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Specialized Gen Rad > Week 11 > Flashcards

Week 11 Flashcards

1
Q

what does the posterior base of breast overlay

A

pectoral & serratus muscles

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2
Q

where does axillary tail of breast extend till

A

from lateral base of breast to axillary fossa

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3
Q

what do each of the breast lobules contain

A
  • acini
  • draining ducts
  • interlobular connective tissues
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4
Q

types of breast tissues

A
  1. glandular
  2. fibrous
  3. adipose
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5
Q

breast composition categories

A
  1. almost entirely fatty
  2. scattered
  3. heterogeneously dense
  4. extremely dense
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6
Q

what is the issue of heterogeneously dense breasts

A

obscures small masses

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7
Q

what is the issue of extremely dense breasts

A

decreased mammography sensitivity by masking calcifications & cancers

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8
Q

benign breast inflammatory diseases

A

acute mastitis
plasma cell mastitis

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9
Q

benign breast fibrocystic change diseases

A

fibroadenoma
cysts

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10
Q

benign breast proliferative breast change diseases

A
  • epithelial hyperplasia
  • sclerosing adenosis
  • radial scar
  • intraductal papilloma
  • fat necrosis
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11
Q

benign breast proliferative breast diseases with atypia

A

atypical ductal hyperplasia
lobular neoplasia

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12
Q

what are punctate microcalcifications indicative of

A

sclerosing adenosis

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13
Q

what are diffuse ‘rod-like’ microcalcifications indicative of

A

plasma cell mastitis

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14
Q

what are round coarse microcalcifications indicative of

A

calcified cyst

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15
Q

what are cylindrical coarse microcalcifications indicative of

A

vascular

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16
Q

non-invasive malignant breast carcinoma

A

ductal + lobular carcinoma in-situ

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17
Q

invasive malignant breast carcinoma

A

invasive ductal + lobular carcinoma

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18
Q

what is paget’s disease associated with

A

breast cancer

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19
Q

Benign vs Malignant for shape

A

benign = round
malignant = varying

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20
Q

Benign vs Malignant for density

A

benign = same throughout
malignant = varying

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21
Q

Benign vs Malignant for distribution

A

benign = scattered + clustered
malignant = clustered

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22
Q

Benign vs Malignant for definition

A

benign = well-defined
malignant = poorly-defined

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23
Q

Benign vs Malignant for uni/bi lateral

A

benign = if seen on both breasts, benign
malignant = unilateral

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24
Q

Benign vs Malignant for surrounding tissues

A

benign = calcification seen within benign appearing mass / surrounding tissue appears normal
malignant = architectural/parenchymal distortion

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25
Q

Benign vs Malignant for increased number since prior mammogram

A

benign = benign
malignant = must consider other factors

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26
Q

Benign vs Malignant for size

A

benign =big/small
malignant = small

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27
Q

how do calcification appear as

A
  1. microlobulated
  2. spiculated
  3. circumscribed
  4. indistinct
  5. obscured
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28
Q

focal asymmetry?

A

true finding rather than superposition and differentiated from a mass

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29
Q

global asymmetry?

A

area asymmetry over at least 1/4 of breast, normal variant usually

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30
Q

developing asymmetry?

A

newer + larger + more visible than previous scans

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31
Q

breast cancer occurance quadrants

A

upper outer = 50%
upper inner = 15%
lower outer = 11%
lower inner = 6%
nipple = 18%

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32
Q

fibroadenoma peaks at ___ then dips

A

20 years old

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33
Q

cysts peaks at ___ then dips

A

50 years old

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34
Q

cancer increases ___ with age

A

exponentially

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35
Q

benign nodularity dips at

A

50 years old

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36
Q

non-modifiable factors of breast cancer

A
  1. age
  2. length of fertile period
  3. genetics
  4. family history
  5. dense breast tissue
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37
Q

which hormones contribute to breast cancer

A

estrogen + progesterone

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38
Q

how long is the length of fertile period

A

1st period till menopause

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38
Q

modifiable factors of breast cancer

A
  1. age of 1st pregnancy (after 30 years/never pregnant)
  2. hormone replacement therapy
  3. alcohol
  4. obese
  5. not active
  6. not breastfeeding
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38
Q

4 views used to detect breast cancer

A

right craniocaudal (RCC)
left craniocaudal (LCC)
right mediolateral oblique (RMLO)
left mediolateral oblique (LMLO)

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38
Q

x-ray vs mammography for voltage

A

x-ray = 40 - 125 kVp

mammo = 23 - 40 kVp

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39
Q

x-ray vs mammography for large FSS

A

x-ray = 2 mm

mammo = 0.3 mm

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40
Q

x-ray vs mammography for small FSS

A

x-ray = 1.0 mm

mammo = 0.1 mm

41
Q

x-ray vs mammography for IR pixels

A

x-ray = 43 x 43 cm

mammo = 24 x 30 cm

42
Q

x-ray vs mammography for pixel size

A

x-ray = 143 micrometer

mammo = 85 micrometer

43
Q

x-ray vs mammography for anode

A

x-ray = tungsten / molybdenum

mammo = tungsten / molybdenum / rhodium

44
Q

x-ray vs mammography for target

A

x-ray = rhenium - tungsten faced molybdenum

mammo = tungsten / molybdenum / rhodium

45
Q

x-ray tube used for fatty breast up to 4 cm thickness

A

Anode target = Molybdenum

Filter = Molybdenum

46
Q

x-ray tube used for glandular breast up 5-7 cm thickness

A

Anode target = Molybdenum

Filter = Rhodium

47
Q

x-ray tube used for breast > 7 cm thickness

A

Anode target = Rhodium

Filter = Rhodium

48
Q

what is area compression used for

A

uniform compression of breasts for uniform density across image

49
Q

what is spot compression used for

A

better compression over small area using small paddle

50
Q

how much force is applied for compression

A

100 - 200 Newtons
10 - 20 daN

51
Q

which anode & filter is used for lowest dose

A

Rhodium / Rhodium

52
Q

what is the ranking scale of anode & filter from highest to lowest dose

A

Mo/Mo > Mo/Rh > Rh/Rh

53
Q

what does more glandular tissue result in

A

higher dose due to higher attenuation

54
Q

when is US used

A

when woman is under 40 or supplementary use once lesion detected

55
Q

what does intralobular connective tissue have

A

abundance of plasma cells that produce IgA into milk

56
Q

interlobular connective tissue AKA

A

cooper’s / suspensory ligaments

57
Q

___ tissue appears white, __ appears black on scans

A

Fibroglandular; adipose

58
Q

Annual glandular dose should not exceed ___

A

3 mGy

59
Q

why are mammograms not used for younger women

A

higher progesterone and estrogen production = increases fibroglandular tissue & breast density =
limited visualization of breast tissues

60
Q

Mammogram reduces mortality rate from __ to __

A

50 to 10%

61
Q

why should AEC be used for mammo

A

Denser breasts require higher kVp to penetrate but that also degrades subject contrast hence AEC best

62
Q

True lesions will persist despite compression

A

true

63
Q

how many times should one do self examinations

A

Self exam once a month, a week after mensus

64
Q

how many mammograms per year for those 40 - 50 years old

A

once per year

65
Q

how many mammograms per year for those > 50 years old

A

once every 2 years

66
Q

what is the number 1 cause of cancer death among women in SG

A

breast cancer

67
Q

clinical signs of breast cancer

A

lump, pulled nipple, dimpling, dripping, rash, skin changes

68
Q

why is the FDD fixed

A

balance between lowering patient dose while ensuring sufficient film dose

69
Q

what does higher progesterone & estrogen mean

A

increased fibroglandular tissue = denser breasts

70
Q

what gene is involved in breast cancer

A

BRCA

71
Q

how does paget disease appear as

A

similar to eczema

72
Q

how are microcalcifications classifed

A

morphology, size, density, distribution,

73
Q

most common cancer type

A

invasive ductal cancer

74
Q

10 - 15% of breast cancers are

A

invasive lobular carcinoma

75
Q

how to differentiate between malignant and benign lesions

A

malignant lesions have ill defined & spiculated margins except benign lesions which have well defined margins

76
Q

Beryllium window purpose

A

o Absorbs low energy photons that cannot penetrate breasts = hardens beam
o Minimises radiation absorption within tube

77
Q

how do filters work

A

K-edge of material helps to filter low and high energy photons

78
Q

why is Mo/Rh used rather than Rh/Mo

A

Mo filters out the characteristic x-rays

79
Q

dual track vs single track

A

o Single track has higher anode heat loading = less exposure time = less motion unsharpness

o Dual track has lower anode heating loading = more risk of motion unsharpness, but has material choice which allows for variation for thicker and thinner breast

80
Q

why does DM use tungsten

A

wider dynamic range

81
Q

how does finite size affect image quality

A

finite size which leads to geometric unsharpness and blurring

82
Q

___ optimal for DM of all thickness and dose reduction on order of 30%

A

Rh/Ag

83
Q

focal spots for contact & magnification mammography

A

0.3 mm for contact; 0.1 for magnification

84
Q

why does magnification need longer exposure time

A

compensate for reduced radiation intensity to IR and needed for quality to see microcalcifications

85
Q

lux

A

illuminance; amount of light that falls onto surface [ambient lighting]

86
Q

Cd/m^2

A

luminance; intensity of light emitted or reflected from surface [brightness & contrast]

87
Q

alternatives to mammography

A

US & MRI

88
Q

provide thyroid shield for those who request

A

no as it would lead to increased repeat risks

89
Q

when is grid not used

A

magnification views

90
Q

rolled views done to

A

separate overlapping tissue

91
Q

Patient externally rotates humerus to __

A

move shoulder away from compression paddle

92
Q

why must PNL be within 1 cm on MLO

A

to verify that enough or most breast tissue included

93
Q

views for male gynecomastia

A

MLO only

94
Q

inframammary fold is __

A

natural lower boundary of breast

95
Q

what is the first line of modality used for women under 30

A

Ultrasound

96
Q

in-situ

A

isolated in that one region

97
Q

3 patterns for self breast exam

A

wedge, spiral, up&down

98
Q

1 breast might have more glandular than another especially in __

A

upper outer quadrant

99
Q

__ discharge when nipple squeezed is normal for most women; only without stimulation then its a concern

A

clear milky

100
Q

___ nipple comes out when stimulated, __ nipples does not

A

inverted; retracted

101
Q

nipple retraction caused by

A

aging, breast cancer, ectasia

102
Q

where is the thickest area of breast

A

base of breast

103
Q

small bumps enlarged during pregnancy is

A

Montogomery glands

104
Q

which asymmetry requires supplementary views to confirm mass

A

focal, global, developing

Specialized Gen Rad (13 decks)

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