Mammography

Question 1

What is the purpose of compression?

Answer 1

• Reduces breast thickness for even tissue distribution
• Reduces patient motion
• Prevents tissue overlap

Question 2

What is the difference between a screening and diagnostic mammo?

Answer 2

Screening Mammogram:
- 2 projections of each breast must be
obtained
Diagnostic Mammogram:
- Additional views

Question 3

What is the machine angulation for MLO view?

Answer 3

30-60 degrees

Question 4

What direction is the breast imaged in MLO?

Answer 4

axilla to IMF

Question 5

What information does MLO provide about a mass?

Answer 5

estimation of location superior or inferior to nipple

Question 6

How is the machine positioned for CC view?

Answer 6

beam is perpendicular with floor

Question 7

Where is the marker placed for CC view?

Answer 7

toward axilla

Question 8

What information does a CC view provide us about a mass?

Answer 8

estimation of location medial or lateral to nipple

Question 9

What is a lateral view?

Answer 9

true lateral, beam is parallel with floor, can be ML or LM

Question 10

What is a lateral view best for imaging?

Answer 10

lesions in sup or inf quads

Question 11

What is spot compression?

Answer 11

used to image small regions with greater compression, can be used w or w/o magnification

Question 12

What is a cleavage view?

Answer 12

images medial aspects of both breasts simultaneously

Question 13

What is a cleavage view best for imaging?

Answer 13

masses in most medial or sternal region

Question 14

What is an axillary tail view?

Answer 14

similar to MLO, focused on Tail of Spence

Question 15

What is a rolled view?

Answer 15

displaces mass or nipple

Question 16

What is an Eklund view?

Answer 16

implant displaced

Question 17

Where are medial and lateral located in CC view?

Answer 17

From nipple to marker: lateral
From nipple away from marker: medial

Question 18

What aspect of the breast is located higher in MLO view?

Answer 18

Since MLO is not a true lateral, medial portion located slightly higher and lateral portion located slightly lower

MULD – Medial Up Lateral Down

Question 19

How much has breast cancer detection increased with the use of CAD?

Answer 19

8-15%

Question 20

What are the pros of using CAD?

Answer 20

• Detects small microcalcs
• Detects small spiculated masses
• Reliable and consistent
• Decreased human error
• Technology is continuing to improve

Question 21

What are the cons of using CAD?

Answer 21

• Should not be used as a diagnostic tool alone
• Radiologist needs to interpret images first
• CAD markings need to be reevaluated and imaged again

Question 22

What is tomosynthesis?

Answer 22

• Provides a volume reconstruction of an image by obtaining 2 projections
• Instead of 2 still images, radiologists can scroll through sliced images of the breast

Question 23

What is a benefit of using tomosynthesis?

Answer 23

allows for displacement of obstructing tissue

Question 24

What is MRI best used for in regards to breast imaging?

Answer 24

• Useful in cancer staging and the evaluation of lymph node involvement
• MRI is the most accurate modality for evaluating augmented breasts and implant rupture

Question 25

What are pros of using MRI?

Answer 25

- Image slices from any plane - Landscape image - Both breasts simultaneously - Sensitive to small lesions - Sensitive to malignant lesions with use of contrast - Breast implant ruptures - Residual cancer after lumpectomy

Question 26

What are cons of using MRI?

Answer 26

- Difficultly distinguishing benign vs malignant - Cannot evaluate microcalcs - Use of contrast injection - Claustrophobia - Time-consuming - Expensive

Question 27

What is breast imaging in nuclear medicine called?

Answer 27

scintimammography

Question 28

What is scintimammography?

Answer 28

- Images the physiologic response to breast disease - A radioactive element is injected into the contralateral arm - This tracer locates and highlights cancer cells in the breast

Question 29

What is nuc med helpful in diagnosing?

Answer 29

- Disease in patients with dense breasts - Palpable abnormalities not well visualized on US/Mammo - Multifocal/Multicentric cancer invasion

Question 30

What is BIRADS cat 0?

Answer 30

incomplete, needs additional imaging

Question 31

What is BIRADS 1?

Answer 31

negative

Question 32

What is BIRADS cat 2?

Answer 32

benign

Question 33

What is BIRADS cat 3?

Answer 33

probably benign

Question 34

What is BIRADS cat 4?

Answer 34

suspicious 4A: low suspicion 4B: moderate suspicion 4C: high suspicion

Question 35

What is BIRADS cat 5?

Answer 35

highly suggestive of malignancy

Question 36

What is BIRADS cat 6?

Answer 36

known biopsy-proven malignancy

Question 37

What are categories A-D in mammo?

Answer 37

A: almost entirely fatty B: scattered areas of fibroglandular density C: heterogeneously dense D: extremely dense

Question 38

What are categories A-C in US?

Answer 38

A: homogenous echotexture- fat B: homogenous echotexture- fibroglandular C: heterogenous echotexture

Question 39

What are categories A-D in MRI?

Answer 39

A: almost entirely fat B: scattered fibroglandular C: heterogenous fibroglandular D: extreme fibroglandular