Mammo 5: 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

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 (sunken chest)

Question 19

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

Answer 19

CC
MLO
SIO or LM

Question 20

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

Answer 20

Patient with Kyphoscoliosis

Question 21

The anomalies are usually not symmetric from side to side.

Answer 21

Patient with Kyphoscoliosis

Question 22

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

Answer 22

Patient with Kyphoscoliosis

Question 23

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

Answer 23

CC
MLO
LM

Question 24

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

Answer 24

Wraparound Breast

Question 25

Recommendations for wraparound breasts

Answer 25

CC XCCL

Question 26

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

Answer 26

contralateral

Question 27

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

Answer 27

three-view study

Question 28

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

Answer 28

Multiple views

Question 29

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 29

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

Question 30

Useful to reveal lymph node involvement

Answer 30

bilateral axilla views

Question 31

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

Answer 31

MRI

Question 32

These breasts may also extend under the armpit, eliminating the lower-outer quadrant from view.

Answer 32

Thin pedicle

Question 33

An SIO with the arm up and over or LM with arm up and over will access this tissue

Answer 33

Breast under the armpit

Question 34

Patient position recommended for patients with large breasts

Answer 34

20° MLO or a true lateral

Question 35

to image the extreme medial tissue

Answer 35

SIO or LM

Question 36

allows the radiologist to evaluate nodal involvement.

Answer 36

axilla view

Question 37

• If there is unilateral lymph node involvement on the ipsilateral side, it is likely that the patient has an inflammatory carcinoma. • The mammography study should include:

Answer 37

⚬ CC ⚬ MLO ⚬ Axilla view on the affected side

Question 38

to image the extreme medial tissue

Answer 38

SIO or LM