BRANT: Chapter 19: #Pathologic (Imaging the Screening Patient)

Question 1

Breast cancer survival is influenced by the following at the time of diagnosis:
a. Size of the tumor
b. Lymph node status
c. Both
d. None of the above

Answer 1

c. Both

Question 2

Minimal cancers are defined as those that are noninvasive or invasive but less than ____ in size with negative nodes.

#pathologic

Answer 2

1 cm

Question 3

The American College of Radiology and the Society of Breast Imaging at this time continue to recommend annual mammographic screening for women starting at age ____

Answer 3

40

Question 4

The American Cancer Society (ACS) recommends starting annual screening at age ____, with an option to transition to biennial screening at age ____.

Answer 4

Annual: 45
Biennial: 55

Question 5

Women who are at high risk have a lifetime risk for breast cancer of greater than ____
a. 15%
b. 20%
c. 25%
d. 30%

Answer 5

b. 20%

Start of screening: 25-30 years of age

Question 6

Primary imaging modality for screening HIGH RISK women in addition to mammographic screening

Answer 6

MRI

Start of screening: 25-40 years of age

If MRI not possible, may do UTZ

Question 7

The following comprise the four mammographic views performed per breast in patients with breast implants, except:
a. CC view
b. MLO view
c. Implant-displaced (ID) view
d. Anterior compression view

Answer 7

d. Anterior compression view

Question 8

Most widely used materials for breast implants include the following, except:
a. Silicone
b. Saline
c. Both
d. Neither

Answer 8

c. Both

Question 9

Which of the following statements is true?
a. Regardless of the material, after the implant is placed in the breast, the body normally generates a fibrous capsule around the implant.
b. Subglandular implants are less associated with capsular contracture than subpectoral implants.
c. Capsular contracture is a radiologic diagnosis where there is abnormal constriction of the fibrous capsule on the implant
d. All of the above are true

Answer 9

a. Regardless of the material, after the implant is placed in the breast, the body normally generates a fibrous capsule around the implant.

b. SUBPECTORAL
c. CLINICAL - and clinically the patient states the implant feels abnormally spherical and firm

Question 10

Most sensitive imaging study to evaluate for silicone implant rupture

Answer 10

MRI

Question 11

The following statements are true, except:
a. Typically, findings that have been stable for 2 years are considered benign.
b. For masses or asymmetries, a suspicious change could include increase in size, increase in density, or development of more suspicious margins.
c. For calcifications, an increase in number or extent is considered a suspicious change.
d. All of the above are true

Answer 11

d. AOTA are true

Question 12

It is the only imaging modality that has been proven to reduce breast cancer mortality when used to screen asymptomatic women

Answer 12

Mammography

Question 13

True about contrast-enhanced spectral mammography (CESM), except:
a. To obtain the images, the patient is first administered intravenous iodinated contrast, then placed in compression, similar to the standard mammographic views.
b. The low-energy image appears similar to a standard 2D image
c. The high-energy image is processed to highlight the iodine-enhanced portions of the breast and suppress the background breast tissue.
d. Early research studies have demonstrated CESM to perform with similar sensitivity in cancer detection to MRI, with both demonstrating improved detection over standard mammography.
e. AOTA are true

Answer 13

e. AOTA are true

Question 14

This substance is employed in breast-specific gamma imaging (BSGI) to detect malignancy

Answer 14

Technetium-99m sestamibi