TEST TEST TEST TEST TEST TEST 4 Flashcards
What are the two major roles of CAD
detection
classification
CAD
computer aided detection
inadequate separation of tissues , non uniformity and uneven exposure levels are all a result of what
lack of compression
benign growths involving the milk ducts. high risk for breast cancer
ductal papilloma
montgomery glands are what type of glands
subaceous gland
forms on the skin surgave of the breast. Seen as multilobulated lesion with sharp outlines
keratosis
a keratosis is demonstrated mammographically as a
sharply outlined multilobulated lesion
Method of locating the lymph noes which cancer is spreading
lymphoscintigraphy or
sentinel node mapping
benign inflammatory condition of the lactiferous duct leading to nipple discharge, inversion or periareolar sepsis
ductal ectasia
are harmatomas benign or malignant
benign
Can be a huge encapsulated lesion occupying the entire breast, seen as smooth boarders
lipoma
essentially a pocket of fat that is encapsulated by a thin fibrous capsule
lipoma
oil cyst are sometimes called
fat necrosis
What are the ACR guidelines for breast cancer screening
begins at at 40
high risk starts at 30 but no sooner than 25
ACR guidelines for high risk screening MRI. What percent is considered high risk
MRI by 30
20% lifetime risk
physician will give you information about a particular treatment/test and you decide whether or not you want to proceed is called
informed consent
MQSA requires no more than ___ dose per image
300 mrad
3 mgray
0.003 gray
what is the superior margin of the breast
clavicle
what is the inferior attachment of the breast
inframammary crease
what is the medial attachment of the breast
sternum
what is the lateral attachment of the breast
axilla
Where is the most glandular tissue found
upper outer quadrant (tail of spence)
in general lesions that are lateral will move _____ on the ML compared to the MLO
down
in general lesions that are medial will move ___ on the ML compeared to the MLO
up
what is the larget organ of the body
skin
where is skin the thickest, and how thick
base of the breasts
2mm
where is the skin thinnest and how thin
nipple
0.5mm
outer most layer of the skin
epidermis
middle layer of the skin
dermins
inner layer of the skin
hypodermis
circular color skin aroudn the nipple
areolar
the nipple contains how many openings
5-15
a modified sweat gland that is milk producing
mammary gland or
glandular tissue
small bumps aroudn the areola. sebaceous gland surroundign the nipple
montgomery gland
opening of the montgomery gland, secretes a bacterostatic lubrication during lactation
morgagin tubercles
largest portion of the breast
tail of spence
angle of deflection where the breast tissue meets the chest wall below the breast
inframammary fold
an extra nipple is called ____and about __% of the population has one
plythelia
10 %
the breast lies on top of the
pectoralis muscle
connective tissue that separates the breast from skin and muscle
fascia
The breast is attached ot the deep fascia via
the suspensory ligaments
(coopers ligaments)
not actually part of the breat but used ofr positioning and image evaluation. Connects the front wall of the chest with the upper arm
pectoralis muscle
Fibrous connections between the inner side of the breast skin and pec muscle. Looks like waves on dense breasts
coopers ligaments
thickening or the density of the breast tissue
fibrous tissue
consists of lobes that produce milk
mammary glands/ducts
within the lobes of the breast are _____ which connect to the lactiferous ducts
lobules
responsible for delivering the milk to the nipple
lactiferous ducts
outside the lobule and connects to the lactiferous duct
extra lobular terminal duct
(segmental duct)
what is another term for the extra lobular terminal duct
segmental duct
What duct is inside the lobule
intra-lobular duct
(sub segmental duct)
what is another term for teh intra lobular terminal duct
sub segmental duct
TDLU
terminal ductal lobular unit
just inside the nipple is the
lactiferous sinus
cancer in the milk duct
ductal carcinoma
cancer in the lobules
lobular carcinoma
innter layer of a cell actually secrets cells of the TDLU
luminal epithelium
middle layer of a duct acts as a barrier to keep everything inside the cell
myoepithelium
the outer layer of the cell that holds it all together and responds to hormal fluctuations
basel membrane or
basement membrane
carry blood and fluid back and forth from the breast tissue to the rest of the body
lymphatic system
The medial aspect of the breast receives ____ of the blood supply via the ____
60%
internal thoracic mammary artery
the lateral aspect of the breast receives ___ % of the blood supply from the four vesseles coming out what two arteries
40%
axillary artery and the intercoatal artery
what 4 vessels come out of the axillary artery
lateral thoracic branches
thoracoacromial branches
lateral mammary branches
mammary branch
lateral thoracic vein comes off the ___ and drains the ___
axillary vein
lateral breast
internal thoracic vein drains the
medial breast
the intercostal vein drains the
lateral breast
what are the two types of lymphatic systems
superficial - skin
deep- within the breast nipple and areola
what 2 groups of lymph nodes receive lymph from the breast tissue, what percent
axillary (75%-90%)
parasternal (10-25%)
the axillary nodes receive how much of the lymph from the breast
75%-90%
the parasternal nodes receive how much of the lymph from the breast
10/25%
BIRAD A
fatty/adipose breast are almost entirely fat
25% density
BIRAD B
scattered fibroglandular density
25-50% dense
BIRAD C
heterogeneously dense
51-75% dense
what BIRAD may obscure small masses
BIRAD C
BIRAD D
extremely dense
75% dense
What BIRAD lowers the sensitivity of mammography
BIRAD D
what are the fixed borders of the breast
medial
superior
what tissue is best demonstrated on the CC view
medial
death rates are decreasing due to what 4 things
- advancement in treatment
- earlier detection
- increased awareness
- reduced use of hormone replacement
True or false
a woman with cancer in one breast has a higher risk of developing a new cancer in tge other breast
true
a womans risk of breast cancer nearly _____ if she has 1 first degree relative who has been diagnosed with breast cancer
double
True or false
a woman with a father or brother with breast cancer also have a higher risk of breast cancer
true
what percent of breast cancers are linked to a gene mutation
5-10%
what is your lifetime risk if you are BRCA 1 positive
70%
BRCA 1 and BRCA 2 have higher risk of getting ____ cancer
ovarian
____ women are most likely to develop breast cancer
caucasion
___ women under the age of 45 are more likely to develop breast cancer and more likely die
african american women
These women have the lowest risk of developing and dying from breast cancer
asia, hispanic, native american
women with benign conditions have a higher risk of cancer. The conditions are called
proliferative lesions without atypia
what are some examples of proliferative lesions without atypia
ductal hyperplasia
fibroadenoma
conidtions in which the cells in the ducts or lobules of the breast grow excessively and no longer look normal
proliferative lesions with atypia
looks like cancer cells are growin in the lobules of the milk producing gland of the breast, but they are not growing through the wall
lobular carcinoma in situ
early menstruation (before 12) gives you an __ risk of breast cancer
increased
women who had late menopause (after 55) have a ____ risk of breast cancer
higher
nulliparity and effect of breast cancer
never given birth
higher
primiparity and effect on breast cancer
1 child
higher
women with dense breast are how much more at risk than the average density
1.5-2 times
a thin supportive layer located between the basal surface and the epithelium and the connective tissue layer of the lobue is called
basement membrane
malignant casting calcifications appear as
framented linear branching
eggshell like and sharply outlined or elongated branching calcification are typycally
benign
primipara
carried pregnancy to over 20 weeks
postmenopausal obesity is associated with
circulating estrogen that is produced in fatty tissue
when questioning your patient what is the purpose of repitition
summarize
“where is your pain” is what kind of quesiton
open ended
proces of removing tissue and fat from teh abdomen and transferrign that tissue to reconstructed breast is called
DIEP - deep inferior epigastric perforator
removal of fluid cytology examines the fluid
cyst aspiration
Biopsy technique that often requires the presence of a cytologist
FNB
any size tumor with extension to chest wall or skin. Four to nine axillary nodes and or internal mammary nodes involved. No metastasis
stage 3
Cancer that has spread to another organ is stage __
4
what are 3 contraindications of a lumpectomy
- previous lumpectomy
- multi cancer sites in one breast
- large tumor in small breast
staging of cancer will determine what 3 things
- if the cancer is invasive
- exact tumor size
- if cancer has spread
with calcifications magnification is used to asses what 3 things
- number
- morphology
- tissue distribution
In the CC projeciton the detector is positioned
at the level of the raised IMF
Why is the MLO preferred to the ML as a routine projection
poorly visualized posterior and lateral breast
Uses high frequency sound waves to image the breast
ultrasound
the thickest skin portion of the breast that travels from the central breast to the lateral side is the
tail of spence
fatty tissue is generally ____ with ___ density
radiolucent
lower
veins are located in the ___ of the breast
periphery
what 3 things will affect the average glandular dose
breast compression
HVL
breast size and composition
Two disadvantages of mammography screening include
granularit of the breast can impact visualization of cancer
mammography will not image all cancers
The TDLU consists of what 2 things
extralobular terminal ducts
interlobular terminal ducts
lactation results in increase ____ making mammography undiagnostic
glandularity
The better the converiosn for DQE the better the ____ ____
image quality
- The two main classifications of breast cancer are
(A) tubular and lobular
(B) lobular and medullary
(C) lobular and ductal
(D) inflammatory and ductal
(C) lobular and ductal
The general criteria to pass the new American College of Radiology Digital Mammography (ACR DM) phantom require a minimum of _______ masses.
(A) 2
(B) 3
(C) 4
(D) 5
(A) 2
- The picture indicates
(A) mammographically benign calcifications
(B) malignant calcifications
(C) keratosis
(D) fibroadenomas
A
- Identify the position shown
(A) MLO
(B) CV
(C) LM
(D) ML
C
The detectors ability to respond to different exposure levels is called ___ ____
dynamic range
25lbs is how many N and how many DaN
111
11.1
what type of system has an amorphous selenium flat panel detector
direct digital
Sarcomas make up what % of breast cancer
1%
What allows repeated access to the venous system
infusaport
ductal carcinoma occurs in __% of women with breast cancer and lobular carcinoma occurs in ____%
90%
5%-10%
Causes of poor contrast include
(A) inadequate exposure
(B) inadequate compression
(C) excessive KVP
(D) all of the above
(D) all of the above
A patient that has an inconclusive mammogram and ultrasound may benefit from an MRI because it can __________________
delineate benign from malignant tumors
What is the leading cause of false-negative mammography results in dense breast tissue
underexposure
beam hardening is a byproduct of inadequate compression, which leads to increased ___
scatter
For magnification mammography the exposure time will be ___ as a result of the units small focal spots
longer
Overexposure results in ___ contrast
lower
A lateral view is an additional type of mammography view used for diagnostic mammograms. A lateromedial view means the x-ray beam is aimed to what aspect?
toward the inner chest
Which of the following is an example of ductal carcinoma?
(A) Comedo
(B) Epithelia hyperplasia
(C) Epitheliosis
(D) Papillomatosis
(A) comedo
Proper positioning helps eliminate which of the following
(A) all contrast
(B) all radiation exposure to the patient
(C) all mammogram artifacts
(D) the majority of mammogram artifacts
(D)
Which of the following would have the largest number of pixels?
(A) workstation monitor
(B) acquisition
(C) diagnostic workstation monitor
(D) laser film
(D)
Ideally, breast compression is maximized when?
(A) Accompanied by a thorough explanation to increase patient cooperation and the exposure is made on arrested inspiration to reduce motion.
(B) The exposure is made on arrested inspiration to reduce motion and the patient recognizes the advantage of compression in reducing radiation dose.
(C) Accompanied by a thorough explanation to increase patient cooperation and the patient recognizes the advantage of compression in reducing radiation dose.
(D) Accompanied by a thorough explanation to increase patient cooperation, the patient recognizes the advantage of compression in reducing radiation dose and the exposure is made on arrested inspiration to reduce motion.
C
The radiation doses of digital mammography exposures tend to be what percent lower than those of screen film mammography (SFM)?
20-30%
The five year survival rate for a patient with a stage 0 breast cancer is approximately which percentage?
100%
What view gives the best view of the mid-body side of the breast?
Open Calculator
LM
During spot compression, the technologist must do what before beginning the procedure?
identify the area of abnormality
Of the following, which should have the least number of pixels?
(A) acquisition
(B) diagnostic workstation monitor
(C) laser films
(D) workstation monitor
D
Three categories of compliance must be met in order to satisfy the MQSA standards for personnel. Which of the following is not one of these categories?
(A) Continuing experience.
(B) Initial qualifications.
(C) Supervisory ratings.
(D) Continuing education.
C
What category of BIRADS is associated with negative mammogram results with benign calcifications?
BIRAD 2
A BIRADS rating of 0 indicates which of the following?
(A) The patient has a known malignancy.
(B) The patient has a highly suscpicious abormality that needs further imaging.
(C) The patient’s results show that no cancer is present.
(D) The patient’s results are incomplete.
D
the production of milk is regulated by ___
hormones
Filtration provides the right amount of radiation to obtain a quality image by doing what?
shortening the exposure time
How should the patient’s arm on the side to be imaged be positioned for an ML view?
stretched out on the object table
Which of the following is true for full field digital machines?
(A) The digital image is not easy to manipulate.
(B) The digital image cannot be manipulated.
(C) The digital image is easy to manipulate.
(D) The digital image cannot be saved.
C
Prolactin is at its highest point when?
1 hour after the onset of sleep
Where would the Ductography be performed?
mammography
HVL is used for _____ _____ and ____ _____
quality assurance
quality control
Which tissues is best visualized using the XCCL view?
posteriolateral
The examination of the__________ assists in revealing the potential of breast cancer spreading to alternative locations in the body?
sentinal lymph node
MR Ductography is considered to be which of the following?
(A) An invasive procedure
(B) A noninvasive procedure
(C) A physical exam
(D) A type of CT scan
(B) A noninvasive procedure
If looking for a malignancy, the characteristics of a microcalcification would be considered which of the following?
(A) Fine size
(B) Single appearance
(C) Faint calcifications
(D) None of the above
A
ROC
Receiver Operating Characteristics
The mammography tube is designed and specifically constructed to capture what
soft breast tissue
What other tissues can be seen on the CC other than medial
Retroareolar, central, some lateral
What view is taken from the side and at an angle of a diagonally-compressed breast?
MLO
The FDA requires any mammography facility to obtain accreditation by completing all of the following except?
(A) Be accredited by an FDA-approved accreditation body.
(B) To continually keep up with all of the standards of accreditation
(C) Undergo an annual MQSA inspection.
(D) To be accredited by OSHA
D
A case of breast cancer in which cancer is found in the lymph nodes near the collarbone would be staged as which of the following?
Stage 3C
According to the image quality metrics (digital mammography) , which of the following would be considered a perceptual (observer-dependent)?
(A) Noise power spectrum
(B) Resolution (PSF)
(C) Limiting resolution
(D) Detective quantum efficiency
C
Which of the following supplies blood to the lateral breast?
(A) Internal mammary artery
(B) Internal maxillary artery
(C) Intercostal artery
(D) Lateral thoracic artery
D
What is the primary goal in breast positioning for screening mammography?
To show as much of the tissue as possible
Radiation therapy for breast cancer in which larger doses are given for three weeks is known as which of the following?
accelerated breast irradiation
The use of low kVp and high mAs will serve to do what
Reduce noise
increase subject contrast
A rolled CC is what type of view
supplementary
Which of the following is true regarding SNR (signal-to-noise ratio)?
(A) Image quality decreases when the signal is higher compared to the background noise.
(B) Image quality increases when the signal is higher compared to the background noise.
(C) Image quality increases when the signal is lower compared to the background noise.
(D) Image quality increases when the signal is higher compared to the contrast quality.
B
For which of the following might a triangulation become necessary?
(A) Focal compression
(B) Internal compression
(C) Stereotactic biopsy
(D) None of the above
(C) Stereotactic biopsy
prolactin is considered a ___
hormone
Which of the following would be considered correct for the 7th section of the HL7 standards?
education and awareness
Which of the following does the 1HE promote?
(A) The use of established standard computer languages
(B) The standards such as Health Level 7 (HL7)
(C) The guidelines of HIPAA
(D) Both A and B
D
Why are diagnostic mammograms typically longer than screening mammograms?
They capture more images
A thickening of swelling of part or all of the breast, which may be a sign of breast cancer, is known as which of the following?
Peau d’ orange
What is the main purpose of mammogram equipment evaluations?
(A) To ensure compliance with the department manager
(B) To verify the repairs made were worth the time/money spent
(C) To ensure that the hospital does/does not need to buy additional equipment
(D) To verify all functions have been successfully restored after repair/alteration
D
Although T-scan impedance imaging is often used in conjunction with mammography, it doesn’t require what
additional radiation
Assessing the final images of the mammogram challenges the technologist’s image execution. Which of the following would not be a factor in image execution?
(A) Inclusion of entire breast anatomy.
(B) Knowledge of each projection.
(C) Intended purpose of each projection.
(D) Positioning techniques of each projection.
A
Which of the following is not part of the image quality phantom test?
(A) SNR/CNR evaluation
(B) Compression thickness
(C) Image quality scoring objects
(D) Artifact evaluation
B
If the kVp is higher, the mammogram image would be which of the following?
grey
what is the only physicist test covered under MQSA
MEE - mammogrpay equipiment evaluation
Approximately what percent of breast cancer occur in women
98%
In mammography the focla spot has ___ ___
dual focus
What view used to be called the cleopatra
AT
What is an advantage of using a frid in mammography
improved contrast
Contrast is usually ___ in thicker breast
higher
What type of imaging has a phosphor flat panel detector
indirect
In DBT images are ____ to the BEAM
perpendicular
ACR guidelines for high risk screening MRI. What percent is considered high risk
MRI by 30
20% lifetime risk
