PRELIMS Flashcards
the mosy treatable cancer
breast cancer
this malignancy is most treatable when it is detected early
breast cancer
the most important innovation in breast cancer control since the radical mastectomy was introduced by ______ in 1898
Halstead
its primary goal is to detect breast cancer if it is palpable
mammography
in _____, a group of male radiologists in Rochester, NY assembled around a view box admiring the chest xray of a buxom woman
1924
father of mammography
Robert Egan, MD
He is a German physician
In 1913, he reported the radiographic appearance of breast cancers
Using radiographic studies of cancerous breasts removed at surgery, he described the mechanism of how breast cancer spread
Dr. Soloman
In 1927, he made the first published radiograph of a living person’s breast in a german medical textbook on malignant tumors
Otto Kleinschmidt
Year when publications on mammography appeared in South America, US and Europe but still the use of mammography for the diagnosis of breast cancer received little clinical interest
1930s
Year when mammography was considered a reliable clinical tool because of such refinements as low kilovoltage xray tubes with MOLYBDENUM targets and high detail industrial grade xray film
Mid 1950s
In 1960s, ________ was introduced and was popularized by WOLFE AND RUZICKA
Xerography
______ substantially lowered the radiation dose received by the px compared with the dose received using industrial grade xray film
Xerography
many physicians found the xerographic images easier to understand and evaluate, ____________ became widely used for evaluating breast diseases
xeromammography
______ company first introduced the combination of higher resolution, faster speed xray film and an intensifying screen
duPont company
year when breast cancer detection demonstration project was implemented
1973
in this project, 280k women underwent annual screening for breast cancer for 5 years at 29 locations throughout the US
organized by the AMERICAN CANCER SOCIETY and NATIONAL CANCER INSTITUTE
this project demonstrated unequivocally that screening, physical exam, mammography and BSE could provide an early diagnosis
breast cancer detection demonstration project
In 1975, _____ and duPont improved screen film combinations
by this time, extremelu high quality mammography images could be produced with very low patient radiation exposures
Kodak and duPont
In 1992, Mammography _______ ______ Act (MQSA) was implemented to mandate the maintenance of high quality breast cancer screening programs
Mammography Quality Standards Act
3 Risk Factors
Age
Hormonal History
Family History
the incidence of breasst cancer increases with ____
age
________ influence the glandular tissye of the breast during the development, pregnancy and lactation
however, hormone levels decline at the onset of ________
hormonal influence ; menopause
as a result, the glandular breast tissue is ____ sensitive to carcinogens during menarche
more sensitive
___ risk women inckude those with early menses, late menopause, first birth after age 30 years and nullipanity
high risk
a woman whose daughter, sister or mother previously developed breast cancer, especially at an early age, is at higher risk of developing the disease
studies have shown that only 13.6% of known breast cancers are found in women with a family history of the disease
family history
______ are lobulated glandular structure located within the superficial fascia of the anterolateral surface of the thorax of both males and females
breast
_______ glands divide the superficial fascia into anterior and posterior components
mammary glands
the breasts are rudimentary and without function
are only rarely subject to abnormalities such as neoplasms that require radiologic evaluation
male breasts
secondary sex characteristics and function as accessorry glands to the reproductive system
female breast
each breast is usually _____ shaped with the base or posterior surfacr of the breast overlying the PECTORALIS MAJOR and SERRATUS ANTERIOR MUSCLES
cone
these muscles extend from the second or ______ rib inferiorlu to the sixth or _____ rib and from near the lateral margin of the sternum laterally toward the anterior axillay plane
third rib ; seventh rib
an additional portion of breast tissue, the _________ prolongation or ______ tail, extends from the upper lateral base of the breasts into axillay fossa
axillary prolonation ; axillation tail
the breast are support by ______ ligaments, suspensory ligaments that extend from the posterior layers of the superficial fascia through the anterior fascia inyo the subcutaneois tissue and skin
cooper’s ligaments
the adult female breast consists of 15 to __ lobes which are distributed so that more lobes are superior and lateral than inferior and medial
15 to 20 lobes
each lobe is divided into many ______ which are the basic structual units of breast
it contains the glandular elements or _____
lobules ; acini
______ _______ adolescent breast contains primarily dense connective tissue and casts a relatively homogenous radiographic image with little tissue differentation
post puberal adolescent breast
during _______, significant hypertrophy of glands and ducts occurs within the breast
this change causes the breasts to become extremely dense and opaque
during pregnancy
NCRP
National Council on Radiation Protection and Measurements
most important ability
understand and master these factors to produce consistent, high contrast, diagnostic images
performance
in performance, the examination room should accomodate the unit with its shield and provide enough space for the technologist to move around and to assist the client for proper positioning
space
additional _____ may be needed to accomodate WOMEN IN WHEELCHAIRS and for storing some supplies and equipmeny accessories in the examination room
space
in performance, some units are on wheels and others must be anchored to the floor or the wall
if the unit is used at various locations, be sure to TEST DRIVE it in a realistic setting
portability
in performance, thisnprivides proper dedicated electric power for the mammography unit
some units plug into wall outlets, while others require THREE PHASE OR 220 WIRING to installed
electrical requirements
in performance, the unit should be user friendly to both the client and operator
ergonomics
in basic components, ______ range of vertical movement should accomodate both tall women (approx 6 ft) and those who need to sit
c-arm
in c-arm, the minimum range of travel is 66 to ___ cm above the floor
66 to 140 cm
the point at which the c arm connects to the tower/collar should be _________ designed so that when moving from the craniocaudal position to the oblique position, the height does not need to be adjusted
isocentrically
_____ or handles should be available to the client to maintain a difficult or awkward position
grips or handles
in basic components, these controls on both sides of the c arm provide easy access for the technologist to adjust the height of c arm and raise and lower the compression device while the client is being positioned
electronic controls
in basic components, adequate space when positioning an obese woman for an oblique view
when magnifying an area in a large breast
when raising the compression device over the needle during preoperative localizations
compression device to receptor distance
in basic components, this are should remain as small as possible to facilitate positioning of the clients head for craniocaudal view and during magnification fields
tube housing or face shield
remote ____ controls for vertical movement of the c arm and the compression device free the hands of the technologist while positioning
foot controls
the amount of compression exerted by the _____ ______ control should be minimal
foot pedal
the FINAL COMPRESSION of the breast should be done using a ____ controlled device
hand controlled device
in basic components, it permit fast and easy exchange of different size film buckys or cassettes
image receptor support device
in basic components, it should be easy to read and to adjust
all units must have AUTOMATIC EXPOSURE CONTROL
control panel
at least NINE DENSITY ADJUSTMENT steps should be available
there should be a 10% to 15% difference in optical debsity between steps
density selection
target units that has a range of at leadt 24 to 32 kVp in no greater than 1 kvp increments
molybdenum target units
target units that has a range of at least 28 to 38 kVp in no greater than 1 kVp increments
rhodium target units
in kVp, lower settings may be used in ______ radiography and higher settings for special views
specimen radiography
it may be fixed or variable
milliamperage selection
in time selection, the grid is not caught in motion when using a grid on a thin adipose replaced breast
short exposures
in time selection, the time setting must surpass the reciprocity law failure of the recording system
long exposures
standard imaging SID: 55 cm
magnification imaging SID: __ cm
60 cm
fixed apertures
interchangeable cones of various sizes
internal set of collimating blades
collimators
a side loading cassette holder or bucky is required if the equipment has preoperative _______ ________ capabilities
needle localization capabilities
the brightnesss of the light source should be 160 lux or higher
field light
misalignment of the xray/light field can be a maximum of _% of the SID
2%
the focal spot compression device and image receptor MUST ALIGN perfectly at the chest wall edge to ensure that all posterior breast tissue is included
alignment
the benefit of this mode is to produce an image using an acceptable length of exposure time to reduce motion blurring and patient dose without compromising imaging quality
automatic technique selection
the operayor can make an exposure only when completely outside of xray field
exposure control
this is to limit operator exposure to well below 0.1 mSv/week based on 40 patients a day 5 days/week
radiation shield
if _____ can be changed, the unit must clearly display which _____ is in place
filter
it terminates the exposure eith a sound or visual indicator
the suggested limits are 250 mAs minimum to 600 mAs maximum
back up timer
must maintain consistent optical density darkening of the film regardless of the kVp setting used, thickness of the compressed breast and ratio of glandular to adipose components
automatic exposure control
in safelight, safelight filters that correspond with GREEN LIGHT SENSITIVE FILMS should be installed in lamps located at least _ feet above work area
4 feet above work area
in safelights, no more than __ watt bulb in an overhead ceiling fixture and no more than . watts in closer fixture
15 watt in overhead ceiling
7.5 watt in closer fixture
these filters should be change periodically, every _ to _ years as they deteriorate with time and use
1 to 2 years
in air quality, there are 3 major factors that influencr obtaining a quality radiographic image
temperature
humidity
ventilation
in air quality, this should be set at approximately 70°F
temperature
when filn is exposed to excessive heat, its emulsion softens and is more susceptible to _______
scratching
a cooler temperature may cause the emulsion to _____ and peel
crack and peel
in air quality, this should be set between 30% and 50%
humidity
if air becomes too dry, _____ marks may appear on film
static marks
if humidity is above 50%, small _____ from air may cling to the film and cause the emulstion to clump
humidity
poor airflow to the processor can hinder image quality, causing ____ and mottling of emulsion
streaking and mottling
_____ is darkroom’s nemesis
dust
they can obscure an area of minute calcifications or can mimic cancer which can lead to misdiagnosis
dust
artifacts that occure during processing procedure, within the processir, by one or more of the processor’s components
roller narks
guide shoe mark
chatter
run back
processing artifacts
artifacts caused by low humidity in the darkroom can cause STATIC ON FILMS
high humidity can SPLOTCH the image
environmental artifacts
improper handling of screen and films will cause artifacts that are visible on mammographic image
film and screen handling artifacts
something not meant to be imaged will inadvertently show up on film
px nose, chin, ear, fingers, necklace or examination gown
positioning artifacts
