Patient Education and assessement

Question 1

The glandular dose is:

Answer 1

Associated with dose to the radiosensitive cells of the breast.

Question 2

Factors that should be reported on the patients medical history documentation because of their significant impact on diagnosis include:

Answer 2

• Hx of breast trauma
• Painful lumps
• Sudden nipple retraction

Question 3

BSE describes:

Answer 3

Bilateral self-check of the breast by the patient

Question 4

The ideal time to conduct a breast examination is:

Answer 4

Within 10-14 days of the menstrual cycle. Or 1 week after the period ends. Periods are 3-7 days long in general.
3 + 7 =10

Question 5

In digital mammography systems, both the film and cassette can be replaced by:

Answer 5

An electronic detector system

Question 6

MRI imaging

Answer 6

Uses complex magnetic properties of elements

Question 7

CAD is used to:

Answer 7

Analyze and pre-read the image before interpretation by a radiologist

Question 8

Minor risk factors of breast cancer are associated with:

Answer 8

Use of HRT and Nulliparity (Never given birth)

Question 9

Major risk factors (outside a women control) for breast cancer include:

Answer 9

Age and genetic risks

Question 10

Arisk factor is any:

Answer 10

Significant factor that increases a person’s chance of getting a disease

Question 11

List three reasons for taking and documenting the patients medical history.

Answer 11

To avoid miss-diagnosis, to avoid unnecessary surgeries or biopsies, to avoid the need for additional work-up projections, to help the radiologist make a final interpretation. Document any history of trauma, surgery to the breast, any breast cancer abnormalities or symptoms, health problems, or risk factors for breast cancer.

Question 12

Why should women practice breast self-examination?

Answer 12

No detection tool is 100% effective; therefore, any additional help will be beneficial.

Question 13

Describe the difference between the BSE and the CBE.

Answer 13

BSE is performed by the women on herself; CBE is performed by a health care provider.

Question 14

How often should a women practice a BSE and CBE?

Answer 14

Age 20-39: CBE every 3 years
Over age 40: CBE every year
Over age 20: BSE every month

Question 15

State the three different methods used to perform a systematic self-examination of the breast.

Answer 15

Up and down line pattern, circular pattern, wedge pattern

Question 16

When is the best time to conduct BSE?

Answer 16

One week after the end of the menstrual period (between day 7 and day 14) or the same time every month for women not having a period.

Question 17

What is the recommended guideline for routine mammography screening as suggested by the ACS?

Answer 17

Women over age 40: Annual screening mammogram. MRI or ultrasound for high risk or dense breast only.

Question 18

What is the maximum average glandular dose for a single mammography projection as recommended by the ACR?

Answer 18

No greater than 0.3 rads with a grid or 0.1 without a grid.

Question 19

State two disadvantages of screening mammography.

Answer 19

The sensitivity of mammography is dependent on breast density plus the age and hormone status of the patient. Mammography understates the multifocality of a lesion. Inadequate position or compression can compromise the image.

Question 20

List two advantages and two disadvantages of breast ultrasound.

Answer 20

Advantage: No radiation. The sensitivity is not affected by the patients age.
Disadvantages: Operator-dependant. High resolution imaging is best achieved on small patients.

Question 21

List two advantages and two disadvantages of MRI of the breast.

Answer 21

Advantages: No radiation. The sensitivity is not age-dependent. Has high sensitivity.
Disadvantages: Low specificity-high false positive rate. Very expensive. Longer study time. Possible magnetic risks and dangers.

Question 22

How is PEM used to detect breast cancer?

Answer 22

PEM imaging will provide useful information on metastases to both soft tissue and bone, and can detect recurrent metastases. The technology works on the principle that most cancerous tissue uses vast amounts of sugar (glucose) and at a much higher rate than benign tissue.

Question 23

How can breast scintigraphy be useful as an adjunct-screening tool?

Answer 23

IT can detect tumors in the breast of young women using technetium Tc99m sestamibi. The radiopharmaceutical accumulates in malignant lesions in the breast but benign lesions do not take up the isotope.

Question 24

Explain the difference between computed and digital mammography.

Answer 24

Digital uses a totally cassettless system whereas computed radiography uses an image plate with a storage phosphor screen (SPS) or photostimulable phosphor (PSP) instead of the cassette and film, thereby adapting the analog system to work with digital technology.

Question 25

How is digital mammography imaging similar to analog mammography screening?

Answer 25

The routine and supplementary projections are the same. Breast compression and patient positioning are equally important.

Question 26

How can CAD improve mammographic interpretation?

Answer 26

It effectively pre-reads the mammograms to increase the productivity and accuracy of the radiologist interpretation.

Question 27

What is the difference between a major and minor risk factor?

Answer 27

Major risk are mainly outside a women’s control, carry a higher probability of breast cancer and often cannot be changed; minor risks carry a lower probability for breast cancer and are often within a women control.

Question 28

What is the biggest risk factor for breast cancer?

Answer 28

Gender - being female.

Question 29

Name four other major risk factors for breast cancer.

Answer 29

Aging, genetic risks, family history o breast cancer, personal history o f breast cancer

Question 30

Name two minor risk factors for breast cancer.

Answer 30

Not having children, early menarche or late menopause, alcohol, use o hormone replacement therapy, not breast feeding, lack of exercise.