Mammography

Quiz
1. Skin thickening can be malignant but could also be caused by nonmalignant factors such
as
Ans: sarcoidosis
2. A rare form of cancer that presents with swelling, warmth, or erythema and
mammographically with skin thickening describes
Ans: inflammatory carcinoma
3. The 5-year survival rate for a patient with a stage 0 breast cancer is about
Ans: 100%
4. All women above the age of _______ should perform a BSE regularly
Ans: 20
5. Morgagni tubercles are usually found
Ans: on the areola
6. 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
Ans: fat necrosis
7. A benign self-limiting breast tumor that is the result of new disorganized cell growth is
Ans: hamartoma
8. An asymptomatic patient presents with an oval, lobulated tumor with unsharp margins.
There is no evidence of a halo sign
Ans: The lesion could be malignant
9. The American College of Surgery recommends that
Ans: new masses or lumps in the breast should be checked by a health-care provider
10. A Breast Self Examination should be done regularly by
Ans: the patient
11. A woman with the greatest risk of developing breast cancer is
Ans: above age 50
12. For a menstruating woman, when is the best time of the month to perform a BSE?
Ans: when the breast is least tender
13. Computer Aided Diagnosis (CAD) is used to
Ans: analyze or preread the image
14. Lymph drainage from the medial half of the breast is generally directed to the
Ans: internal mammary lymph nodes
15. Immediately behind the nipple, there is a widened area of the collecting duct called the
Ans: lactiferous sinus
Modules
Which statement is correct?
Ans: a. The structure of the male breast is nearly identical to that of the female breast.
What happens to the breasts at menopause?
Ans: d. Declining estrogen levels at the menopause make breast tissue dehydrated and less
Elastic
What cyclical changes happen to the breasts during the menstrual cycle?
Ans: c. Changes in breast texture.
What is the first visible sign of breast development?
Ans: c. The breast becomes rounded and only the nipple is raised.
It is describe as the first breastfed receive by baby.
Ans: b. Colostrum
What happens during perimenopause?
Ans: b. Estrogen levels dramatically decrease. This leads to many of the symptoms commonly
linked to menopause.
What symptoms experience by women taking hormone during peri menopause?
Ans: c. on and off menstrual bleeding.
It is the time in woman's life when her period stops.
Ans: c. Menopause.
Describes the secretion of milk from the mammary glans and the period of time the mother
lactates to feed her young.
Ans: a. Lactation.
It is a period of time after a woman has not bled for an entire year.
Ans: c. Post menopause
What is the code for, Malignant tumor 10 o’clock, right breast?
Ans: a. C504, superior lateral.
What is the code for, Metastatic tumor, 4 o’clock , left breast?
Ans: b. C505, inferior outer lower lateral
Which of the following statement is correct?
Ans: c. BI-RADS 2: benign, 0% probability of malignancy
d. BI-RADS 3: probably benign, <2% probability of malignancy short interval follow-up
suggested
Which of the following statement is correct?
Ans: a. BI-RADS 0: incomplete, need additional imaging evaluation (additional mammographic
views or ultrasound) and/or for mammography, obtaining previous images not available at the
time of reading
b. BI-RADS 1: positive, symmetrical and no masses, architectural distortion, or suspicious
calcifications
c. BI-RADS 2: benign, 0% probability of malignancy
Which of the following statement is correct?
Ans: b. BI-RADS 1: negative, symmetrical and no masses, architectural distortion, or suspicious
calcifications
c. BI-RADS 2: benign, 0% probability of malignancy
What BI-RAD 3 indicates?
Ans: b. negative, symmetrical and no masses, architectural distortion, or suspicious
calcifications
How many percent BI-RADS 5 indicate for malignancy?
Ans: c. >95%, highly suggestive malignancy.
What BI-RADS Category 6 indicates?
Ans: a. known biopsy-proven malignancy
What BI-RADS stands for?
Ans: d. Breast Imaging Reporting and Database System Score
What does BIRADS 2 categorize?
Ans: b. Benign.
Which of the following is the correct answer?
Ans: b. Axillary Tail of Spence: variable in size, is a narrow part of the mammary gland that
extends to the axilla.
Which of the following is the correct answer?
a. Nipple: The nipple protrudes inward from the outer area of the areola.
b. Axillary Tail of Spence: variable in shape, is a narrow part of the mammary gland that
extends to the axilla.
c. Skin: The breasts are covered by mammary glands.
d. Inframammary fold (IMF): zone of distal from superficial fascial system to the underlying
chest wall.
Ans: NOTA
Which of the following is the correct answer?
Ans: b. Axillary Tail of Spence: variable in size, is a narrow part of the mammary gland that
extends to the axilla.
c. Skin: The breasts are covered by skin.
It is anatomically defined as the area where the skin of the lower pole of glandular breast
tissue meets the chest wall.
Ans: d. Inframammary fold (IMF)
It is a gland that produce and secrete substances onto an epithelial surface by way of a duct.
Ans: b. Sweat glands
These ligaments maintain the shape and structure of your breasts and help to prevent
sagging
Ans: d. Cooper's ligaments
It store the excess energy and release it when required by the body.
Ans: a. Adipose Tissue
Its function is to conduit for milk.
Ans: a. Luminal Cells
They suppress stromal invasion of tumor cells by the secretion of various anti-angiogenic
and anti-invasive factors.
Ans: b. Myoepithelial Cells
What is the transport system for milk?
Ans: d. Milk ducts
It forms the outer layer of luminal cells and basement membrane
Ans: b. Myoepithelial Cells
Which statement is correct.
Ans: c. Breast development begins during second month of gestation.
Which statement is correct.
Ans: c. Breast development begins during second month of gestation.
It provides majority of the breast volume.
Ans: c. Interlobular stroma
What TLDU stands for?
Ans: d. Terminal Ductal Lobular Unit
It is surrounds and supports acini of TDLU
Ans: c. Intralobular stroma
Which statement is correct.
Ans: a. Myoepithelial cells help produce and maintain basement membrane which lesions of
myoepithelial cells often associated with matrix production.
Bacteria invades the breast through small erosions in the nipple of a lactating woman and
abscess can result.
Ans: d. Acute Mastitis
It is a condition for having largest breast.
Ans: b. Macromastia
It is lack of muscle development on one side of the body also characterized by lack of chest
wall.
Ans: d. Poland Syndrome
It is malignant cells multiplying abnormally in the breast, eventually spreading to the rest of
the body if untreated.
Ans: c. Breast Cancer
Breast cancer in the duct cells that has not invaded deeper or spread through the body.
Ans: a. Ductal Carcinoma in situ
A breast biopsy may show normal-appearing, noncancerous ductal cells multiplying
abnormally
Ans: b. Breast Hyperplasia
Enlargement of breast in male.
Ans: c. Gynecomastia
It is considered as most challenging of congenital anomalies in breast.
Ans: d. Macromastia
A rare, usually large, rapidly growing breast tumor that looks like a fibroadenoma on
ultrasound.
Ans: d. Tuberous Breast Deformity
Inflammation of the breast, causing redness, pain, warmth, and swelling.
Ans: b. Mastitis
It is a congenital anomalies which the deformity is a result of a constricting ring at the base
of the breast causing the vertical and horizontal deficiencies.
Ans: b. Tuberous breast deformity
It is a growth of tissue that develops within the breast.
Ans: c. Lumps
It is a non-cancerous tumor made of an abnormal mixture of normal tissues and cells from
the area in which it grows.
Ans: d. Mammary Hamartoma
It is a common sign of inflammatory breast cancer which draws its name from inflamed
appearance
Ans: b. Breast dimpling
Redness of the skin of the breast
Ans: a. Breast erythema
Common congenital malformations that consist of nipple and related tissue in addition to
the nipples normally appearing on the chest
Ans: b. Polythelia
It is a benign uncommon form of stromal overgrowth within breast tissue.
Ans: a. Pseudoangiomatous stromal hyperplasia
It is caused by bacterial infection which is painful build up.
Ans: b. Abscess
A condition on which one or both breast of the mammary glands is absent.
Ans: c. Amazia
Bacteria invades the breast through small erosions in the nipple of a lactating woman and
abscess can result.
Ans: d. Acute Mastitis

Possible Questions
A lesion located in the upper outer quadrant of the right breast is located in the
1. 5-o'clock position
2. 2-o'clock position
3. 10-o'clock position
4. 7-oc'clock position
Ans: 10-o'clock position
An inverted nipple
Ans: sometimes indicates breast cancer
Compression of the breast is most effective and most comfortable when applied against the
Ans: inferior and lateral aspects
The normal breast may have
Ans: 15-20 lobes
The structure that gives the breast its support and shape is called
Ans: Cooper ligament
The breast extends vertically from the
Ans: second through the sixth rib
The thickest portion of the breast is the
Ans: tail of Spence
Cooper ligaments attach anteriorly to the
Ans: fascia of the skin
Typically, a pt with dense fibrous and glandular tissue throughout the entire breast on a
baseline mammogram is
Ans: below 45
Fatty tissue is generally _____ and on the mammogram is seen as areas of _____optical
density.
Ans: radiolucent/higher
Glandular tissue is usually found in the ____ of the breast.
Ans: central and upper outer quadrant
The portion of the breast that holds the milk-producing element is the
Ans: lobule
Veins are normally located
Ans: in the periphery of the breast
The TDLU consists of the
Ans: both the ETDs and the ITDs
A pt began taking synthetic hormones 6 months prior to her current mammogram. The
mammogram is most likely to
Ans: show increased glandular tissue compared to her previous mammogram
A baseline mammogram shows that the pt's breast consists primarily of adipose tissue. This
pt is most likely to be
Ans: above 60
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
Ans: 1, 2, and 3
A woman is referred to as nullipara. This means
Ans: she has never given birth to a viable offspring
Hormone replacement therapy could be recommended to?
1. relieve insomnia symptoms
2. prevent osteoporosis
3. reduce weight gain
Ans: 1 and 2 only
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.
Ans: 2 and 3 only
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
Ans: 1 and 3 only
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
Ans: ultrasound
An infusa-port can be used to
Ans: allow repeated access to the venous system
The biggest risk factor for breast cancer is
Ans: gender
One of the minor risk factors for breast cancer could be
Ans: not breastfeeding
What is the approximate risk of developing breast cancer for a woman whose sister has the
disease?
Ans: higher than normal risk
Symptoms of a possible breast disease that will not be demonstrated on the mammogram
may include
Ans: nipple discharge
Symptoms of very early DCIS may include
Ans: None of the above
Risks factors associated with taking hormone replacement therapy (HRT) include
Ans: increased risks for breast cancer
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
Ans: 1 and 2 only
It is necessary for the technologist to document which of the following?
Ans: all of the above
Pre-examination instructions that can be given to the patient include
Ans: A and B
Benefits of communication with your patient include
Ans: all of the above
In developing patient rapport, the technologist should strive to enhance the patient's self-
esteem. This means that the technologist should
Ans: offer reassurance and encouragement if the patient is confused or unable to help herself
The two-step method of BSE is to
Ans: look and feel for changes in the breast
When visually inspecting the breast, the changes that should be recorded include:
1. changes in breast size and shape
2. changes in texture or color of the breast
3. indentations on the skin of the breast
Ans: 1, 2, and 3
Stressing the importance of the BSE can be controversial because:
Ans: BSE can cause unnecessary anxiety in women
Postmenopausal obesity is associated with
Ans: circulating estrogen that is produced in fatty tissue
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
Ans: 1 and 3 only
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 varying degrees of pressure while palpating of the breast
Ans: 1, 2, and 3
Which of the following statements is true?
1. Breast cancer death rates in the United States are going down.
2. Breast cancer is the leading cause of cancer-related deaths among women in the United
States.
3. The second leading cause of cancer-related deaths among women in the United States is
breast cancer.
Ans: 1 and 3 only
In routine mammography, the glandular dose per projection is generally about
Ans: 1-2 mGy (0.1-0.2 rad)
Which age group is likely to get the most radiation dose during mammography?
Ans: 20 to 35 years
During mammography, 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
Ans: 1, 2, and 3
In breast imaging, the dose calculation is based on
Ans: dose absorbed by the glandular tissue of the breast
What is the purpose of requesting the patient to provide prior mammograms before starting
the mammogram examination?
Ans: to provide the radiologist with an additional aid
Patients who are allowed to play an active role in applying compression are usually
1. less likely to tolerate the compression
2. more likely to tolerate the compression
3. more relaxed during the compression
Ans: 2 and 3 only
The age of a woman taking HRT is likely to be:
Ans: over 40 years
The term primipara refers to a woman who
Ans: carried a pregnancy to over 20 weeks but had a stillbirth
In mammography, information included on the medical history documentation includes
which of the following as they relate to the breast?
1. patient's history of trauma
2. history of surgery
3. unusual skin condition
Ans: 1, 2, and 3
All of the following are forms of subjective patient data except
Ans: patient has a palpable lump in the right breast
When questioning a patient to obtain an accurate patient history
Ans: start with open-ended questions and then follow up with more direct inquiries
Which of the following are positive questioning skills that the radiographer can use when
verifying the accuracy of patient information?
Ans: repeating information
What is the purpose of "probing" questions used when interviewing patients?
Ans: clarifies information by asking for specific details
In gathering more information on a patient's complaint of pain, a good probing question to
ask would be
Ans: "If the pain comes and goes, how often does it occur, and what is the time span between
occurrences?"
When questioning your patient, what is the purpose of repetition?
Ans: to summarize
There are two types of data collection processes. If your patient says he or she has a bruise
on the left breast, this information is regarded as
Ans: objective
"Where is your pain?" is an example of
Ans: an open-ended question
Which of the following will not result in increased breast cancer risks?
Ans: having a first child before age 30 years
An informed consent is required before performing which of the following examination?
Ans: fine-needle biopsy (FNB)
Phone consent is an example of
Ans: oral consent
The patient has to sign an informed consent
1. when there are significant risks associated with the procedure or test
2. for all diagnostic examinations in the imaging department
3. if the procedure is invasive
Ans: 1 and 3 only
Which kind of consent is binding but difficult to prove?
Ans: oral
Which of the following is not required information that must be included on any informed
consent?
Ans: patient height and weight
Methods of acknowledging the patient and treating the patient courteously can included all
of the following except
Ans: avoiding eye contact
The glandular dose is
Ans: associated with dose to the radiosensitive cells of the breast
The technologist should review the previous mammography report to
Ans: confirm the type of exam (screen or diagnostic) needed
Two disadvantages of mammography screening include
1. the granularity of the breast can impact visualization of cancers
2. mammography will not image all cancers
3. the radiation dose from mammography is dangerous
Ans: 1 and 2 only
Having a dense breast will
Ans: increase the risk of breast cancer
Why should the patient remove deodorant before mammography?
Ans: Deodorant can mimic malignant calcifications.
Generally when is the best time to do a BSE?
Ans: The patient should perform BSE 5 to 10 days after the start of the menstrual period or
when the breasts are not tender or swollen.
In gathering more information on a patient's complaint of pain, a good open ended question
to ask would be
Ans: "When did the pain first occur?"
During a mammogram, which of the following will affect the average glandular dose per
breast?
1. Degree of breast composition
2. The HVL of the X-ray beam
3. Breast size and composition
Ans: 1, 2, and 3
A health care provider should evaluate which of the following breast changes?
1. Lumps or swelling
2. Skin irritation or dimpling
3. Milky discharge from the nipple
Ans: 1 and 2
Which of the following hormones is responsible for lobular proliferation and growth?
Ans: Progesterone
The first step in evaluating a woman with suspected breast cancer is a:
Ans: Complete medical history and CBE
Sclerosing duct hyperplasia (radial scar):
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
Ans: 1 and 3
The first step in evaluating a woman with suspected breast cancer is a:
Ans: Complete medical history and CBE
A radiolucent implant used in breast reconstruction is the:
Ans: TRAM flap implant
A patient with breast cancer in one breast will have ________ risk of developing cancer in
the opposite breast
Ans: Greater
A technique describing reshaping of the breast is called:
Ans: Mammoplasty
Breast reconstruction options include:
1. Flap surgery
2. Implants
3. TRAM flap
Ans: 1, 2, 3
Of the three basic types of biopsy procedures, which is used to evaluate no palpable lesions
which will likely go to surgery?
Ans: Needle localization
During a CBE, lumps or masses in the armpit may indicate the spread of breast cancer to
lymph nodes in the:
1. Axilla
2. Collarbone
3. Arm
Ans: 1 and 2
MR is a 42 y.o. female with newly diagnosed inflammatory right breast cancer. What is the
best option for primary therapy at this time?
Ans: Chemotherapy.
The estimated risk for breast cancer is which of the following?
Ans: 1 in 8
Most women with breast cancer present with:
Ans: A painless lump in the breast.
Which of the following are considered risk factors for developing breast cancer?
Ans: Age, hormone replacement therapy, first pregnancy after age 30.
Which of the following hormonal therapies is most appropriate for adjuvant treatment in a
premenopausal woman?
Ans: Tamoxifen