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MAMMOGRAPHY > MODULE 2 > Flashcards

MODULE 2 Flashcards

1
Q

performed by a healthcare professional/ physician to detect any abnormalities and warning signs

A

Clinical Breast Exam

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2
Q

every woman should do once a month at home; do it yourself

A

Breast Self-Exam

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3
Q

Screening method:

A

Opportunistic or Programmatic

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4
Q

What is screening?

A

refers to a test, examination, evaluation, assessment performed on an asymptomatic individual

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5
Q

GOAL of screening?

A

prevent death and suffering/occurrence of diseases through an early intervention

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6
Q

General Principle of Screening:

A
  • screening is of greatest value for individuals who are most likely to
    develop a certain disease
  • early treatment is more effective than later treatment in reducing mortality
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7
Q

Important to determine a person’s risk of developing breast cancer
and use that information to:

A
  1. Recommend the modality
  2. Frequency of screening
  3. Determine whether referrals are needed for genetic testing
    /chemoprevention / prophylactic surgery
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8
Q

Harms of Screening

A
  • raise anxiety if there is false positive screening
  • overtreatment of some tumors that would never become apparent
  • economic cost: healthcare system/patient
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9
Q

Risk Factors

A

Hormone Therapy
Non-modifiable
Postmenopausal
Reproductive Factor
Subtances Use

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10
Q
  • can’t be changed
  • family history
  • age, chest radiation history, dense breast tissue, genetic alteration, race
A

NON-MODIFIABLE

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11
Q
  • obesity
A

POSTMENOPAUSAL

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12
Q

Combined estrogen-progesterone in
women with intact uteri

A

HORMONE THERAPY

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13
Q

⬆️ age

A

the more susceptible we are to breast CA

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14
Q
  • Alcohol
  • Current smoking
A

SUBTANCE USE

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15
Q
  • Absence of breastfeeding
  • Early menarche
  • Late first pregnancy >35 years old
  • Nulliparity
A

REPRODUCTIVE FACTOR

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16
Q

never been pregnant or given birth

A

NULLIPARITY

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17
Q

Highest Probability (%) of developing breast cancer by Age

A

70 and older

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18
Q

Defective Genes

A

BRCA1
BRCA2
p53
STK11
CDH1
PALB2
PTEN
Mismatch repair genes

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19
Q

Components of Breast Screening Examination

A

I. Breast Awareness
II. Physical Examination
III. Risk Assessment
IV. Screening Mammography
V. MRI
VI. UTS

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20
Q
  • screening method used in attempt to detect early breast cancer
  • checking your own breast for possible lumps, distortions, or swelling
A

BREAST SELF EXAMINATION

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21
Q

Benefits of BSE

A

• Education about self-awareness

• Empower women
• General breast health
• Lower risk of death or metastasis
• Lesser advanced-stage cancer
• Raise awareness among women at risk

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22
Q

Harm of BSE

A

• False positive result
• Gain anxiety if found abnormality

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23
Q

It is advisable to do BSE..

A

once a month after menstruation

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24
Q

STEPS TO BREAST SELF-EXAMINATION

A
  1. Stand infront of a mirror
    Shoulder straight
    Hands on hip
    Look for dimpling, dripping, lump, pulled in nipple (inverted/retracted), rash, skin changes
  2. Raise arms, look for the same changes
  3. Look for sign of fluid cominf out (blood, milky/ yellow fluid, watery)
  4. Palpate breast while lying. Use finger pads to palpate.
    Cover entire breast, side to side (from collarbone to abdomen: armpit to cleavage)
  5. Feel breast while standing/ sitting. However, many find it easier to feel breast while showering or wet.
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25
Q

PATTERNS FOR PALPATION

A

CIRCULAR
LINES
WEDGES

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26
Q

systematic palpation
visual inspection of the entire breast
performed by doctor, nurse practitioner, nurse, or physician assistant

A

Clinical Breast Examination

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27
Q

GOAL of MAMMOGRAPHY

A

early detection of breast cancer, typically through characteristic detection of masses or microcalcifications

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28
Q

highly engineered so we can image the breast

A

mammographic machine

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29
Q

BASIC PROJECTION:

A

Cranio-caudal (CC)
Medio-lateral Oblique (MLO)

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30
Q

other name for MLO

A

Lundgren’s Oblique View

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31
Q

(Z) atomic # of tissue:

A

7-8

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32
Q

(Z) atomic # of tumors, calcifications:

A

20

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33
Q

easier to image..

A

older breast bcs of fatty replacement

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34
Q

a lot of scattering (compton) than absorption (photoelectric effect)

A

causes low differential absorption

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35
Q

type of xrays we use:

A

Characteristic xrays

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36
Q

lower xray energy used,

A

improve contrast resolution
enhance differential absorption

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37
Q

Components of equipment:

A

• Anti scatter grids
• Automatic exposure control
• Breast compressor
• Cassette holder
• Collimator / cone
• Generator
• Support system
• X-ray tube

38
Q

xray energy required for good
contrast:

A

20 - 40 kVp

39
Q

maximum mA:

A

200 mA

40
Q

For homogenous x-ray beam,

A

High Frequency Generator is required

41
Q

Target materials:

A

Molybdenum 42
Rhodium 45
Tungsten 74

42
Q

most common anode target material used?

A

Molybdenum

43
Q

Advantages of using Molybdenum

A
  • increased number of low-energy photons is produced
  • high radiographic contrast is achieved in the image
  • specific x-ray energies required for breast imaging are produced
44
Q

Disadvantages of using Molybdenum

A
  • less x-ray photon output due to a lower atomic number—42
  • increased mAs is required to maintain image receptor exposure
  • increased pt dose
45
Q

low atomic number

A
  • produce low-energy characteristic x-rays
  • used in mammography
46
Q

to compensate the low xray photon output of Molybdenum

A

increase mAs

47
Q

focal spot sizes:

A

0.3 - typical
0.10 - 0.15 - magnification

48
Q

SID

A

60 - 65 cm

49
Q

Tube tilt

A

6 - 24°

50
Q

anode angle

A

0 - 6°

51
Q

Effective anode angle

A

at least 22-24° for a 24 × 30-cm field area

52
Q

(Be) Beryllium

A
  • has low atomic no. and lower absorption of less than 5 kVp x-rays
53
Q

1mm of Be is equivalent to..

A

0.1mm Al material

54
Q

achieves better uniformity of the
transmitted x-rays through the breast

A

anode heel effect

55
Q

decreases the equipment bulk near the patient’s head

A

Positioning the cathode over the chest wall of the patient and the
anode over the nipple

56
Q

tilted XRT allows a narrower effective FS improving..

A

spatial resolution

57
Q

Target and filter combination:

A

• Mo-42 target with 0.03mm Mo-42 filter
• Rh-45 target with 0.025mm Rh-45 filter
• W-74 target with 0.05mm Rh-45 filter

58
Q

using target & filter combination we can..

A

protect low xray energy by filtering high xray energy

59
Q

uses 17.6 keV & 19.7 keV to produce characteristic radiation

A

Moly/Moly Spectrum
Moly/Rhodium Spectrum

60
Q
  • good for denser breast
  • breast greater than 5 cm thick
A

Molybdenum/Rhodium Filter
Rhodium/Rhodium Filter

61
Q

Rhodium anode

A

20.3 keV & 22.7 keV

62
Q

molybdenum filter

A

20 keV

63
Q

rhodium filter

A

23.22 keV

64
Q

for breasts less than 5 cm thick

A

moly/moly filter

65
Q
  • used for proper direction of xray beam
  • embedded inside
  • proper collimation
  • rejecting scatter radiation
  • protection of chest wall and lungs from unnecessary radiation
A

Collimator / Cones

66
Q

THREE DESIGN ARE CURRENTLY USED:

A

Fixed aperture
Interchangeable cones for various sizes of breast
Internal set of collimating blades

67
Q

preferred interspace material?

A

carbon fiber

68
Q

must be a moving grid?

A

anti scattered grid

69
Q

3 types of anti scattered grid

A

linear grid structure
cellular grid structure
air gap & magnification

70
Q

use of grid increases

A

patient dose

71
Q

4:1 grid ratio

A

double the patient dose

72
Q

unique grid is developed specially for the mammography:

A

High Transmission Cellular (HTC) Grid
crossed type grid

73
Q

HTC grid

A

copper - grid stripe
air - interspace

74
Q

flat surfaced plate used for uniform
compression

A

compression plate

75
Q

for equal compression to all areas of the breast

A

slanted S.O.F.T paddles

76
Q

Advantages of Compression Plate

A

➢ Provides immobilization of the POI during exposure
➢ Produces radiograph of uniform density
➢ Reduces geometric unsharpness due to closer object to IR distance
➢ Reduces scatter and improves contrast
➢ Reduces tissue overlap and improves resolution
➢ Enhances recognition of architectural distortion produced by tumors

77
Q

used to magnify small area of breast for better visualization
better compression for over small area

A

spot compression

78
Q

Amount of compression:

A

25 - 40 pounds of pressure

79
Q
  • designed to measure x –ray intensity at image receptor and x –ray quality
  • place after the image receptor
A

PHOTOTIMERS or AUTOMATIC EXPOSURE CONTROL

80
Q

A preset value corresponds to a specified..

A

SNR for digital mammography
Acceptable optic density for film-screen

81
Q

single-coated film-screen combination commonly used

A

GADOLINIUM OXYSULPHITE

82
Q

MAMMOGRAPHIC CASSETE

A

18X24/ 24X30 cm

83
Q

digital mammography

A

full-field digital mammography

84
Q

Direct conversion uses

A

Amorphous Selenium

85
Q

Indirecr Conversion uses

A
86
Q

MASTECTOMY

A

INTRODUCED IN 1898 BY HALSTEAD

87
Q

Developed clinical techniques for mammography

A

LE BORGNE- URUGUAY GERSHON-COHEN- US
GROS- GERMANY

88
Q

Breast XEROGRAPHY introduction by WOLFE and RUZICKA in

A

1960

89
Q

INDICATIONS: BCCEFFIT

A

BREAST CARCINOMA
CALCIFICATION
CYST
EPITHELIAL HYPERPLASIA
FIBROADENOMA
FIBROSIS

INTRADUCTAL PAPILLOMA
TUMOR

90
Q

grid ratio

A

3:1
5: 1

MAMMOGRAPHY (3 decks)

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