needle localization pneumocystogram FNB None . [According to MQSA regulations, which of the following is not required on the final mammographic image?] date of the examination technical factors used mammographer/technologist identification cassette/screen identification None . [It may be necessary to use manual technique with small breast because the] multiple detectors can be moved according to breast size automatic exposure control (AEC) detector may not cover the small breast tissue area AEC detector cannot compensate for breast size AEC cannot compensate for varying breast tissue types None . [Which projection can be used instead of the CC to image patients with severe kyphosis?] ML TAN FB CV None . [The mammographer can differentiate motion unsharpness from screen unsharpness because] motion unsharpness is generally localized to a small area screen unsharpness is generally localized to a small area motion unsharpness will result in blurring screen unsharpness is less likely at exposures below 2 seconds None . [Compression of the breast is most effective and most comfortable when applied against the] medial and lateral aspects inferior and superior aspects medial and superior aspects inferior and lateral aspects None . [Why is the specimen magnified?] to ensure that the lesion has been completely removed to visualize the calcifications within the specimen to compare the magnified and nonmagnified images to check the number and placement of calcifications None . [Which of the following techniques use a small-gauge needle to obtain cellular samples from a lesion?] core biopsy FNB ductography ductal lavage None . [Which of the following is (are) considered a first-degree relative? 1. mother 2. aunt 3. sister] 1 only 1 and 2 only 2 and 3 only 1 and 3 only None . [The radial scar or sclerosing duct hyperplasia 1. can sometimes be mistaken for carcinoma 2. sometimes has a solid dense central tumor 3. is usually not associated with skin thickening or dimpling over the lesion] 1 only 1 and 2 only 2 and 3 only 1 and 3 only None . [The calcification seen in Figure have the typical appearance of] an oil cyst plasma cell mastitis calcification a small calcified hematoma a calcified sebaceous gland None Comment . [The patient had trauma to the breast 1 month ago and has developed a lump. Such an injury may show mammographically as a] galactocele hematoma lymph node fibroadenoma None . [With its high sensitivity, MRI is ideal as] a routine screen tool for breast cancer a replacement for mammography screening in detecting breast cancers an adjunctive tool in detecting breast cancer None . [Which section of the breast is poorly visualized on the CC projection?] medial axial lateral superior None . [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] pneumocystogram ultrasound biopsy no further testing; the tumor is benign None . [Glandular tissue is usually found in the _______ of the breast] medial and lower inner quadrant central and upper outer quadrant medial and lower outer quadrant central and upper inner quadrant None . [Under the MQSA, how long are facilities required to maintain the records of a patient who died shortly after her first mammogram?] 5 years 10 years 20 years permanently None . [Contaminated developer will likely result in 1. decreased film speed 2. increased image receptor contrast 3. increased film base density] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Under which of the following circumstances is it necessary to reestablish processor QC operating levels] a change in film volume a change in mammographer an unexplained upward change in the data using a different sensitometer None . [What effect does compression have on Compton interactions?] The absolute number of Compton interactions increases. The absolute number of Compton interactions decreases. Compression has no affect on Compton interactions. Compression affects Compton interaction only above 70 kVp. None . [The position used to determine whether an abnormality is superior or inferior to the nipple is the] CC MLO XCCL TAN None . [In establishing processing quality control operating levels, the speed index is designated as the density] closest to but not less than 2.20 closest to but not less than 1.20 closest to but not less than 0.45 2.20 or higher None . [Using a small focal spot size is recommended for magnification] to reduce the resultant loss of image detail because of increased patient dose to compensate for the small OID to compensate for motion unsharpness None . [A woman taking estrogen replacement therapy may notice changes in the breast such as 1. breast enlargement 2. lumpy breast 3. cysts] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [In establishing processor quality control (QC), the high average density is generally the density closest to] but not less than 2.20 but not less than 1.20 but not less than 0.45 2.20 None . [Breast tissue can extend medially to the] latissimus dorsi muscle midsternum retromammary space inframammary crease None . [A clinical breast examination (CBE) and breast self-examination (BSE) are similar in that both] involve looking and feeling for changes in the breast are done by a trained medical professional are done monthly are done yearly None . [A barrel-chested patient whose chest wall protrudes outward may have breast tissue extending laterally under the arm. What projection, used to image the breast with the beam directed superiorly to inferiorly, should be taken in addition to the CC?] AT XCCL CV MLO None . [In general, when imaging tall, thin patients the angulation is adjusted to] below 30 degrees between 30 and 40 degrees close to 60 degrees almost 70 degrees None . [What factors are used to maintain a sharp image during magnification? 1. adjustable focal spot sizes 2. decreasing the thickness of the body part 3. decreasing the resolution] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [Quantum mottle on the image is reduced by] high kVp high mAs motion fast intensifying screens None . [The minimum and maximum kilovoltage peak (kVp) of a mammography unit depends on which main factor(s)?] Radiologist preference or recommendations Characteristics of the screen-film combination Processing and the patient’s breast size Target and filtration material selected None . [What is the major disadvantage of magnification?] reduced resolution of the image increased patient dose increased scattered radiation none of the above None . [Using a cassette with poor film screen contact will result in] a noisy image localized unsharpness motion unsharpness a lower subject contrast None . [The cells lining the alveoli in the lobules are called] epithelial cells myoepithelial cells basement cells superficial cells None . [A CBE can be performed by which of the following? 1. the radiologist 2. the patient 3. a health-care professional] 1 only 2 only 2 and 3 only 1 and 3 only None . [Radiation therapy can be used 1. combined with other treatment options 2. to kill any remaining cancer cells in the breast, or chest wall area 3. to shrink the size of a tumor before surgery] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The greatest difference between digital technology and conventional mammography imaging is] The higher resolution system results in an increase in patient dose in digital technology. There is no latent image formation when using digital technology. In digital technology, the final image can be manipulated. The image can never be displayed on a film in digital technology. None . [In conventional imaging, some causes of underexposure include 1. processing deficiencies 2. inadequate compression 3. improper AEC setting] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [Morgagni tubercles are usually found] on the nipple on the lateral border of the breast in the terminal duct lobular unit (TDLU) on the skin of the areola None . [What immediate action is used to reduce motion unsharpness in mammography?] compression low mAs (milliamperes per second) low kVp (kilovoltage peak) small focal spot size None . [In mammography, the commonly used focal spot size for routine work is] 3 mm 0.3 mm 1 mm 0.1 mm None . [In the rolled medial (RM) position, the lower surface of the breast is rolled in which direction?] laterally medially inferiorly superiorly None . [A major cause of radiographic noise is] image graininess quantum mottle poor contrast resolution motion None . [The FB projection can be useful in imaging 1. nonconforming patients 2. abnormalities high on the chest wall or superior aspect of breast 3. inferior lesions or lesions near the IMF] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Ultrasound uses] high-frequency sound waves to image the breast low-frequency sound waves to image the breast longitudinal microwaves to image the breast radiofrequency waves to image the breast None . [The compression force should not exceed _______ on the initial power drive (automatic) mode.] 25 lb 35 lb 40 lb 45 lb None . [If the residual hypo in the mammography film exceeds 0.05 g/m2 or 5 g/cm2, this can indicate 1. improper washing of the film 2. improper fixer replenishment 3. the film will have poor archival quality] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [In assessing the degree of compression for any one patient, the mammographer should take into consideration 1. the maximum to which the patient’s breast can actually be compressed 2. the amount of compression the patient can tolerate 3. compression that should be just sufficient to immobilize the breast] 1 only 1 and 2 only 1 and 3 only 2 and 3 only None . [The half-value layer (HVL) of the x-ray beam is measured with a] star pattern slit camera pinhole camera quality-control dosimeter None . [In high-contrast imaging or conventional imaging] skin detail is easily seen bright light is needed to see skin detail glandular tissue and skin detail are seen equally glandular tissue and skin detail are seen poorly None . [A lesion on the lateral aspect of the breast is not seen on the CC. An additional projection used to image the lesion could be the] CV XCCL FB TAN None . [If, after examining a phantom image, the number of visualized fibers or masses has changed significantly, the next step is to] record the new values call the medical physicist call the equipment service personnel check the mammography unit or the image processor None . [Grid use in magnification mammography is contraindicated because 1. grid use increases subject contrast 2. scatter is already minimized 3. the grid results in increased patient dose] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Identify the projection shown in Figure.] RM CV RL MLO None Comment . [The air gap in magnification increases subject contrast by] increasing scatter reducing scatter reducing motion increasing motion None . [The superior inferior oblique (SIO) will best demonstrate the] OUQ and the LOQ of the breast LIQ and the UIQ of the breast UIQ and LOQ of the breast LIQ and the OUQ of the breast None . [If any of the visual checks fail, the first step is to] correct or replace the item call the medical physicist call the processor service call the equipment service representative None . [MRI imaging involves the use of] radiation to detect breast lesions sound waves in the imaging of the breast magnetic properties plus radio waves to image the breast strong sound and radio waves in imaging the breast None . [The specimen is radiographed to] confirm that the lesion was removed compare various needle localization techniques magnify the lesion to assess any possible microcalcifications check the position of the lesion None . [A lesion moved up on the ML projection from its original position on the MLO. The location of the lesion within the breast is] laterally medially inferiorly superiorly None . [Which of the following could be used when imaging extremely small breasts in the craniocaudal (CC) position?] spatula ML cleavage (CV) exaggerated craniocaudal (XCCL) None . [Magnification in mammography can be useful in all of the following except] specimen radiographs to define borders of masses to assess calcification routine screening None . [The nominal focal spot size of the mammography unit is 0.3. This means that the] actual focal spot size is 0.3 effective focal spot size is 0.3 both effective and actual focal spot size is 0.3 actual focal spot is smaller than 0.3 None . [In taking medical history, hormones use (both natural and artificial) are taken into account because 1. hormones cause breast cancer 2. early menarche can increase breast cancer risks 3. contraceptive use can increase breast cancer risk] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Causes of radiographic noise include 1. quantum mottle on the image 2. scattered radiation 3. film graininess] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The mammography report has an assessment finding of Breast Imaging Reporting and Data System (BIRAD) 0. This means that] the mammogram is negative there is a high probability of a benign finding additional imaging is needed the findings are suspicious None . [Which projection is used to determine if a lesion is medial or lateral to the nipple?] CC MLO TAN ML None . [The characteristic curve of two films is plotted. The curve of film A is positioned to the left of the curve of film B. 1. film A is faster than film B 2. film B is faster than film A 3. at any optical density, film A will require less exposure than film B] 1 only 2 only 2 and 3 only 1 and 3 only None . [Total filtration with a rhodium target filtration combination is] the added filtration plus the inherent filtration equal to the added filtration equal to the inherent filtration the added filtration minus the inherent filtration None . [The breast of a woman below age 35 is] not related to radiation sensitivity less sensitive to radiation less sensitive to low-dose radiation more sensitive to radiation None . [The base of the breast refers to the] the nipple area of the areola area adjacent to the chest wall axilla area of the breast lower outer quadrant of the breast None . [In routine mammography, the radiation dose per projection is generally about] 0.1–0.2 rad 1.0–2.0 rad 0.01–0.02 rad 2–3 mrad None . [Gynecomastia defines] a localized abscess increased breast tissue in the male breast decreased breast tissue in the female breast None . [The screen-cleaning test should be carried out whenever] there is an upward drift in the operating data levels there is a change in the types of chemical used there is a change in film brand or type a mammographer notices dust artifacts on the image None . [All the fluorescent tubes in the mammography view box should be replaced at the same time because] Fluorescent tubes decrease in brightness with age. Fluorescent tubes will only last about 18–24 months. They have a higher luminescence than conventional tubes. It saves time to replace them all at the same time. None . [Mammography facilities can receive certification from 1. the ACR 2. the FDA 3. an SAC state] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 only None . [If an artifact is noted on some mammographic images, which appropriate MQSA regulation will identify the dirty cassette/ image receptor quickly and easily?] processor QC test screen cleanliness visual checklist standardized image labeling None . [During magnification, positioning the breast away from the image receptor utilizes which law/principle in scatter reduction?] inverse-square law reciprocity law heel effect line focus principle None . [What principle does compression use to visualize the borders of circumscribed lesions? 1. It brings the lesion closer to the image receptor. 2. It spreads apart overlapping tissue. 3. It separates superimposed areas of glandular tissue.] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [The CC shows a circumscribed oval radiolucent lesion. There was a definite halo surrounding the lesion. It is most likely to be a] fibroadenoma lymph nodes cyst hematoma None . [A finding of BIRAD 1 on the mammogram means that the mammogram] cannot accurately evaluate the breast showed benign findings showed suspicious findings is suggestive for malignancy None . [A woman with one first-degree relative with breast cancer has a higher risk for breast cancer than a woman with 1. early menarche, taking oral contraceptives 2. a personal history of breast cancer 3. late menopause] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The large air gap used in magnification functions to 1. increase scatter 2. improve contrast 3. reduce scatter] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [A benign inflammatory condition of the lactiferous ducts leading to nipple discharge, nipple inversion, or periareolar sepsis is called] ductal ectasia Paget disease of the breast peau d’o range ductal papilloma None . [Two main disadvantages of extended processing are] decreased film speed and increased film fog increased film speed and decreased film fog increased processing artifact and increased film fog decreased processing artifact and increased film speed None . [A rolled projection can be performed to 1. remove superimposed tissues 2. separate superimposed breast tissue 3. determine the location of a finding seen only on one of the standard projection] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [In general, the optimal duration of tamoxifen treatment is] 2 years 3 years 4 years 5 years None . [Which of the following can be used with any projection with or without magnification?] spot compression XCCL AT CV None . [Which of the following is used to spread out the tissue and improve resolution on a localized area of interest?] CV AT TAN spot compression None . [Spot compression 1. applies more compression to a localized area 2. can be performed with magnification 3. employs a coned collimated field to limit the area of interest] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [A film was accidentally bent prior to loading into the mammography cassette. If this film is used in mammography screening, an artifact would appear as] a minus-density artifact a plus-density artifact static lines parallel to the direction of film travel None . [A routine series on patients with encapsulated implants could include an additional projection such as the] AT CC MLO ML None . [In the optimum position of the patient for the CC projection, the patient’s head is turned] toward the side under examination away from the side under examination depending on the preference of the mammographer to the patient’s right None . [Lumpectomy describes the process of] removing the entire breast including the nipple removal of the breast cancer tumor and surrounding margins of normal breast making a small incision over or near the site of breast lesion removing benign lumps from the breast None . [Which of the following tests are performed monthly?] phantom images repeat/reject analysis compression check visual checklist None . [Which of the following characteristics are unique to mammography cassettes?] must be easy to open should be durable generally have a single intensifying screen should have low absorption characteristics None . [Chemotherapy is a class of drugs that can be used to] stop the spread of cancer to other parts of the body block estrogen from cancer cells reduce estrogen levels in the body kill cancer cells by using high-energy radiation None . [The density difference, DD on the sensitometric strip is the difference between] the average density closest to 2.20 and the mid-density the mid-density and the base plus fog the average density closest to 0.45 and the mid-density the high and low average densities None . [What is epithelial hyperplasia?] A calcified hematoma resulting from trauma An oil cyst within the breast An overgrowth of cells in the ducts or lobules An epidermoid cyst on the skin of the breast None . [The breast extends vertically from the] first through the ninth rib second through the tenth rib second through the sixth rib third through the tenth rib None . [Identify the projection shown in Figure.] MLO CV LM ML None Comment . [In viewing phantom image, which of the following viewing conditions need not apply?] on the same view box using the same type magnifier at the same time of day using the same film emulsion batch None . [Anatomic parts with low subject contract will have] sharp difference in x-ray absorption very little difference in x-ray absorption the same x-ray absorption characteristics similar x-ray absorption characteristics None . [Who performs the compression device check for mammography QC?] physicist staff technologist radiologist mammographer None . [The low-density radiopaque lesions seen in Figure suggests a] benign fibroadenoma skin mole galectocele keratosis None Comment . [After parturition, contraction of which cells help to eject milk from the alveoli?] epithelial cells myoepithelial cells basement cells superficial cells None . [The mammogram shows an oval-shaped lesion with mixed density. The lesion has a central radiolucent area and is freely movable. This lesion is most likely to be a] fibroadenoma hematoma lymph node galactocele None . [The most common cause of under compression is] a faulty compression paddle inadequate compression by the mammographer patient pain tolerance level broken automatic compression device None . [Two film emulsions are compared on a characteristic curve. The higher contrast film will] have the steeper slope have a longer toe shift to the right of the lower contrast film shift to the left of the lower contrast film None . [Biopsy performed using a 14-gauge needle to remove tissue samples from the breast is termed] core biopsy cytology ductography aspiration None . [A grid is not necessary during magnification because] grid use decreases spatial resolution the small focal spot used will compensate for the loss of image detail the large OID produces the same effect as a grid magnification will magnify the normally invisible grid line None . [Today all mammographers (radiographer performing mammograms independently) must have 1. satisfied the interim requirements of the FDA 2. completed at least 40 contact hours of documented training in mammography 3. performed at least 25 examinations under direct supervision of a qualified mammographer] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The best time for a woman to perform a BSE is] before the start of the monthly period just after the period starts within 5–10 days after the start of the period anytime None . [A four-projection mammography series shows a solitary tumor without calcification in the upper outer quadrant (UOQ) of the left breast. Only the anterior margins are seen. The next recommended step is] biopsy spot compression stereotactic localization aspiration None . [For the daily quality control testing, the baseplus- fog level should remain within] +0.15 of the established levels +0.10 of the established levels +0.30 of the established levels +0.03 of the established levels None . [The portion of the breast that holds the milkproducing element is the] ampulla segmental duct lobule lactiferous sinus None . [An infusa-port can be used to] provide radiation therapy treatment allow repeated access to the venous system infuse radioactive tracers directly into the breast lesion infuse drugs directly into the arterial system None . [Which of the following projections would best separate superimposed 12-o’clock and 6-o’clock masses?] MLO XCCL CC AT None . [As the size of the x-ray field decreases, to maintain a constant image density the exposure will] increase decrease not change significantly decrease inversely None . [On the American College of Radiology (ACR)-approved accreditation phantom, the total number of fibers, speck groups, and masses are] five fibers, five speck groups, and five masses five fibers, six speck groups, and five masses six fibers, five speck groups, and five masses five fibers, five speck groups, and six masses None . [Identify the projection shown in Figure.] RM CV RL MLO None Comment . [In the LMO projection, the beam is directed from the] upper inner aspect to the lower outer aspect of the breast inner outer aspect to the upper outer None . [Patients who are allowed to play an active role in applying the compression are usually 1. less likely to tolerate the compression 2. more likely to tolerate the compression 3. more relaxed during the compression] 1 only 2 only 1 and 3 only 2 and 3 only None . [Over age 40, it is recommended that women have a CBE every] year 2 years 3 years 4 years None . [Ideally, breast compression is maximized when 1. accompanied by a thorough explanation to increase patient cooperation 2. the exposure is made on arrested inspiration to reduce motion 3. the patient recognizes the advantage of compression in reducing radiation dose] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Malignant casting-type calcifications appear on the mammogram as] granulated sugar or crushed stone calcifications eggshell-like calcifications elongated, branching, and needlelike calcifications fragmented, linear branching calcifications None . [Causes of poor subject contrast include all of the following except] inadequate exposure lower kVp inadequate compression failure to use a grid None . [Positron emission tomography (PET) imaging is useful in staging tumors because] the positron emitting isotopes are radioactive PET imaging can display an image of the tumor bed the positron emitting isotopes destroy the tumor bed PET imaging tracks the increased blood flow from the cancerous tumor None . [A patient with pectus excavatum may present a positioning problem because the patient has] extensive pectoral muscle barrel chest kyphosis depressed sternum None . [Which of the following will affect the ratio of glandular tissue to total breast tissue? 1. the woman’s genetic predisposition 2. ratio of total body adipose tissue to total body weight 3. drastic weight gain or weight loss] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [A facility has a sign posted advising patients to contact a designated person within the organization with comments. This facility is meeting the U.S. Food and Drug Administration (FDA)’s] medical outcome audit program record-keeping program patient communication of results program customer complaint program None . [In the CC projection, a technique especially useful in maximizing the amount of lateral breast tissue imaged on the small-breasted patient with rounded shoulders is] 5-degree lateral tube angulation 5-degree medial angulation using a straight tube the ML projection None . [The normal breast may have] 0–5 lobes 15–20 lobes 30–40 lobes 340–350 lobes None . [In addition to the routine series, many postmastectomy patients will also need a] CC MLO ML CV None . [What is the best placement for the needle wire during needle localization?] The needle wire should pass immediately below the lesion. The needle wire should pass immediately above the lesion. The needle wire should pass through the lesion. The needle wire should pass immediately beside the lesion. None . [The functional milk-producing units of the breast are contained within the] lactiferous sinuses lobules ampulla areola None . [Seventy-seven percent of breast cancers are discovered in women in which age group?] age 30 or below above age 50 between ages 30 and 40 above age 20 but below age 30 None . [A beryllium (Be) window enhances contrast by] increasing the output of the x-ray tube reducing production of scattered radiation transmitting more low-energy photons transmitting more high-energy photons None . [Calcifications seen on the mammogram are suspected to be in the skin. The best projection necessary to prove this theory is the] LMO TAN LM AT None . [Which of the following projections could be used to replace the MLO in patients where the MLO is not possible?] ML lateromedial (LM) rolled lateral (RL) AT None . [Selection of rhodium anode/filter combination for a fatty breast 1. overpenetrates the fatty breast 2. alters the penetrating power of the beam 3. results in loss of subject contrast] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [The chest wall edge of the compression paddle should be aligned just beyond the chest wall edge of the IR to] avoid pushing the patient’s chest away and losing breast tissue properly position and compress the breast permit uniform exposure and reduce patient discomfort avoid projecting the chest wall edge of the paddle on the mammogram None . [In addition to the patient’s name, all mammographic reports should have the 1. final assessment of findings 2. hospital number or additional patient identifier 3. name of the radiologist] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [Which of the following statements is (are) true? 1. Compression increases image sharpness by reducing the focal spot size. 2. Compression increases subject contrast by reducing the thickness of the penetrated tissue. 3. Compression increases the uniformity of the image-making diagnosis easier.] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [An MQSA certificate is issued when a mammography facility has been accredited. This certification is valued for] 1 year 2 years 3 years 4 years None . [A cyst aspiration can only be performed] under ultrasound guidance using mammographic imaging using MRI guidance none of the above None . [Magnification can be used to assess the] margins of a lesion size of a lesion location of a lesion density of a lesion None . [The circular mixed-density lesions seen in Figure suggests a] calcified microhematomas galactocele, calcified malignant calcification epidermoid cyst None Comment . [When visually inspecting the breast, the changes that should be recorded include 1. changes in size and shape 2. changes in texture or color 3. indentations] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [A dimpled skin condition seen in cases of lymphatic edema of the breast is called] inflammatory carcinoma ductal ectasia plasma cell mastitis peau d’o range None . [An ultrasound of a lesion showed a spherical mass with smooth regular borders, anechoic interior, and acoustic enhancement. The lesion is likely to be a] fibroadenoma abscess simple cyst ductal carcinoma None . [The clinical breast examination (CBE) should be performed] at or near the time of the annual mammogram only by the radiologist monthly, preferable at the same time of the month at least twice a year None . [In imaging the augmented breast in the CC position, using the modified implant displaced technique, the breast tissue is pulled/pushed] anteriorly posteriorly inferiorly superiorly None . [Typically, grid ratios in mammography range from] 7:1 to 8:1 6:1 to 7:1 4:1 to 6:1 3:1 to 5:1 None . [Most AEC circuitry in modern mammographic imaging has at least three detectors. Three or more detectors are recommended because] Multiple detectors allow for maximum variations in breast size and tissue density. AEC detectors eliminate the guesswork in determining the proper exposure factor for each patient. Detectors have the ability to terminate the exposure by back-up timer when a maximum exposure time or maximum milliamperes (mA) per second is reached. All AEC detector systems provide consistent image densities because of the high-contrast mammography films. None . [Identify the projection shown in Figure.] MLO CV LM ML None Comment . [What target-filtration combination provides the best penetration for dense or thick breast?] molybdenum target with molybdenum filtration rhodium target with rhodium filtration tungsten target with tungsten filtration molybdenum target with appropriate K-edge filtration None . [Approximately how much contrast agent is injected into the breast during ductography?] 1–5 cc 15–25 cc 30–40 cc 50–100 cc None . [At higher magnification factors there is 1. higher skin dose 2. increased scatter 3. decrease source-to-object distance (SOD)] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [All of the following are characteristics of double emulsion film/screens combination. Which characteristic makes these systems undesirable in mammography use?] They are less susceptible to imaging dust and dirt than the single emulsion systems. They do not require extended processing times to develop optimum contrast and speed. The screens are very efficient at converting x-ray energy to visible or ultraviolet light. The system has a lower spatial resolution than the single emulsion systems. None . [The retromammary space describes the area] between the breast and pectoral muscle separating the skin of the breast from the deep fascia separating the skin from the superficial fascia between the glandular tissue and the inframammary fold None . [Which procedure is performed to obtain cellular material from a suspicious area for cytological analysis?] Ductography Needle localization Pneumocystogram Fine needle aspiration (FNA) None . [Under what circumstances are triangulation techniques necessary? 1. to locate an abnormality visualized on one projection only 2. during sterostatic breast biopsy 3. to perform spot magnification] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [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] prevents the posterior and axillary fat from overlapping the body of the breast allows uniform compression of the posterior breast tissue helps to increase structural strength of the compression paddle ensures greater compression of the anterior breast tissue None . [A small but growing cancer is often not obvious to the individual because it often presents as] skin irritation inverted nipples a painless mass a painful mass None . [All women above the age _______ should perform a BSE regularly.] 20 30 40 50 None . [During a mammogram, which of the following will affect the average glandular dose per breast? 1. degree of breast compression 2. the half-value layer (HVL) of the x-ray beam 3. breast size and composition] 1 only 2 only 3 only 1, 2, and 3 None . [Ductal papilloma is] a benign proliferation of tissue in the male breast a malignant tumor involving the ducts a collection of blood in the breast, which can occur after surgery benign growths involving the milk ducts None . [Immediately behind the nipple, the connecting duct widens to form the] lactiferous sinus ampulla acinus TDLU segmental duct None . [Men with a family history of breast cancer will] have a greater risk for breast cancer have a minor risk for breast cancer have no significantly increased risk for breast cancer always get breast cancer None . [Which alternative projection could be used, in addition to the CC, in imaging a patient with a prominent pacemaker?] ML lateromedial oblique (LMO) XCCL MLO None . [One major difference between collimation in mammography and collimation in general radiography is that] in mammography the entire image receptor area is exposed decreasing collimation increases exposure in mammography mammography uses a variety of beam limiting devices in radiography the entire image receptor area is always exposed None . [Magnification is contraindicated 1. when imaging the mastectomy site 2. in specimen radiography 3. as a normal/routine screening tool] 1 only 3 only 2 and 3 only 1 and 3 only None . [The basic premise of a medical audit is that 1. all positive mammograms should be followed 2. the pathology results of all biopsies performed should be collected 3. all pathology results should be correlated with the radiologist’s findings] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Magnification is beneficial in all of the following situations except] imaging the surgical site of a patient with a lumpectomy imaging a specimen radiograph evaluating microcalcifications in a lesion routine imaging None . [Characteristics of a malignant stellate tumor include which of the following? 1. The spicules are generally bunched together. 2. The presence of a central tumor mass. 3. The larger the tumor, the longer the spicules.] 1 only 1 and 2 only 2 and 3 only 1 and 3 only None . [The structure that gives the breast its support and shape is called] Montgomery ligament Cooper ligament fibroglandular tissue fatty tissue None . [Which projection could be used to demonstrate a deep medial lesion not seen on the CC?] axillary tail (AT) XCCL CV MLO None . [In the test for screen contact there were multiple points of small areas (<1 cm in diameter) of poor contact. The corrective action is to] replace the cassettes; this result is not acceptable repeat the test return the cassette to clinical use clean the screens, wait 15 minutes, then repeat the test None . [The inframammary crease is located at approximately the level of the] second to third rib third to fourth rib fourth to fifth rib sixth to seventh rib None . [The posterior nipple line (PNL), visualized on the ML, should be within how many centimeters of the PNL on the CC?] 0.25 0.50 1.00 1.50 None . [Optical densities less than 1.0 in the dense glandular tissue of the breast is considered a/an] underexposure overexposure normal exposure above average but not overexposure None . [In the tangential (TAN) projection, any tube angulation will depend on] the size of the patient’s breast the location of the abnormality the location of the nipple in relation to the abnormality whether the abnormality is palpable or nonpalpable None . [What projection/position is shown in Figure?] CC MLO CV XCCL None Comment . [Which projection is used to give a profile image of the area in question without superimposition of breast tissue?] CV TAN LMO AT None . [To reduce the possibility of imaging the abdomen in the MLO position, the mammographer could] have the patient stand just at the image receptor and bend back have the patient stand away from the image receptor and bend forward have the patient turn medially to image the lateral breast on the CC discard the MLO and image the breast in the lateral position instead None . [Erythema of the breast generally indicates] inflammatory breast cancer breast abscess breast infections further testing of the breast is necessary None . [A galactocele] is always radiolucent is usually associated with trauma is associated with nursing usually has irregular borders None . [The Mammography Quality Standards Act (MQSA) mandates that the average glandular dose received per projection/position during routine screen-film mammography cannot exceed] 100 mrad 200 mrad 300 mrad 400 mrad None . [In positioning for the superior-inferior oblique (SIO), the _________ of the breast will rest on the image receptor.] lateral surface superior surface medial surface inferior aspect None . [Contrast resolution in conventional imaging refers to the ability to] image high-contrast small objects such as microcalcifications distinguish anatomic structures with similar subject contrast visualize recorded detail when image contrast and optical density are optimized visualize recorded detail None . [A control film crossover should be carried out] whenever the processing chemistry is changed when a new box of film is opened if a new processor is installed if the control limits consistently exceed the normal values None . [Which projection best shows the extreme medial aspect of the breast?] CC MLO ML CV None . [After a routine four-projection mammographic series, the nipple is not seen in profile on any of the images. Additional projections are done if 1. the nipple is indistinguishable from a mass 2. a subareolar abnormality is suspected 3. the nipple is not marked with a BB (lead shot)] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The primary purpose of the grid in mammography is to] improve image sharpness reduce the production of scatter reduce patient dose increase the subject contrast None . [The from below (FB) projection utilizes a beam directed] perpendicular to the image receptor horizontally tangentially parallel to the image receptor None . [The last degree of compression should be applied] using manual compression after the breast is released from compression with the automatic compression device with the mammographer’s hand between the breast and the compression paddle None . [Of these four, which would best demonstrate microcalcifications within the breast?] ultrasound spot compression spot magnification TAN projection None . [A benign self-limiting breast tumor that is the result of new disorganized cell growth] sarcoma radial scar invasive lobular carcinoma hamartoma None . [Variation in compression levels causes 1. inadequate exposure on one portion of the breast 2. over- or underexposure in other portions of the breast 3. adequate exposure throughout the breast] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 only None . [A radiopaque implant used in breast reconstruction that easily adjusts for cup size after placement is the] silicone gel implant transverse rectus abdominis muscle (TRAM) flap implant silicone liquid implant saline implant None . [In the CC projection of the breast, the IR is positioned] at the level of the raised inframammary crease below the level of the raised inframammary crease at the level of the inframammary crease just below the level of the inframammary crease None . [During pregnancy and lactation, the breast] shows increased density increases in fatty content atrophy of glandular structures shows decreased density None . [MRI could be used 1. as a primary breast cancer detection tool 2. to image patients with breast implants to evaluate ruptures 3. to determine tumor margins and the extent of tumor spread] 1 only 1 and 2 only 2 and 3 only 1 and 3 only None . [The operating level density difference (DD) for the phantom should be at least] 0.40 0.80 0.02 1.20 None . [One box of film should be dedicated to processing QC because] it is easier to track the repeat rate multiple boxes introduce multiple variables overall film density may cause fogging films need consistent handling None . [Medical history is important in 1. assessing risk factors for breast cancer 2. preventing breast cancer 3. evaluating treatment options] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The purpose of the certification and accreditation process is to] provide legal mammography services establish minimum national quality standards for mammography ensure that all women have access to certified mammography facility authorize certain states to certify mammography facilities and conduct inspections None . [Which of the following are methods used in BSE? 1. using the pads of the three middle fingers to palpate the entire breast 2. palpating around the breast in a vertical pattern 3. using up varying degrees of pressure while palpation of the breast] 1 only 1 and 2 only 1 and 3 only 1, 2, and 3 None . [Daily processing control can involve all of the following except] cleaning the processor feed tray using the sensitometer to measure the densities on the strip recording the temperature of the developer tank mixing the chemicals None . [In general, greater magnification will require the use of a] larger focal spot size smaller OID smaller focal spot larger SID None . [A patient began taking synthetic hormones 6 months prior to her current mammogram. The mammogram is most likely to] be unchanged from the previous year show increased glandular tissue compared to her previous mammogram show decreased glandular tissue compared to her previous mammogram show increased fatty tissue compared to her previous mammogram None . [When imaging the breast using the MLO projection, drooping breast can be a result of which of the following? 1. too much compression of the anterior breast 2. too little compression of the anterior breast 3. too much axilla included in the compression field] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Skin thickening can be malignant but could also be caused by 1. a breast abscess 2. a calcified fibroadenoma 3. postradiation] 1 only 2 only 1 and 2 only 1 and 3 only None . [The intensity of the x-ray beam from the cathode side of the tube is generally higher because] Soft characteristic radiation emerges from the anode side. The cathode side is directed to the thickest part of the breast. The heel effect causes variation in the intensity of the x-ray beam. The heel effect increases the intensity of the beam at the anode side. None . [A lesion is present on the MLO but is not seen on the CC projection. What projection could best be used to determine whether the lesion is laterally or medially located?] XCCL CV ML AX None . [Which of the following mammographic quality control tests is performed monthly?] phantom images visual checklist repeat analysis screen cleanliness None . [Your patient’s sister had breast cancer. Your patient is considered to have] a greater risk for breast cancer a lower risk for breast cancer no significantly increased risk for breast cancer None . [A magnification image of breast shows several oval-shaped radiolucent lesions with eggshell-like calcifications. These are most likely to be] ductal papilloma fibroadenomas oil cysts hematomas None . [Increasing the kVp by two points will] force a doubling of exposure time reduce the exposure time by half have no effect on the exposure time increase the subject contrast None . [The patient’s medical history and documentation will 1. provide the radiologist with information on the patient’s risk factors for breast cancer 2. give the radiologist information about general symptoms of breast cancer 3. provide information about possible benign breast conditions of the patient] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Your patient has had recent chest surgery and has a scarred and painful area running along the sternum. With the medial aspect of the breast immobile, which of the following is an alternative to the RMLO?] RLMO LMLO LLM RML None . [Most of the glandular tissue is arranged in the breast around the] medial and upper inner quadrants lateral and lower inner quadrants central and upper outer quadrants medial and upper outer quadrants None . [Lymph drainage from the medial half of the breast is generally directed to the] internal mammary lymph nodes external mammary lymph nodes axillary lymph nodes axilla None . [A palpable mass that is not seen on a diagnostic mammogram generally means] breast cancer is ruled out; the mass is probably benign other diagnostic testing must be considered the mass is likely breast cancer the mass is likely caused by fluctuating hormones None . [With calcifications, magnification can be used to assess 1. the number 2. morphology 3. distribution] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [The type of x-rays created from displacement of K-shell-binding electrons in the molybdenum atom are called] coherent scattering characteristic radiation Compton effect bremsstrahlung radiation None . [Visual inspection done during CBE involves] feeling for changes in the breast looking for changes in the breast palpating the breast examining areas under the armpit None . [If no previous mammograms are available for comparison, the automatic exposure control (AEC) detector should be placed] in the central aspect of the compressed area of the breast as close to the chest wall as possible toward the medial aspect of the breast anywhere—placement will not affect the exposure None . [One of the two reasons towels are used in the compression test is to] protect the cassette holder ensure that the compression is adequate force slower application of compression simulate 4 cm of compressed breast None . [Which of the following biopsy techniques is most accurate?] FNB open surgical biopsy core biopsy MRI core biopsy None . [Proper compression of the breast is indicated when the] patient is in pain compression paddle stops breast is taut breast feels soft None . [If a cyst moves down on the ML from its position on the MLO, the cyst is located] centrally medially laterally at the areola None . [The implant-displaced (ID) projection is possible on all of the following cases except] implants placed posterior to the pectoral muscle implants placed anterior to the pectoral muscle soft implants encapsulated implants None . [Since 1989, the death rate from breast cancer has declined because] more cancers are discovered at a later stage more cancers are discovered at an earlier stage the long-term survival rate for breast cancer patients is stable patients who survive 5 years will survive an additional 10 years None . [Increasing the kVp will influence the 1. optical density on the image 2. penetrating power of the beam 3. subject contrast and exposure latitude] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Which technique accurately describes how the breast is rolled for the RM?] The superior surface is rolled medially and the inferior surface does not move. The superior surface is rolled laterally and the inferior surface is rolled medially. The inferior surface is rolled medially and the superior surface does not move. The inferior surface is rolled laterally and the superior surface is rolled medially. None . [In imaging the phantom, the technical factors used should be the same as those used clinically for a ______ -cm-thick breast of medium glandularity.] 6.0–6.5 5.0–5.5 4.0–4.5 3.0–3.5 None . [Identify the projection in Figure.] TAN FB XCCL ML None Comment . [The characteristic curve, obtained by plotting density values from a sensitometer, can be used to assess all of the following except] to compare two different types of films to compare the same film under different processing conditions to compare the x-ray beam quality with different films to monitor the daily processing conditions None . [Which factors cause increased skin dose in magnification? 1. larger OID 2. smaller focal spot size 3. increased mAs] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Stereotactic breast localization is used to] obtain two-dimensional information on palpable breast lesions calculate the vertical position of nonpalpable lesions obtain a three-dimensional image of the breast calculate the horizontal, vertical, and depth position of nonpalpable lesions None . [A mammographer using a 0.1-mm focal spot size is most likely performing] routine mammography work magnification imaging spot compression imaging stereotactic work None . [When positioning for the right CC, where is the patient’s left arm placed?] Brought back. This action rotates the shoulder to remove it from the imaging area. Brought forward. The patient can hold the handle bar of the unit. Brought forward. The patient can hold the IR. Remains at the patient’s side. None . [Good compression results in 1. increased spatial resolution 2. decreased spatial resolution 3. improved subject contrast] 2 only 3 only 1 and 3 only 2 and 3 only None . [In imaging the breast in the MLO projection, compression to the lower portion of the breast is compromised if 1. the image receptor is too high 2. the patient has a protruding abdomen 3. too much axilla and shoulder are under compression] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [The ACS recommends that 1. All women should have a screening mammogram every year. 2. Women above 40 should have a screening mammogram every year. 3. New masses or lumps in the breast should be checked by a health-care provider.] 1 only 2 only 1 and 3 only 2 and 3 only None . [Preoperative localization will 1. direct the surgeon to the area requiring biopsy 2. help the surgeon to excise a smaller specimen 3. ensure that the correct area was removed] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [If the humidity in the dark room drops lower than 30%, the result is] an increase in base fog film scratches static patterns on film reduced film speed None . [In ultrasound, the term acoustic enhancement refers to] a structure without internal echoes a structure with internal echoes the amount of sound passing through a structure few echoes within a structure None . [Cooper ligaments attach anteriorly to the] deep fascia of the lobes fascia of the skin posterior surface of the breast connective and supporting stroma None . [The right craniocaudal (RCC) of the routine imaging series showed a small, irregular shaped lesion at the edge of the image plus scattered calcifications including calcification clusters (Figure). The next immediate step would be1. spot compression including magnification2. additional imaging to include the margins of the lesion3. ultrasound] 1 and 2 only 2 and 3 only 1 and 3 only None Comment . [If the backup time stops a breast exposure, the mammographer can repeat the radiograph using a] higher kVp setting greater density compensation higher mAs setting different AEC setting None . [In positioning for the CC projection, if the Carm of the mammography unit is raised too high the IMF is overelevated, resulting in loss of 1. superior breast tissue 2. inferior breast tissue 3. posterior breast tissue] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [In positioning for the MLO, the tube is always angled] 90 degree 60 degree 50 degree none of the above None . [A hamartoma is] a malignant tumor of the breast a benign tumor of the breast associated with trauma of the breast associated with nursing None . [The Mammography Quality Standards Act (MQSA) requires that the maximum compression for the initial power drive not exceed] 100 newtons 200 newtons 400 newtons 500 newtons None . [Which age group is likely to get the most radiation dose from a mammogram?] between 20 and 35 between 40 and 50 between 55 and 60 above 70 None . [Medical history may include questions on hormone use because] synthetic hormones such as hormone replacement therapy (HRT) will always cause breast cancer reproductive hormones are a factor in breast cancer risks family history of hormone use predisposes a woman to cancer personal history of hormone use decreases a woman’s risk for breast cancer None . [The two main classifications of breast cancer are 1. ductal 2. lobular 3. medullary] 1 only 2 only 1 and 2 only 1 and 3 only None . [The developer temperature should always be] 95°C 95°F ±0.5°F (±0.3°C) of the manufacturer’s recommendation ±5.0°F (±3.0°C) of the manufacturer’s recommendation None . [The breast can be imaged in the FB projection 1. to improve visualization of lesions in uppermost aspect of breast by reducing object-to-image receptor distance (OID) 2. during needle localization to provide a shorter route to inferior lesions 3. to maximize the amount of tissue visualized in patients with kyphosis] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The use of low kVp and high mAs will serve to] reduce radiographic noise and increase subject contrast reduce subject contrast and reduce radiographic noise increase radiographic noise and reduce subject contrast increase subject contrast and increase radiographic noise None . [If the nipple is not imaged in profile on the four projection series, indications to take additional projections with the nipple in profile include 1. the nipple cannot be differentiated from a mass 2. the patient has a possible retroareolar mass 3. the patient is male] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [Digital images can be viewed on a computer monitor or printed using] dry laser technology single emulsion mammography film single emulsion laser film double emulsion film, sensitive to the red-light spectrum emitted by lasers None . [Which projection gives a mirror image of the MLO?] ML LM LMO AT None . [For the SIO projection, the central ray (CR) is directed] inferolateral to superomedial superomedial to inferolateral inferomedial to superolateral superolateral to inferomedial None . [Compression reduces radiation to the breast by] providing a uniform breast thickness decreasing breast thickness decreasing motion unsharpness separating superimposed areas of glandular None . [Radiation changes that the breast may exhibit include 1. erythema 2. edema 3. hardening] 1 and 2 2 and 3 1 and 3 1, 2, and 3 None . [Which projection is best used to visualize the tail of the breast?] LMO TAN LM AT None . [The lesion seen in Figure is not palpable and is not associated with nipple or skin changes. It is likely to be] invasive ductal breast carcinoma a mammographically malignant tumor a mammographically benign tumor nonspecific; further testing is indicated None Comment . [Which statement best describes a parallel or linear grid?] Lead strips are aligned adjacent to one another and placed lengthwise in the same direction within the structure of the grid. Lead strips are aligned at right angles to each other. Lead strips are designed to take advantage of the divergence of the x-ray beam as it leaves the x-ray tube. Lead strips are designed to move during the exposure. None . [Manual technique is sometimes necessary when imaging implants because] the implant covers the AEC detector patients with implants have small breasts patients with implants have large breasts the implant does not cover the AEC detector None . [Antiestrogen drugs such as tamoxifen can be used to 1. slow or stop the cancer’s growth 2. prevent breast cancer in high-risk women 3. prevent the recurrence of breast cancer] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [The major difference between the general radiography grid and the grid used in mammography is that the] grid used in general radiography causes an increase in exposure grids used in general radiography have higher ratios use of a grid in mammography increases patient dose grids in mammography improve the radiographic image contrast None . [Women with lumpectomy should have magnified images taken of the tumor bed to 1. confirm the removal of the cancer 2. check calcium deposits that may result from radiation and surgical changes 3. check for recurrence of the cancer] 1 and 2 2 and 3 1 and 3 1, 2, and 3 None . [Rhodium is not used as the primary anode material when imaging thinner breast because] rhodium has an emission spectrum similarto tungsten the higher energy of the rhodium beam is unsuitable for thinner breast the lower energy of the rhodium beam is unsuitable for thinner breast rhodium anodes are more expensive None . [Ideally, in an open surgical biopsy, when should a breast tissue specimen be imaged?] immediately after surgery within 24 hours of the surgery while the patient is still in the recovery room before the surgery is terminated None . [Factors that lower breast cancer risk include 1. having your first child after age 30 2. breast-feeding your child 3. late menarche] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Which of the following is used as a treatment for estrogen-dependent tumors in post- and premenopausal women?] radiation therapy chemotherapy tamoxifen antibody therapy None . [A thin supportive layer located between the basal surface of the epithelium and the connective tissue layer of the lobule is called] chief cells myoepithelial basement membrane superficial A cells None . [X-ray photons leaving the breast enter the top of the cassette/image receptor 1. to go through the intensifying screen before reaching the film 2. then go through the film before reaching the intensifying screen 3. interact with the single intensifying screen of the cassette/image receptor] 1 and 2 2 and 3 1 and 3 1, 2, and 3 None . [Hormone replacement therapy could be recommended to? 1. relieve insomnia symptoms 2. prevent osteoporosis 3. reduce weight gain] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [Which of the following are considered agencies granting accreditation under the FDA regulation? 1. ACR 2. ARRT 3. NY State Department of Health] 1 only 2 only 1 and 2 only 2 and 3 only None . [The same mammographer should view the phantom images because] subjective judgment about images is always difficult it is not wise to have different individuals handling the phantom not all mammographers know the MQSA regulations given set values, different mammographers will calculate the densities differently None . [The craniocaudad mammograms of the same woman prior to menopause and 1 year after the onset of menopause are compared. The woman has never taken synthetic hormones. What is the most likely difference?] The mammogram taken prior to menopause shows signs of atrophy. The mammogram taken after the onset of menopause shows signs of atrophy. There will be little or no change in the glandularity of the breast. The mammogram taken after menopause will show increased glandularity. None . [How many projections are routinely required to image a patient with implant augmented breasts?] 5 6 7 8 None . [The calcifications seen in Figure have the typical appearance of] mammographically malignant-type calcifications mammographically benign-type None Comment . [A highly recommended labeling that is not required by the MQSA is] technologist/mammographer identification date stickers technical factors flash card identification system None . [In mammography, the AEC detector is placed directly] above the image receptor below the grid above the grid below the image receptor None . [A health-care provider should evaluate which of the following breast changes? 1. lumps or swellings 2. skin irritation or dimpling 3. milky discharge from the nipple] 1 only 1 and 2 only 2 and 3 only 1, 2, and 3 None . [Collimation should not extend beyond any edge of the image receptor by more than] 1% of the SID 2% of the SID 3% of the SID 4% of the SID None . [Increased OID causes loss of image detail in magnification mammography. What factors help to compensate for this loss of image detail? 1. compression of the part 2. decreased focal spot size 3. increased OID] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Identify the projection in Figure.] TAN FB XCCL RM None Comment . [A CBE should be performed every 1. year after age 40 2. 3 years between ages 20 and 39 3. month after age 50] 1 only 2 only 1 and 2 only 2 and 3 only None . [The repeat rate should be analyzed if the rate changes from the previous measure rate by more than] ±2% ±3% ±4% ±5% None . [Which of the following involves the use of a thin needle to remove cell samples from a suspected cancerous lesion in the breast for cytological analysis?] core biopsy excisional biopsy needle localization fine needle aspiration (FNA) None . [Adequate “air bleed time” refers to the] elapsed time between film loading and exposure time taken to release air from the processor drain tank time taken to remove air from the water tank time taken to empty or bleed the processor chemistry None . [In imaging the breast for the CC projection, what technique is used to minimize skin folds in the lateral aspect of the breast?] lift the posterior lateral aspect of the breast onto the image receptor drape the contralateral breast over the corners of the image receptor have the patient’s head turned away from the breast being imaged on the side being imaged, the patient’s None . [Identify the projection in Figure.] rolled medial (RM) mediolateral (ML) XCCL mediolateral oblique (MLO) None Comment . [The circular pigmented area around the nipple is called the] skin areola Montgomery gland ampulla None . [In which of the following modified projection is the superior surface of the breast rolled medially?] RM RL M lateral medial (LM) None . [Figures A and B are mammograms of the same patient. Figure B was taken 6 months after Figure A. These mammograms demonstrate a] resolving oil cyst galactocele radial scar hematoma None Comment . [In conventional imaging, the leading cause of false-negative mammograms in dense breast tissue is] motion overexposure underexposure grid lines None . [In quality control (QC), if the data consistently exceed the operating level the recommendation is] establish new operating limits narrow the control limits widen the control limits improve QC procedures None . [If too much upper axilla and shoulder are under the compression paddle when imaging for the MLO, the effect is to] inhibit proper compression of the upper breast inhibit proper compression of the lower breast ensure equal compression of the upper and lower breast ensure proper compression of the lower breast None . [Question content The material used for the exit port of the mammography tube is necessary because] The intensity of the beam is less on the anode side than on the cathode side. Regular glass would harden the emerging beam. The intensity of the beam is more on the anode side than the cathode side. Regular glass would soften the emerging beam. None . [A keratosis is demonstrated mammographically as a] sharply outlined multilobulated lesion sharply outlined lesion with a halo mixed-density circular lesion with a radiolucent center mixed-density oval lesion None . [In positioning terminology, CV means] compressed position Cleopatra view cleavage view compression view None . [The MLO projection demonstrates a large encapsulated lesion occupying almost the entire breast. The contour is sharp and the lesion is radiolucent. This lesion is most likely to be a(an)] oil cyst hematoma fibroadenoma lipoma None . [The importance of BSE and a CBE is stressed because 1. both will detect benign breast diseases, which are very common 2. both will help in the detection of malignant breast conditions 3. a mammogram is not 100% effective] 1 only 2 only 2 and 3 only 1 and 3 only None . [The grid ratio can vary in modern mammography units. A common grid ratio used is] 8:1 6:1 4:1 2:1 None . [What does the actual focal spot size measure?] the area on the anode exposed to electrons the area projected on the patient the area projected on the image receptor the nominal focal spot size None . [Manual compression in mammography] must be between 25 and 45 lb depends solely on breast size depends on breast size and the patient’s pain tolerance generally depends on the patient’s pain tolerance None . [In which of the following are breast cysts more common? 1. young women in their early 20s 2. premenopausal woman 3. postmenopausal woman on estrogen therapy] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [After a four-projection mammogram, calcifications are visualized superior to the nipple but only on the MLO projection. What additional projection would best be used to locate the position of the lesion?] exaggerated craniocaudal (XCCL) cleavage (CV) ML AT None . [For the daily processor QC, the mid-density should remain within] ±0.15 of the established levels ±0.10 of the established levels +0.30 of the established levels +0.03 of the established levels None . [Ductography can be used to determine 1. the location of the lesions in the ducts 2. if a lesion is benign or malignant 3. changes or abnormalities associated with the ducts] 1 only 1 and 2 only 1 and 3 only 2 and 3 only None . [The image viewing environment 1. has no effect on the detection of cancerous lesions 2. can obliterate the advantages of optimum image quality 3. should eliminate extraneous viewbox light] 1 and 2 only 1 and 3 only 2 and 3 only 1, 2, and 3 None . [A technique describing reshaping of the breast is called] reduction mammoplasty mammoplasty breast augmentation breast biopsy None . [Which projection is used to prove breast calcifications are benign (teacup type)?] CC XCCL FB ML None . [The AT projection best demonstrates the] subareolar area medial aspect of the breast axillary aspect of the breast lower inner quadrant of the breast None . [The criteria for a properly positioned MLO includes 1. a concave pectoral muscle on the anterior border 2. fat visualized posterior to the fibroglandular tissues 3. an open inframammary fold (IMF)] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [In the RS position, the surface __________ the IR is rolled _______.] furthest from/inferiorly closest to/superiorly furthest from/superiorly closest to/inferiorly None . [In digital mammography, both the film and cassette can be replaced by] a detector and electronic system the CAD technology system a flexible storage phosphor photostimulable plates None . [Typically, a patient with dense fibrous and glandular tissue throughout the entire breast on a baseline mammogram is] age 20 or younger between age 50 and 60 above 70 below 45 None . [Failure of the hyporetention test will result in what type of long-term artifact marks on the image?] streaks of increased optical density areas of reduced density yellow brown stains round spots of increased density None . [A patient is to have a routine baseline mammogram, but it is determined that the woman is lactating. What should be done and why?] Lactating breasts are extremely sensitive to compression; the mammogram should be postponed. The mammogram should be done; radiation has no effect on lactation. Although lactating breasts are extremely dense, the mammogram should not be rescheduled. Lactation causes increased glandularity; the mammogram should be postponed. None . [In mammography imaging, exposure factors used depends on all of the following except] the patient target material screen/film combination viewing conditions None . [Daily processor control is used to 1. determine the film speed 2. check the film contrast 3. check the stability of the processor] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Which is true for all tangential (TAN) projection positioning?] The patient is always in the CC position. The central ray is always directed vertically. The central ray is always parallel to the plane of the breast. The central ray is always perpendicular to the skin surface. None . [Symptoms of benign breast disease not seen mammographically can include 1. nipple discharge 2. skin thickening 3. circumscribed tumors] 1 only 3 only 2 and 3 only 1 and 3 only None . [Between ages 20 and 30 an asymptomatic woman should be having a mammogram every] year 2 years 3 years none of the above None . [If the magnification mammography is performed without using a small focal spot, the resulting image will be magnified] and blurred and sharply outlined with increased subject contrast with increased detail None . [The TDLU consists of the] mammary ducts and the extralobular terminal ducts (ETDs) intralobular terminal duct (ITD) and the segmental ducts the ETDs and the lactiferous ducts both the ETDs and the ITDs None . [In which modified projection is the superior aspect of the breast rolled medially?] RM RL M LM None . [Which of the following statements are true? 1. Breast cancer death rates in United States are going down. 2. Breast cancer is the leading cause of cancer death in women in United States. 3. The second leading cause of cancer death in women in United States is breast cancer.] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Postmenopausal obesity is associated with] a relatively high risk of developing breast cancer overall reduction in breast cancer risks circulating estrogen that is produced in fat tissue a lower overall estrogen level None . [Which projection is especially useful when analyzing calcifications?] RM M LM ML None . [Imaging males will present the same difficulty as imaging small, firm-breasted females. An added problem may be that] males have more problems with the compression the male breast is smaller than the smallest female breast males have more muscular breast tissue hair on the chest of males makes compression difficult None . [there is an upward drift in the operating data levels there is a change in the types of chemical used there is a change in film brand or type a mammographer notices dust artifacts on the image] check the developer temperature be sure the view boxes are clean clean the cassette screens with screen cleaner check the cassettes for dirt or lint None . [A patient had an ultrasound, which confirmed the presence of a cyst in the breast. The radiologist wished to rule out intracystic tumor. What additional study could be recommended?] ductography needle localization pneumocystogram FNA None . [Identify the projection in Figure.] TAN from below (FB) XCCL ML None Comment . [A procedure whereby the lactiferous duct is cannulated and a small amount of contrast agent is injected into the duct is termed] ductography needle localization pneumocystogram FNA None . [Montgomery glands are specialized] sweat glands sebaceous gland Cooper ligaments hair follicles None . [An inverted nipple] always indicates breast cancer sometimes indicates breast cancer never indicates breast cancer usually indicates breast cancer None . [A “camel’s nose” breast contour can be prevented in the MLO projection by] including all of the breast under the compression paddle angling the image receptor parallel to the pectoralis muscle properly supporting the breast during compression ensuring that the nipple remains in profile during compression None . [Breast reconstruction can involve the placement of small fluid-filled sacs behind the pectoral muscle. Two common types of such implants are] saline and flap surgery TRAM flap and silicone implant silicone or saline implants saline-filled implant and latissimus dorsi flap implant None . [Which of the following relationships does not change when moving from routine to magnification mammography?] OID focal spot size SID source-to-object distance (SOD) None . [In radiology, according to the line focus principle, the effective focal spot is] larger than the actual focal spot smaller than the actual focal spot the same as the actual focal spot decreased as the target angle increases None . [In conventional imaging, overexposure is sometimes called the recoverable error because] it can be corrected during developing high illumination and masking can overcome it magnification can overcome it the use of small focal spot sizes will reduce it None . [Mercury in a glass-type thermometer is not recommended for use in QC testing because 1. Mercury is potentially inaccurate. 2. Mercury is a potential source of contamination. 3. Glass-type thermometers may break.] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [Lack of breast compression is most likely to cause] geometric unsharpness screen unsharpness motion unsharpness parallax unsharpness None . [Which of the following patients has the greatest risk for breast cancer?] A nulliparous woman at age 40 A never married woman A woman, age 70 A woman, age 30 None . [The area of minus density in the upper part of Figure best represents] the patient’s shoulder a pressure artifact occurring after the exposure the patient’s chin None Comment . [A baseline mammogram shows that the patient’s breast consists primarily of adipose tissue. This patient is most likely to be] on hormone therapy above 60 below 20 above 35 None . [Repeated films are] films used for processor cleaning films used for quality control films that involve exposure to the patient all discarded films None . [In the low kVp range using a molybdenum target tube, what type of photon interaction predominates?] photoelectric interaction Compton interactions Bremsstrahlung interaction Coherent interaction None . [Scattered radiation is reduced during magnification mammography by] using a small focal spot size using a grid using the air-gap technique increasing the source-to-image receptor distance (SID) None . [Identify the position/projection shown in Figure.] FB XCCL ML AT None Comment . [Which of the following quality control tests does not require a densitometer?] darkroom fog screen-film contact screen cleanliness phantom images None . [Montgomery glands are located on the breasts] skin nipple areola muscle None . [Involution of the breast describes a process by which] milk is removed from the breast by suckling breast epithelium proliferates during menstruation breast epithelium decreases because of postmenopausal changes estrogen causes an overall density decrease in the breast None . [The primary goal of compression is to] reduce the OID of the lesion allow uniform penetration of structures within the breast reduce the possibility of motion during the exposure reduce the radiation dose to the breast None . [In general, ID series are taken in] AT and MLO projections CC and ML projections CC and MLO projections CC and LM projections None . [The function of the filter in mammography is to remove 1. low-energy x-rays not needed to produce the breast image 2. high-energy x-rays that cause a reduction of subject contrast 3. low-energy x-rays that increase patient dose] 1 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [In digital imaging, a graph of the density range to the log of relative exposure (the characteristic curve or Hurter and Driffield (H&D) curve used in conventional imaging) shows a] shallow sloping curve steep sloping curve linear response curve similar to conventional imaging None . [The criteria to pass the ACR Mammography Accreditation on conventional phantom imaging require a minimum of _______ masses.] two three four five None . [A woman should perform breast self examination (BSE) monthly to] become familiar with both of her breasts localize cancerous lumps recognize breast dimpling discover nipple discharge None . [If the AEC cell is placed over an area of adipose tissue on a breast with a mixture of adipose and glandular tissue, the areas of glandular tissue will be] underexposed overexposed normally exposed the AEC cell position will not affect the exposure None . [When cleaning the intensifying screens, the loaded cassette is unloaded under safelight conditions in the darkroom. The film in the cassette is] stored in the film bin during the cleaning process removed from the cassette and discarded returned to the cassette after cleaning returned to the film bin None . [The single projection that will best visualize the maximum amount of breast tissue is the] CC MLO ML XCCL None . [Figure shows a (an)] ruptured implant encapsulated implant herniated implant implant removal None Comment . [A BSE should be done regularly by 1. the radiologist 2. the patient 3. a health-care professional] 1 only 2 only 2 and 3 only 1 and 3 only None . [The phantom image background optical density should never be] more than 1.20 less than 1.20 more than 1.40 less than 1.40 None . [Which of the following hormones has the most influence on the normal physiological changes of the breast? 1. prolactin 2. estrogen 3. progesterone] 1 and 2 only 2 and 3 only 1 and 3 only 1, 2, and 3 None . [A galactocele is] a lesion associated with trauma to the breast a benign milk-filled cyst associated with eggshell-like calcification associated with a central radiolucent hilus None . [Which of the following patients is likely to be diagnosed with pathological gynecomastia?] lactating woman elderly man premenopausal woman young man None . [In mammography, selecting extremely low kVp values] reduces contrast and lowers patient dose increases contrast but increases patient dose reduces contrast but increases patient dose increases contrast and reduces patient dose None . [For the repeat analysis to be meaningful, a patient volume of at least _______ patients is needed.] 50 100 250 300 None . [Fatty tissue is generally radiolucent and will show on the mammogram as] glandular areas high-density areas low-density areas medium-density areas None . [Conventional ultrasound imaging of the breast is often used to] map the extent of a breast tumor verify that a lesion seen on the mammogram is solid or fluid filled verify the presence of microcalcifications biopsy a lesion seen only on MRI None . [The two-step method of BSE is to] look and feel for changes in the breast examine your breasts and have a regular mammogram check for lumps in the breast and keep a journal of changes in the breast examine your breasts and nipples None . [The retromammary space is filled with] supportive and connecting tissue adipose tissue fibroglandular tissue blood vessels None . [The principle of mobile versus fixed tissue is used in mammography imaging to image the maximum] medial breast on the MLO projection inferior breast on the CC projection superior breast on the MLO projection medial tissue on the CC projection None . [When imaging an extremely dense breast using AEC, the exposure sometimes terminates, resulting in an underexposed image because of the action of the] exposure timer backup timer phototimer device timer None . [Sometimes described as an oil cyst, this lesion represents an encapsulated area on the mammogram and can be caused by surgery, biopsy, trauma, or radiation therapy.] stellate lesion galactocele fat necrosis lipoma None . [An asymptomatic patient presents with an oval, lobulated tumor with unsharp margins.There is no evidence of a halo sign.] If the lesion is also radiolucent it is likely to be benign. The lesion could be malignant. All oval lesions are benign. The absence of a halo indicates malignancy. None . [Fibrous and glandular tissues are more _______ than fatty tissue and result in areas of _______ optical density on the radiograph] radiolucent/lower radiolucent/higher radiopaque/higher radiopaque/lower None . [A woman is referred to as nullipara. This means] she has never given birth to a viable offspring the woman has had only one child the woman has given birth to more than one viable offspring she carried a pregnancy past the point of viability regardless of the outcome None . [A process of removing tissue, muscle, and fat from the belly and transferring that tissue to reconstruct the breast is called] TRAM flap latissimus dorsi flap implant placement silicone implant None . [All of the following statements about magnification are true except] With magnification, patient dose increases. Magnification can be used to image specimen radiographs. Magnification can be used to assess suspicious lesions. Magnification images the entire breast with one exposure. None . Time's up
