Chapter 8: The Non-Conforming Patients

Question 1

demonstrates the anterior, central,
medial, and posteromedial portions of the breast well, but the extreme lateral tissue poorly

Answer 1

CC

Question 2

demonstrates the extreme
posterior and UOQ well, but the medial and anterior tissue poorly.

Answer 2

MLO

Question 3

If the same posterolateral tissue is missing from the MLO, ____ are necessary

Answer 3

supplementary projections

Question 4

Patients with a ____ base of attachment are usually also firm breasted,
presenting a problem in mobility.

Answer 4

wide

Question 5

Projections to perform to patients with wide base of attachment

Answer 5

CC
MLO

Question 6

A projection tha focuses on the extreme
posteromedial tissue

Answer 6

CC

Question 7

A projection that focuses on the extreme posterolateral tissue

Answer 7

MLO

Question 8

Compression paddles with a tilt design are often used for these situations;
be aware that they may impose technical issues that affect the amount of posterior tissue visualized

Answer 8

Wide Pedicle

Question 9

maintaining the breast in the “up and out” position may be impossible

Answer 9

Thin pedicle

Question 10

The CC projection does not often
pose a problem in these patients;
however, ____ patients
present a number of issues in
performing the MLO.

Answer 10

large-breasted

Question 11

These patients may require a third view to demonstrate the anterior breast, or mosaic imaging to demonstrate all of the tissue on several images.

Answer 11

Large breasted patients

Question 12

The chest wall excessively protrudes
outward in this body habitus

Answer 12

Barrel Chest (Pigeon Breast)

Question 13

The breast will extend laterally under the arm. Rarely is it possible to image the entire breast with two views

Answer 13

Barrel Chest (Pigeon Breast)

Question 14

For Barrel Chest, perform the ___ to image the medial tissue

Answer 14

CC

Question 15

For Barrel Chest, perform the ___ to image posterolateral
tissue and the upper-outer quadrant.

Answer 15

MLO

Question 16

For Barrel Chest, perform a ___ to image
lateral tissue or repeat the ____ using a
quadrant paddle

Answer 16

20° MLO or XCCL, MLO

Question 17

Projections recommended for patients with Barrel Chest

Answer 17

CC
MLO
20 degrees MLO/XCCL
Repeat MLO using a quadrant paddle

Question 18

This patient presents with a sunken sternum and rib cage.

Answer 18

Pectus Excavatum

Question 19

Rarely is it possible to image the medial breast tissue with either of the
standard views

Answer 19

Pectus Excavatum

Question 20

Rarely is it possible to image the
entire breast with two views

Answer 20

Barrel Chest (Pigeon Breast)

Question 21

Projections recommended to perform for patients with Pectus Excavatum (Sunken Chest)

Answer 21

CC
MLO
SIO or LM

Question 22

This patient presents hunched over, and may have many defomities of the rib cage.

Answer 22

Patient with Kyphoscoliosis

Question 23

The anomalies are usually not symmetric from side to side.

Answer 23

Patient with Kyphoscoliosis

Question 24

The patient may also present with either a pectus excavatum or a barrel chest, or a combination of these two.

Answer 24

Patient with Kyphoscoliosis

Question 25

If there is a combination of pectus excavatum and barrel chest, perform the study as follows:

Answer 25

CC MLO LM

Question 26

Imaging the extreme lateral tissue with the standard mammogram may be impossible.

Answer 26

Wraparound Breast

Question 27

Recommendations for wraparound breasts

Answer 27

CC XCCL

Question 28

The patient with a history of breast cancer has an increased risk of developing cancer in the ____ breast.

Answer 28

contralateral

Question 29

a _____ of the contralateral breast will give the radiologist a better opportunity to diagnose a new malignancy

Answer 29

three-view study

Question 30

____ are necessary to satisfactorily image the post-irradiation breast.

Answer 30

Multiple views

Question 31

To determine if an undifferentiated tumor found elsewhere in the body is a result of metastases from a clinically occult breast cancer, the mammogram should include the following:

Answer 31

⚬ CC ⚬ MLO (SM-IL) ⚬ Bilateral axilla views ⚬ 20° MLO, if the patient has dense glandular tissue

Question 32

Useful to reveal lymph node involvement

Answer 32

bilateral axilla views

Question 33

____of the breast may also be indicated in a search for primary breast cancer

Answer 33

MRI