Mammography

[What does the glandular dose measure?]

[The fatty versus fibroglandular nature of breast tissue is affected by which of the following?
1. age
2. hormone use
3. number of pregnancies]

[Identify the lactiferous sinus in Figure.]

[Which projection gives a mirror image of the MLO?]

[Identify the projection in Figure.]

[A woman should perform breast self examination (BSE) monthly to]

[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]

[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]

[The tumor seen in Figure is characteristic of]

[Visual inspection done during CBE involves]

[The mammogram of a woman age 50 who has recently started estrogen replacement therapy is likely to be]

[Which of the following is used as a treatment for estrogen-dependent tumors in post- and premenopausal women?]

[An asymptomatic patient presents with an oval, lobulated tumor with unsharp margins.There is no evidence of a halo sign.]

[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)]

[Glandular tissue is usually found in the _______ of the breast]

[In addition to the routine series, many postmastectomy patients will also need a]

[The circular pigmented area around the nipple is called the]

[With its high sensitivity, MRI is ideal as]

[A grid is not necessary during magnification because]

[The compression force should not exceed _______ on the initial power drive (automatic) mode.]

[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]

[Lymph drainage from the medial half of the breast is generally directed to the]

[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]

[Which projection is used to prove breast calcifications are benign (teacup type)?]

[A cyst aspiration can only be performed]

[In the rolled medial (RM) position, the lower surface of the breast is rolled in which direction?]

[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]

[Magnification can be used to assess the]

[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]

[Typically, a patient with dense fibrous and glandular tissue throughout the entire breast on a baseline mammogram is]

[For the SIO projection, the central ray (CR) is directed]

[Which alternative projection could be used, in addition to the CC, in imaging a patient with a prominent pacemaker?]

[In mammography, the commonly used focal spot size for routine work is]

[A patient with pectus excavatum may present a positioning problem because the patient has]

[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]

[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]

[A procedure whereby the lactiferous duct is cannulated and a small amount of contrast agent is injected into the duct is termed]

[In the optimum position of the patient for the CC projection, the patient’s head is turned]

[The normal breast may have]

[A highly recommended labeling that is not required by the MQSA is]

[In the dedicated mammography unit, the single intensifying screen is positioned in contact with the film emulsion on]

[Identify the projection shown in Figure.]

[The retromammary space is filled with]

[The air gap in magnification increases subject contrast by]

[The Mammography Quality Standards Act (MQSA) requires that the maximum compression for the initial power drive not exceed]

[Ideally, in an open surgical biopsy, when should a breast tissue specimen be imaged?]

[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]

[A major cause of radiographic noise is]

[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?]

[Which of the following characteristics are unique to mammography cassettes?]

[Compression of the breast is most effective and most comfortable when applied against the]

[In establishing processing quality control operating levels, the speed index is designated as the density]

[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?]

[The type of x-rays created from displacement of K-shell-binding electrons in the molybdenum
atom are called]

[Identify the projection in Figure.]

[A lesion located in the upper outer quadrant of the right breast is located in the]

[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]

[Why is the specimen magnified?]

[If, after examining a phantom image, the number of visualized fibers or masses has changed significantly, the next step is to]

[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?]

[One of the minor risk factors for breast cancer could include]

[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?]

[The absorbed dose in mammography is generally _______ the entrance skin exposure (ESE).]

[Identify the position/projection shown in Figure.]

[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]

[The last degree of compression should be applied]

[Increased kVp during mammography is sometimes necessary to penetrate dense fibroglandular tissue. Increased kVp, however,generally causes]

[Which of the following quality control tests does not require a densitometer?]

[The greatest disadvantage of magnification is]

[Typically, grid ratios in mammography range from]

[A galactocele is]

[Which of the following patients is likely to be diagnosed with pathological gynecomastia?]

[The specimen is compressed to]

[Rhodium is not used as the primary anode material when imaging thinner breast because]

[All the fluorescent tubes in the mammography view box should be replaced at the same time because]

[A lipoma]

[Radiation therapy is a treatment that utilizes]

[Figures A and B are mammograms of the same patient. Figure B was taken 6 months after Figure A. These mammograms demonstrate a]

[In high-contrast imaging or conventional imaging]

[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]

[In the LMO projection, the beam is directed from the]

[During pregnancy and lactation, the breast]

[The grid ratio can vary in modern mammography units. A common grid ratio used is]

[The primary purpose of the grid in mammography is to]

[Using a cassette with poor film screen contact will result in]

[Approximately how much contrast agent is injected into the breast during ductography?]

[Over age 40, it is recommended that women have a CBE every]

[Which procedure is performed to obtain cellular material from a suspicious area for cytological analysis?]

[The portion of the breast that holds the milkproducing element is the]

[A “camel’s nose” breast contour can be prevented in the MLO projection by]

[In mammography imaging, exposure factors used depends on all of the following except]

[If the backup time stops a breast exposure, the mammographer can repeat the radiograph using a]

[The posterior nipple line (PNL), visualized on the ML, should be within how many centimeters of the PNL on the CC?]

[The two main classifications of breast cancer are
1. ductal
2. lobular
3. medullary]

[Figure  indicates ?]

[Which of the following could be used when imaging extremely small breasts in the craniocaudal (CC) position?]

[A thin supportive layer located between the basal surface of the epithelium and the connective tissue layer of the lobule is called]

[When imaging a small breast, scattered radiation can be minimized by
1. increasing compression
2. reducing kVp
3. reducing field size]

[In imaging the augmented breast in the CC position, using the modified implant displaced technique, the breast tissue is pulled/pushed]

[Question content The material used for the exit port of the mammography tube is necessary because]

[In positioning terminology, CV means]

[Increasing the kVp will influence the
1. optical density on the image
2. penetrating power of the beam
3. subject contrast and exposure latitude]

[The best time for a woman to perform a BSE is]

[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.]

[An infusa-port can be used to]

[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]

[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]

[Conventional ultrasound imaging of the breast is often used to]

[Hardcopy viewing of the digital imaging describes]

[Magnification is contraindicated
1. when imaging the mastectomy site
2. in specimen radiography
3. as a normal/routine screening tool]

[Breast tissue can extend medially to the]

[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)]

[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]

[Why is the MLO preferred to the ML as a routine projection?]

[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]

[Figure shows]

[Since 1989, the death rate from breast cancer has declined because]

[Regardless of the reason, if the proper amount of compression cannot be applied which of the following must apply?]

[One box of film should be dedicated to processing QC because]

[Gynecomastia defines]

[If any breast tissue is poorly imaged or missed on the MLO projection it is likely to be]

[The use of low kVp and high mAs will serve to]

[The darkroom fog test is performed]

[Which projection could be used to demonstrate a deep medial lesion not seen on the CC?]

[For the daily quality control testing, the baseplus- fog level should remain within]

[Ductal papilloma is]

[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]

[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]

[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]

[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]

[Quantum mottle on the image is reduced by]

[According to MQSA regulations, which of the following is not required on the final mammographic image?]

[If too much upper axilla and shoulder are under the compression paddle when imaging for the MLO, the effect is to]

[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.]

[A routine series on patients with encapsulated implants could include an additional projection such as the]

[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]

[To select a 12% increase in mAs before exposure, the mammographer could]

[The circular mixed-density lesions seen in Figure suggests a]

[Proving that a darkroom fog failure is a result of safelight problems involves]

[Seventy-seven percent of breast cancers are discovered in women in which age group?]

[Which projection is used to determine if a lesion is medial or lateral to the nipple?]

[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]

[The calcification seen in Figure have the typical appearance of]

[Paget disease of the breast is a(an)]

[Increasing the kVp by two points will]

[Which factors cause increased skin dose in magnification?
1. larger OID
2. smaller focal spot size
3. increased mAs]

[One major difference between collimation in mammography and collimation in general radiography is that]

[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?]

[Identify the projection shown in Figure.]

[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]

[In digital imaging a repeat analysis test is]

[A woman taking estrogen replacement therapy may notice changes in the breast such as
1. breast enlargement
2. lumpy breast
3. cysts]

[When is imaging of the irradiated breast recommended?]

[Which of the following patients has the greatest risk for breast cancer?]

[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]

[Anatomic parts with low subject contract will have]

[All of the following are characteristics of double emulsion film/screens combination. Which characteristic makes these systems undesirable in mammography use?]

[MRI imaging involves the use of]

[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)]

[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]

[A galactocele]

[Hormone replacement therapy could be recommended to?
1. relieve insomnia symptoms
2. prevent osteoporosis
3. reduce weight gain]

[Daily processor control is used to
1. determine the film speed
2. check the film contrast
3. check the stability of the processor]

[A keratosis is demonstrated mammographically as a]

[Identify the projection in Figure.]

[Chemotherapy]

[If any of the visual checks fail, the first step is to]

[What immediate action is used to reduce motion unsharpness in mammography?]

[Between ages 20 and 39, a woman should have a CBE every]

[Delaying the processing of films will affect the
1. speed of the film
2. film contrast
3. density of the film]

[Fatty tissue is generally _______ and on the mammogram is seen as areas of _______ optical
density.]

[Your patient’s sister had breast cancer. Your patient is considered to have]

[Optical densities less than 1.0 in the dense glandular tissue of the breast is considered a/an]

[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]

[The structure that gives the breast its support and shape is called]

[To reduce the possibility of imaging the abdomen in the MLO position, the mammographer could]

[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]

[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]

[In which modified projection is the superior aspect of the breast rolled medially?]

[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]

[Radiation changes that the breast may exhibit include
1. erythema
2. edema
3. hardening]

[Identify the projection in Figure.]

[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]

[In positioning for the superior-inferior oblique (SIO), the _________ of the breast will rest on the image receptor.]

[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]

[Film fog is best demonstrated on the characteristic curve as]

[In the CC projection of the breast, the IR is positioned]

[Breast reconstruction can involve the placement of small fluid-filled sacs behind the
pectoral muscle. Two common types of such implants are]

[Medical history is important in
1. assessing risk factors for breast cancer
2. preventing breast cancer
3. evaluating treatment options]

[What effect does compression have on Compton interactions?]

[In conventional imaging, the leading cause of false-negative mammograms in dense breast tissue is]

[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 operating level density difference (DD) for the phantom should be at least]

[The 5-year survival rate for a patient with a stage 0 breast cancer is about]

[Contrast resolution in conventional imaging refers to the ability to]

[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]

[Most AEC circuitry in modern mammographic imaging has at least three detectors. Three or more detectors are recommended because]

[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 be
1. spot compression including magnification
2. additional imaging to include the margins of the lesion
3. ultrasound]

[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]

[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?]

[How many projections are routinely required to image a patient with implant augmented breasts?]

[In establishing processor quality control (QC), the high average density is generally the density closest to]

[Mammography is more accurate in]

[The from below (FB) projection utilizes a beam directed]

[A small but growing cancer is often not obvious to the individual because it often presents as]

[The lesion seen in Figure is not palpable and is not associated with nipple or skin changes. It is likely to be]

[The primary goal of compression is to]

[What is the major disadvantage of magnification?]

[The Mammography Quality Standards Act (MQSA) mandates that the average glandular dose received per projection/position during routine screen-film mammography cannot exceed]

[Cooper ligaments attach anteriorly to the]

[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]

[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]

[In imaging the breast for the CC projection, what technique is used to minimize skin folds in the lateral aspect of the breast?]

[The projection best used to demonstrate the true representation of medial breast structures in relation to the nipple is the]