Mammography Toughest Trivia Quiz: Can You Pass This Test?

Collimation in mammography refers to the process of restricting the X-ray beam to a specific area of interest. It involves adjusting the size and shape of the X-ray beam to match the size and shape of the detector. By collimating the X-ray beam to the detector, unnecessary radiation exposure to surrounding tissues is minimized, resulting in a clearer and more accurate image. Therefore, the correct answer is "the detector."

When imaging implants, compression is used for immobilization only. This means that the compression is applied to keep the implant in place and prevent movement during the imaging process. It is not used to separate the breast tissue or spread out the implant.

Reduction mammoplasty is a surgical procedure that aims to reduce the size and reshape the breasts. It typically involves the removal of breast tissue, along with the relocation of the nipple to a higher position on the breast. This helps to achieve a more proportionate and aesthetically pleasing breast shape. The procedure does not specifically involve reducing the size of individual lobules or the ampule, nor does it solely involve the removal of glandular tissue.

A fibroadenoma is a round, movable, but often benign lesion. This means that it is a non-cancerous growth that is typically found in the breast tissue of women. Fibroadenomas are usually smooth, firm, and easily movable under the skin. They are most commonly found in younger women, but can occur at any age. While fibroadenomas are generally harmless, they should still be monitored by a healthcare professional to ensure there are no changes or signs of malignancy.

A history of breast trauma, painful lumps or masses, and sudden nipple retraction are all factors that should be reported on the patient's medical history documentation because they can significantly impact the diagnosis. Breast trauma can lead to the formation of scar tissue or other abnormalities that may need to be investigated further. Painful lumps or masses can be a sign of a benign or malignant condition, and their presence should be noted. Sudden nipple retraction can be indicative of an underlying issue such as breast cancer or infection, and should also be reported.

The ratio of glandular tissue to total breast tissue can be affected by multiple factors. Firstly, a woman's genetic predisposition can play a role in determining this ratio. Different individuals may have different levels of glandular tissue based on their genetics. Secondly, the ratio can also be influenced by the ratio of total body adipose tissue to total body weight. Higher levels of body fat can result in a higher proportion of adipose tissue in the breasts. Lastly, drastic weight gain or weight loss can also impact the ratio as it can lead to changes in overall body composition, including the breast tissue. Therefore, all three factors mentioned in the answer can affect the ratio of glandular tissue to total breast tissue.

The correct answer is TRAM flap. TRAM flap stands for transverse rectus abdominis myocutaneous flap. It is a surgical procedure in which tissue, muscle, and fat are taken from the belly and used to reconstruct the breast. This technique is commonly used in breast reconstruction surgeries after mastectomy. The TRAM flap provides a natural-looking and feeling breast reconstruction option for women who desire autologous tissue reconstruction.

PEM (Positron Emission Mammography) and scintimammography are the breast imaging methods that fall under the category of nuclear imaging. PEM uses a small amount of radioactive material to detect breast cancer, while scintimammography uses a radioactive tracer to produce images of the breast tissue. MRI (Magnetic Resonance Imaging) does not involve the use of radioactive materials and therefore does not fall under the category of nuclear imaging.

The MQSA standards were enacted to address the poor quality of mammograms that were available. This suggests that there was a recognized issue with the quality of mammograms being performed, which prompted the need for regulations and standards to ensure that mammograms meet a certain level of quality and accuracy. The focus of the standards is on improving the quality of mammograms rather than overregulating or enforcing continuing education for the radiologic technologist or radiologist.

The correct answer is 8 because when imaging a patient with implant augmented breasts, additional projections are needed to adequately visualize the implants and surrounding tissues. These projections include the standard four views (cranio-caudal, mediolateral oblique, and implant displaced views), as well as additional views like the cleavage view, implant displacement views, and implant displacement with Eklund technique. These extra projections help in assessing the position, integrity, and complications related to the breast implants, making a total of 8 projections routinely required for imaging.

The correct answer is 2 and 3 only. This is because the American Cancer Society (ACS) recommends that women above 40 should have a screening mammogram every year, which aligns with option 2. Additionally, the ACS also recommends that new masses or lumps in the breast should be checked by a health-care provider, which aligns with option 3. Option 1, stating that all women should have a screening mammogram every year, is not in line with the ACS recommendation, as they specify that it is for women above 40.

Breast reconstruction can involve the placement of small fluid-filled sacs behind the pectoral muscle. The two common types of implants used in this procedure are silicone implants and saline implants. Silicone implants are made of a silicone outer shell filled with silicone gel, while saline implants are filled with sterile saltwater. Both types of implants have their own advantages and disadvantages, and the choice between them depends on factors such as personal preference, body type, and desired outcome.

All of the above options are true regarding breast implants and mammography. Implants can interfere with the interpretation of the mammogram because they obscure breast tissue, compression during mammography is necessary and can potentially rupture breast implants, and implant imaging often requires additional images to ensure accurate results.

Eggshell-like calcifications and lucent centers are characteristic of oil cysts. Oil cysts are benign breast lesions that form when fatty tissue in the breast is damaged or dies. The calcifications appear as thin, curved lines resembling an eggshell, and the lucent centers refer to the clear or empty spaces within the cysts. This pattern is typically seen on mammograms and helps differentiate oil cysts from other breast conditions such as melanomas, hemangiomas, and galactoceles.

MR-guided core biopsy is the most appropriate option for biopsy in a case where a lesion is only seen on MRI of the breast. This is because MR-guided core biopsy allows for precise targeting and sampling of the lesion under real-time MRI guidance, ensuring accurate and effective sampling of the abnormal tissue. Ultrasound-guided core biopsy, stereotactic biopsy, and mammography-guided FNAB are not suitable in this scenario as they rely on imaging modalities other than MRI.

The correct answer is to look and feel for changes in the breast. This is because the two-step method of BSE (Breast Self-Examination) involves visually inspecting the breasts for any changes in size, shape, or appearance, as well as physically feeling for any lumps or abnormalities. By regularly checking for changes, individuals can detect any potential issues early on and seek medical attention if needed. It is important to note that BSE is not a substitute for regular mammograms or clinical breast exams, but rather a complementary practice for breast health awareness.

Oil cysts are not often malignant but are rarely benign. They are typically seen on a mammogram as eggshell-like calcifications. These calcifications are formed when oil from ruptured breast lobules leaks into surrounding breast tissue, creating a cyst filled with oil. Oil cysts are more commonly observed in post-pregnancy cases. Therefore, the correct answer is that oil cysts are seen on the mammogram as eggshell-like calcifications.

After 5 years, the benefits of tamoxifen become negligible. This suggests that the drug is most effective in the first 5 years of treatment, and its effectiveness decreases significantly after this time period. It is important for patients to adhere to the recommended duration of tamoxifen treatment to maximize its benefits.

The mammogram is 90% accurate on average. This means that out of 100 mammograms, 90 of them will provide correct results. The accuracy of a mammogram is important in detecting breast cancer at an early stage and determining the need for further diagnostic tests or treatments. However, it is important to note that a mammogram can still produce false positive or false negative results, and additional tests may be required to confirm the diagnosis.

The higher energy of the rhodium beam is unsuitable for thinner breast because it can cause excessive radiation exposure and potential damage to the breast tissue. Thinner breast tissue requires a lower energy beam to ensure accurate imaging without harming the patient.

A lesion with no internal echoes, no spiculations, and fewer than four gentle lobulations is likely to be a benign lesion on ultrasound. Malignant lesions often display internal echoes, spiculations, and more than four lobulations. Therefore, based on the absence of these characteristics, it can be inferred that the lesion is not malignant but benign.

The technologist's initial mammography qualifications required by MQSA include completing a 40-hour mammography course, completing 25 supervised examinations, and completing 8 hours of training specific to digital mammography. These qualifications ensure that the technologist has received comprehensive training in both the theoretical and practical aspects of mammography, as well as specific training in the use of digital technology. This ensures that they are well-prepared to perform mammograms accurately and effectively, and to interpret the results correctly. Therefore, the correct answer is 1, 2, and 3.

Based on the information provided, a baseline mammogram showing that the patient's breast consists primarily of adipose tissue suggests that the patient is most likely to be above 60 years old. Adipose tissue is more common in older individuals, and hormone therapy is not necessarily indicated by the given information. The age range below 20 is unlikely to have a significant amount of adipose tissue in the breast, and while individuals above 35 may have some adipose tissue, it is less likely compared to those above 60.

The age group between 20 and 35 is likely to get the most radiation dose from a mammogram because younger women tend to have denser breast tissue, which requires more radiation to produce clear images. As women age, their breast tissue becomes less dense, requiring less radiation for imaging. Therefore, the younger age group is more likely to receive a higher radiation dose during a mammogram.

When imaging the breast in the MLO (mediolateral oblique) view, all three conditions mentioned must be met. The pectoral muscle should extend to or below the posterior nipple line (PNL) to ensure proper visualization. Additionally, visualized fat should be posterior to all the fibroglandular tissues, which helps in distinguishing between normal and abnormal breast tissue. Lastly, the inframammary fold (IMF) should be open to allow for proper positioning and imaging of the breast. Therefore, all three conditions (1, 2, and 3) must be met when imaging the breast in the MLO.

Imaging of the irradiated breast is recommended 6-12 months after treatment. This is because immediate imaging after treatment may not provide accurate results due to post-treatment changes in the breast tissue. Waiting for 6-12 months allows the breast tissue to settle down and any post-treatment changes to stabilize, making the imaging more reliable in detecting any abnormalities or changes. Imaging at this time interval helps in monitoring the effectiveness of the treatment and detecting any potential recurrence or complications.

The optimal duration of tamoxifen treatment is 5 years because this is the recommended time period for reducing the risk of recurrence and improving survival rates in patients with hormone receptor-positive breast cancer. Studies have shown that longer durations of tamoxifen therapy provide greater benefits in terms of preventing the return of cancer cells. Therefore, it is important for patients to complete the full 5-year course of treatment to maximize its effectiveness.

A risk factor is a significant factor that increases a person's chance of getting a disease. This means that certain factors, such as smoking, poor diet, or lack of exercise, can contribute to the likelihood of developing a disease. These risk factors are within a person's control and can be modified or eliminated to reduce the chances of disease occurrence. On the other hand, factors outside a person's control, such as genetics or environmental factors, may also increase the risk of disease but cannot be changed by individual actions.

The correct answer is MQSA. The mandatory mammography quality assurance act passed by the US Congress in 1992 refers to the MQSA (Mammography Quality Standards Act). This act was established to ensure the quality and accuracy of mammography screenings in order to detect breast cancer in its early stages. It requires mammography facilities to meet certain standards and undergo regular inspections and certifications to ensure the safety and effectiveness of mammography services provided to patients.

The correct answer is gender. Gender is the biggest risk factor for breast disease. Women are at a higher risk of developing breast cancer compared to men. This is because women have more breast tissue and hormonal factors that increase their susceptibility to breast diseases.

The term "dynamic range" refers to the range of values that a system can effectively respond to. In the context of this question, it specifically refers to the gray-scale range. A system with a high dynamic range is capable of accurately capturing and displaying a wide range of gray-scale values, from the darkest to the brightest. Therefore, dynamic range is the correct answer in this case.

The pectoralis major muscle is the correct answer because it is located immediately posterior to the breast. This muscle is a large, fan-shaped muscle that covers the upper part of the chest. It originates from the clavicle, sternum, and ribs and inserts into the upper arm bone. The pectoralis major muscle is responsible for movements of the shoulder joint, such as flexion, adduction, and medial rotation.

The BI-RAD category for a negative mammogram is BI-RAD 1. This means that the mammogram is negative for any signs of breast cancer or other abnormalities. BI-RAD 1 is the lowest category on the Breast Imaging Reporting and Data System (BI-RADS) scale, indicating that there is a very low suspicion for cancer.

The greatest disadvantage of magnification is increased patient dose. When magnification is used, the image is enlarged, which requires more radiation to penetrate the patient's body and produce a clear image. This increased radiation exposure can be harmful to the patient, especially if repeated exposures are necessary. Therefore, while magnification may provide a clearer image, it comes at the cost of increased radiation dose to the patient.

Open surgical biopsy is the most accurate biopsy technique because it involves the complete removal of a tissue sample for examination. This allows for a comprehensive analysis of the sample, including its cellular composition and any abnormalities present. FNB (fine needle biopsy), core biopsy, and MRI core biopsy are less invasive techniques that may provide a smaller or less representative sample, leading to a potential for inaccuracies or missed diagnoses.

A galactocele is a benign cyst that forms in the breast tissue due to the accumulation of milk. It is usually associated with nursing or breastfeeding, as it occurs when milk ducts become blocked or damaged. The cyst is typically filled with milk and may cause pain or discomfort. The other options, such as being radiolucent or having irregular borders, do not accurately describe a galactocele.

MRI is unable to image microcalcifications clearly, particularly lesions smaller than 5 mm. This is because MRI primarily relies on the detection of changes in magnetic fields caused by different tissue types, and microcalcifications do not produce significant magnetic field changes. Therefore, MRI is not as effective in detecting very small lesions or microcalcifications compared to other imaging modalities such as mammography or ultrasound.

Inflammatory carcinoma is a rare form of cancer that is characterized by symptoms such as swelling, warmth, and erythema. It can also be detected through mammography, where skin thickening is observed. This type of cancer is known for its aggressive nature and tends to spread quickly. Inflammatory carcinoma is different from other types of breast cancer, such as invasive ductal carcinoma, lobular carcinoma in situ, and papillary carcinoma, which may have different symptoms and characteristics.

Reduction mammoplasty is a surgical procedure that involves removing excess breast tissue and reshaping the breast to achieve a smaller size. In some cases, this procedure may also involve repositioning the nipple to achieve a more aesthetically pleasing result. Therefore, reduction mammoplasty is the correct answer as it accurately describes the technique of reconstructing the breast by removing tissue and relocating the nipple.

The removal of tissue and muscle from the abdomen to reconstruct a breast mound using microsurgical techniques is called a TRAM flap. This procedure involves taking a flap of skin, fat, blood vessels, and muscle from the lower abdomen and transferring it to the chest to create a new breast shape. The TRAM flap is commonly used in breast reconstruction surgeries and provides a natural-looking result.

The technical factors used for imaging the phantom should be the same as those used clinically for a 4.0-4.5 cm-thick breast of medium glandularity.

Ultrasound biopsies have no radiation, lower cost, and real-time imaging. This means that they do not expose the patient to harmful radiation like stereotactic mammography or MRI biopsies do. Additionally, ultrasound biopsies are less expensive than the other two options. Moreover, they provide real-time imaging, allowing the healthcare professional to visualize and guide the biopsy procedure more accurately. Therefore, the correct answer is "all of the above."

When an air gap is introduced in magnification, it reduces scatter. Scatter refers to the radiation that is deflected or scattered in different directions when passing through an object. By reducing scatter, the air gap helps to improve subject contrast. This means that the differences in density or composition within the subject are more easily distinguishable, resulting in a clearer and more detailed image. Therefore, the correct answer is reducing scatter.

The correct answer is TAN because the TAN projection (Tangential) is the best way to visualize calcifications in the skin. This projection involves positioning the breast so that the nipple is pointing towards the detector, allowing for a clear view of the skin and any calcifications present. The LMO projection (Latero-medial oblique) and LM projection (Latero-medial) are used to visualize different areas of the breast, while the AT projection (Anterior-Posterior) is used to visualize the breast from front to back. Therefore, TAN is the most appropriate projection for confirming the presence of calcifications in the skin.

The correct answer is XCCL. The XCCL projection, also known as the exaggerated craniocaudal lateral, is used to image the breast with the beam directed superiorly to inferiorly. This projection is necessary for a barrel-chested patient whose chest wall protrudes outward because it allows for better visualization of breast tissue extending laterally under the arm.

The glandular dose refers to the dose received by the radiosensitive cells of the breast. This means that it is the measure of radiation absorbed by the cells in the breast tissue that are more susceptible to radiation damage. It is important to measure and monitor the glandular dose as it helps in assessing the potential risk of developing radiation-induced breast cancer.

A patient with peau d'orange-type breast will present with breast skin that is obviously thickened. Peau d'orange is a condition characterized by the appearance of dimpled, pitted, or orange-peel-like skin on the breast. It is often associated with inflammatory breast cancer, a rare and aggressive form of breast cancer. The thickening of the breast skin is caused by the infiltration of cancer cells into the lymphatic vessels, leading to lymphatic obstruction and fluid buildup. This results in the characteristic appearance of peau d'orange.

A lumpectomy is the most breast-conserving surgery among the options provided. This procedure involves removing only the tumor and a small margin of surrounding healthy tissue, while preserving the majority of the breast. Chemotherapy is a systemic treatment that uses drugs to kill cancer cells throughout the body. Mastectomy involves complete removal of the breast, and modified radical mastectomy includes removal of the breast tissue, lymph nodes, and possibly other nearby structures. Therefore, a lumpectomy is the least invasive option that conserves the most breast tissue.

The component parts of the mammography tube that differentiate it from a regular x-ray tube include the size of the focal spots, the type of added filtration, and the material of the exit port window. The size of the focal spots in a mammography tube is smaller compared to a regular x-ray tube, allowing for better resolution and detection of small abnormalities in breast tissue. The type of added filtration in a mammography tube is specifically designed to remove low-energy x-rays, which can interfere with the visibility of breast tissue. The material of the exit port window in a mammography tube is typically made of materials like beryllium or molybdenum, which have low atomic numbers and allow for better transmission of low-energy x-rays.

Antiestrogen drugs such as tamoxifen are used to slow or stop the growth of cancer cells. They can also be used to prevent breast cancer in high-risk women by reducing the risk of developing the disease. Additionally, these drugs can help prevent the recurrence of breast cancer in patients who have already been treated for the disease. Therefore, options 1, 2, and 3 are all correct.

BSGI (Breast-specific gamma imaging) and PEM (Positron emission mammography) are imaging techniques used to detect breast abnormalities. However, they are not suitable for screening purposes due to the high doses of radiation involved. Screening tests are typically performed on asymptomatic individuals to detect early signs of diseases, and it is important to minimize radiation exposure in such cases. Therefore, the statement that BSGI and PEM are not suitable for screening due to high radiation doses is true.

Morgagni tubercles are small, raised bumps that are typically found on the skin of the areola. These tubercles are a normal anatomical feature and are more prominent in some individuals than others. They are believed to be remnants of embryonic structures and are not usually a cause for concern.

A patient with pectus excavatum may present a positioning problem because the patient has a depressed sternum. Pectus excavatum is a condition where the sternum and rib cage grow abnormally, causing the chest to appear sunken or depressed. This deformity can affect the positioning of the patient during medical procedures or surgeries, as it may make it difficult to properly position the patient on the operating table or imaging equipment. It is important to consider the patient's condition and take appropriate measures to ensure their comfort and safety during medical interventions.

Compression in mammography is used to allow uniform penetration of structures within the breast. By applying compression, the breast tissue is spread out evenly, reducing overlapping structures and allowing for a clearer image. This helps in detecting small abnormalities and improves the accuracy of the mammogram. Compression also helps to immobilize the breast, reducing the possibility of motion artifacts during the exposure. While compression may slightly reduce the radiation dose to the breast, its primary goal is to ensure uniform penetration and image quality.

Exposure reproducibility refers to the ability of an x-ray tube to consistently produce the same intensity of radiation when the same set of technical factors is used for an exposure. This means that the x-ray tube can accurately and reliably reproduce the desired radiation output, ensuring consistent image quality and dose to the patient. It is an important characteristic of an x-ray tube as it allows for consistent and repeatable imaging procedures.

The statement that circumscribed lesions are usually always malignant is false. Circumscribed lesions refer to abnormal growths or masses that have well-defined borders. While some circumscribed lesions can be malignant (cancerous), it is not always the case. Many benign (non-cancerous) growths can also have well-defined borders. Therefore, it is incorrect to assume that circumscribed lesions are always malignant.

The pigmentation of the areola is partly dependent on estrogen levels. Estrogen, a hormone primarily produced by the ovaries, affects various aspects of the female body, including breast development. It stimulates the growth of mammary glands and increases blood flow to the breasts, which can lead to changes in the coloration of the areola. Higher levels of estrogen can cause the areola to darken, while lower levels may result in a lighter color. Other factors such as breast shape, breast density, and the size of the areola may also play a role but are not specifically mentioned in the question.

An adult female breast typically has 15-20 lobes. Lobes are the glandular structures within the breast that produce milk. The number of lobes can vary slightly among individuals, but the average range is 15-20.

The retromammary space is the correct answer because it refers to the area between the breast and the pectoral muscle that contains fat. This space provides a separation between the breast tissue and the muscle, allowing for movement and flexibility of the breast. The inframammary fold is the crease underneath the breast where it meets the chest wall. Supporting and connective tissue refers to the structures that provide support and shape to the breast. The milk line is a developmental feature that extends from the armpit to the groin and represents the potential sites of breast tissue development.

Preoperative localization is important for several reasons. Firstly, it helps direct the surgeon to the specific area that requires biopsy, ensuring that the correct tissue is targeted. Secondly, it aids the surgeon in excising a smaller specimen, which can be beneficial for minimizing invasiveness and reducing potential complications. Lastly, preoperative localization is crucial for ensuring that the correct area is removed, preventing unnecessary tissue removal and potential harm to surrounding healthy tissue. Therefore, all three options (1, 2, and 3) are correct.

MRI can be used to map the extent of a tumor, as it provides detailed images of the body's soft tissues. It can also be used to image patients with implants, as it does not involve the use of radiation and is therefore safe for individuals with implants. Additionally, MRI can be used to evaluate patients with dense breasts, as it is able to detect abnormalities that may not be visible on a mammogram. Therefore, all three options (1, 2, and 3) are correct.

Magnification can be used to assess the margins of a lesion. By magnifying the image, it becomes easier to examine the edges or boundaries of the lesion. This is important in determining whether the lesion is well-defined or has irregular or blurry margins. Assessing the margins of a lesion can provide valuable information about its nature and potential for malignancy.

Spatial resolution refers to the ability of an imaging system to distinguish between small objects or details in an image. In this context, the question is asking about the ability to image small objects that have a high subject contrast. Spatial resolution is directly related to this ability because it determines how well the imaging system can capture and display fine details with high contrast. Therefore, spatial resolution is the correct answer in this case.

The statement is true because when imaging the mediolateral oblique (MLO) projection, the detector should not be automatically angled at 45 degrees for every patient. The MLO projection is used to visualize the breast tissue in a diagonal orientation, and the angle of the detector should be adjusted based on the patient's breast size and shape. This ensures that the breast tissue is adequately spread out and compressed for accurate imaging. A fixed angle of 45 degrees may not be suitable for all patients and may result in suboptimal imaging.

The US Food and Drug Administration has stated that nipple aspirate tests can potentially cause harm due to false-negative and false-positive results. This means that the test may incorrectly indicate the absence or presence of a condition, leading to unnecessary worry or delayed diagnosis. Therefore, the statement "True" is correct.

Under MQSA guidelines, if the patient does not return to a facility for additional mammograms, the radiographs and medical records must be kept for not less than 10 years. This is to ensure that the records are available for future reference and comparison, as well as for any potential legal or medical reasons that may arise. Keeping the records for this length of time also allows for continuity of care and the ability to track any changes or developments in the patient's health over an extended period.

The lymph drainage from the medial half of the breast is generally directed to the internal mammary lymph nodes. This is because the internal mammary lymph nodes are located near the sternum and receive lymphatic drainage from the medial aspect of the breast. The axillary lymph nodes, on the other hand, receive drainage from the lateral aspect of the breast. The external mammary lymph nodes are not typically involved in the drainage of the breast.

Given the description of the tumor on the mammogram, it is important to further investigate the characteristics of the tumor. The fact that it is low-density and has an oval shape, lobulated appearance, and a halo along one border suggests that it may be a suspicious or potentially malignant tumor. Therefore, the next logical step would be to perform an ultrasound to gather more information about the tumor's characteristics and determine if further testing or a biopsy is necessary.

The correct answer is both the ETDs and the ITDs. The TDLU, or terminal ductal lobular unit, is a functional unit of the breast that consists of both the extralobular terminal ducts (ETDs) and the intralobular terminal ducts (ITDs). The ETDs are located outside the lobules and carry milk from the lobules to the lactiferous ducts, while the ITDs are located within the lobules and are responsible for producing milk. Therefore, both the ETDs and the ITDs are part of the TDLU.

Taking synthetic hormones can lead to an increase in glandular tissue in the breasts. This is because synthetic hormones can stimulate the growth of glandular tissue, causing it to become more dense and prominent on a mammogram. Therefore, it is likely that the patient's current mammogram will show increased glandular tissue compared to her previous mammogram.

When using the Hologic digital breast tomosynthesis (DBT) system, patient motion can be indicated by several factors. Nonlinear movement of calcifications can suggest patient motion, as well as anterior-posterior movement of lesions or objects. Additionally, if lesions or objects appear sharper in one projection but not in the opposing projection, it can also indicate patient motion. Therefore, all of the above factors can be used to indicate patient motion when using the Hologic DBT system.

Repeated films are films that involve exposure to the patient. This means that these films are taken multiple times during a medical procedure or examination where the patient is exposed to radiation. These repeated films are necessary to ensure accurate and clear imaging for diagnosis or treatment purposes. The other options, such as films used for processor cleaning, films used for quality control, and all discarded films, do not specifically refer to films involving patient exposure.

The responsibility of the medical physicists includes monitoring and controlling the average glandular dose, which refers to the amount of radiation absorbed by the patient's breast tissue during a mammogram. Medical physicists ensure that the dose is kept at a safe and appropriate level to minimize the risk of radiation exposure to the patient while still obtaining accurate diagnostic images. They use their expertise to calculate and optimize the dose, as well as ensure compliance with regulatory standards and guidelines.

An MQSA certificate is issued to a mammography facility after it has been accredited. This certification is valid for a period of 3 years. This means that the facility has met the necessary standards and requirements for providing mammography services and has been recognized as a reliable and trustworthy provider. The 3-year validity period allows for regular monitoring and reassessment of the facility's practices to ensure continued quality and safety in mammography services.

The angle of the anode affects focal spot size because it determines the size and shape of the electron beam that interacts with the anode target. A steeper angle will result in a smaller focal spot size, while a shallower angle will produce a larger focal spot size. This is important because a smaller focal spot size leads to better image resolution, while a larger focal spot size can result in decreased image sharpness. Therefore, the angle of the anode is a crucial factor in determining the quality of the resulting image.

Spot compression can be used with any projection with or without magnification. This technique involves applying localized compression to a specific area of the breast during a mammogram. It helps to better visualize and evaluate a suspicious area by reducing overlapping breast tissue. Whether the projection is magnified or not, spot compression can be used to obtain a clearer image and aid in the detection and diagnosis of breast abnormalities.

Windowing is a postprocessing option in digital imaging that allows the user to adjust the brightness and contrast of an image. By changing the window level and width, the overall brightness of the image can be modified. This technique is commonly used in medical imaging to enhance the visibility of certain structures or abnormalities within the image.

Lumpectomy is a surgical procedure that involves the removal of the breast cancer tumor along with a small margin of normal breast tissue surrounding it. This procedure aims to remove the cancerous tissue while preserving as much of the breast as possible. It is a common treatment option for early-stage breast cancer and is often followed by radiation therapy to ensure complete removal of any remaining cancer cells. Unlike other options that involve removing the entire breast, lumpectomy allows women to retain their breast shape and size to a large extent.

AT is the best projection to visualize the tail of the breast. The tail of the breast is located in the upper outer quadrant of the breast, towards the armpit. The AT projection, also known as the axillary tail projection, specifically focuses on this area by angling the x-ray beam towards the armpit. This projection helps to visualize any abnormalities or lesions in the tail of the breast, providing a clear and detailed image for diagnosis and evaluation.

The correct answer is "reduce tissue thickness". When a specimen is compressed, it reduces the thickness of the tissue, allowing for clearer imaging and reducing the potential for motion unsharpness. This compression technique is commonly used in mammography to improve image quality and enhance the detection of abnormalities. It also helps to reduce radiation exposure as thinner tissues require less radiation to penetrate. Additionally, by reducing the tissue thickness, it minimizes the magnification factor, resulting in more accurate measurements and evaluations.

The correct answer is MLO. MLO stands for Mediolateral oblique projection, which is a mammographic view used to demonstrate the posterior lateral aspect of the breast. This projection is taken at an angle to the CC (craniocaudal) view, allowing visualization of the breast tissue that is not seen on the CC view alone. XCCL, ML, and LMO are not recognized or commonly used projections in mammography.

The MLO (mediolateral oblique) projection is an imaging technique used in mammography. The correct answer suggests that for a successful MLO projection, two key points should be considered. First, the tube angulation should be between 30 and 70 degrees. This ensures that the image captures the desired angle and perspective of the breast tissue. Second, the compression applied during the imaging process must support the anterior breast tissue. This is important to ensure that the breast is properly flattened and positioned for accurate imaging. The inframammary fold being closed is not mentioned as a key point in the question, so it is not included in the correct answer.

Ductography is a technique performed to evaluate suspicious nipple discharge. It involves injecting a contrast medium into the ducts of the breast and then taking X-ray images to identify any abnormalities or blockages in the ducts. This procedure helps in diagnosing the cause of the nipple discharge, such as a ductal papilloma or intraductal carcinoma. Aspiration biopsy, lumpectomy, and axillary dissection are not specifically used for evaluating nipple discharge.

The given information does not provide enough evidence to determine whether the lesion is benign or malignant. While a radiolucent lesion is more likely to be benign, other factors such as the shape, margins, and presence of a halo sign are also important in making a diagnosis. Therefore, the possibility of the lesion being malignant cannot be ruled out based on the given information alone.

In the modified projection where the superior aspect of the breast is rolled medially, the correct answer is RM. This means that the breast is rotated in a way that the superior part of the breast is moved towards the middle of the body.

A stereotactic biopsy is a minimally invasive procedure that is used to remove a nonpalpable lesion and determine whether it is benign or malignant. This procedure involves the use of imaging guidance, such as mammography or MRI, to precisely locate the lesion and guide the biopsy needle to the area of concern. It is a less invasive alternative to open surgical biopsy, which requires a larger incision. Ultrasound imaging and breast MRI are imaging techniques that may be used to help identify and characterize the lesion, but they do not involve the actual removal of tissue for diagnosis.

MRI is the single best modality to image silicone implant ruptures because it provides excellent soft tissue contrast and can detect even small ruptures or leaks. It is highly sensitive and specific in detecting implant ruptures, allowing for accurate diagnosis and appropriate management. Mammography and ultrasound may be used as adjunctive imaging modalities, but they are not as sensitive or specific as MRI in detecting implant ruptures. DBT (Digital Breast Tomosynthesis) is a type of mammography and is not specifically indicated for imaging silicone implant ruptures.

The MQSA certificate must be placed in the waiting area visible to all patients because it is important for patients to be aware that the facility is certified to perform mammography. Placing the certificate in the waiting area ensures that all patients have the opportunity to see it and be reassured of the facility's credentials. This helps to build trust and confidence in the facility's mammography services.

Photodynamic therapy is a treatment that combines a light source and a photosensitizing agent to destroy cancer cells. This therapy involves the administration of a photosensitizing agent, which is then activated by light of a specific wavelength. The activated agent produces reactive oxygen species that can damage or destroy cancer cells. This targeted approach makes photodynamic therapy an effective treatment option for certain types of cancer, as it selectively destroys cancer cells while minimizing damage to healthy tissues. Thermal ablation, immunotherapy, and cryotherapy are different treatment methods that do not involve the use of a photosensitizing agent and light source.

Improper placement of dense breast tissue/size over the detector can cause AEC failure and result in an underexposed radiograph. This is because the automatic exposure control (AEC) system relies on the detection of radiation passing through the breast tissue to determine the appropriate exposure. If the dense breast tissue is not properly positioned over the detector, it can block or attenuate the radiation, leading to an underexposed image.

The given answer, ML, refers to the Mediolateral projection. This projection is commonly used in routine series on patients with encapsulated implants. It involves taking an X-ray from the side of the breast, with the X-ray beam passing from the side to the middle of the breast. This projection helps to provide a different view and additional information about the implant and surrounding tissues, aiding in the evaluation and monitoring of the implants.

The specimen is radiographed to confirm that the lesion was removed. Radiographing the specimen allows for visual confirmation that the entire lesion was successfully removed during the procedure. This is important to ensure that there are no remaining cancerous or abnormal cells that could potentially cause further health issues.

Ultrasound uses high-frequency sound waves to image the breast. These sound waves are emitted by a transducer and penetrate the breast tissue. When the sound waves encounter different tissues, they bounce back and create echoes. These echoes are then converted into images by a computer, allowing healthcare professionals to visualize the internal structures of the breast. High-frequency sound waves are used because they can provide detailed images and are safe for the patient as they do not involve ionizing radiation.

Skin thickening can be caused by various factors, including malignancy, breast abscess, and postradiation. Option 1 is correct because a breast abscess can cause skin thickening. Option 3 is also correct because postradiation can lead to thickening of the skin. Option 2 is incorrect because a calcified fibroadenoma does not typically cause skin thickening. Therefore, the correct answer is 1 and 3 only.

As women age, their breast tissue tends to become less dense and more fatty. Therefore, a woman aged 30 years would likely have denser glandular breast tissue compared to the other options provided. It is important to note that dense breast tissue can make it more difficult to detect abnormalities on a mammogram, so women with dense breasts may require additional imaging or screening methods.

Open surgical biopsy is the most accurate biopsy technique because it involves the complete removal of a tissue sample for examination. This allows for a thorough analysis of the tissue, including its cellular composition and any abnormal changes. Other biopsy techniques, such as FNAB (fine-needle aspiration biopsy), Core biopsy, and Stereotactic breast biopsy, may provide valuable information but may not always provide a comprehensive sample for analysis. Open surgical biopsy ensures a larger and more representative tissue sample, increasing the accuracy of the diagnosis.