Breast Imaging: A Core Review (3 page)

Based on the screening mammogram images, what is the most appropriate BI-RADS assessment?

A. BI-RADS 0

B. BI-RADS 1

C. BI-RADS 2

D. BI-RADS 3

E. BI-RADS 4

8b
 The patient is called back for a repeat mediolateral oblique (MLO) image of the right breast (see below):

The reason the mediolateral oblique view was repeated was because of

A. Hair artifact

B. Motion artifact

C. Chin artifact

D. Deodorant artifact

E. Skin artifact

9
 The posterior nipple line measures 13 cm on the mediolateral oblique (MLO) view. What is an acceptable posterior nipple line measurement on the craniocaudal (CC) view?

A. 8 cm

B. 9 cm

C. 10 cm

D. 11 cm

E. 12 cm

10
 In order to meet MQSA requirements, all mammography facilities must review medical outcomes audit data for the aggregate of interpreting physicians as well as data for each individual interpreting physician at that facility. How often must the medical outcomes audit data be reviewed?

A. 3 months

B. 6 months

C. 12 months

D. 24 months

11
 Prior to independently interpreting any new mammographic modality the interpreting physician must first obtain and document additional training in this modality. How many hours of training are required?

A. 4 hours

B. 6 hours

C. 8 hours

D. 12 hours

12
 A screening mammogram contains significant motion artifact on one view. Which member of the team is responsible for assuring appropriate corrective action is taken?

A. Interpreting physician

B. Radiologic technologist

C. Medical physicist

D. Equipment vendor

13a
 A 41-year-old female with history of a palpable lump in the right breast. Images are provided below.

Based on the diagnostic mammogram images provided, what is the most appropriate next step?

A. Repeat MLO view due to possible artifact.

B. Proceed to a targeted right breast ultrasound of area that is palpable.

C. Request rolled craniocaudal views of the right breast.

D. Recommend return to annual screening mammography.

E. Refer the patient to see a breast surgeon.

13b
 The patient is called back for a repeat mediolateral oblique (MLO) image of the right breast (see below).

The reason the mediolateral oblique view was repeated was because of

A. Hair artifact

B. Chin artifact

C. Deodorant artifact

D. Suboptimal patient positioning

E. Motion artifact

14
 Which of the following is correct regarding screening mammography guidelines as recommended by American College of Radiology?

A. Annual mammograms starting at age 40 until 80

B. Biannual mammograms starting at age 35 and annual after age 40

C. Annual mammograms starting at age 50

D. Biannual mammograms starting at age 40 and annual after age 50

E. Annual mammograms starting at age 40 until the individual’s overall health allows

15
 Which of the following is correct regarding proper positioning of breasts in mammography?

A. The craniocaudal (CC) view is a projection parallel to the pectoralis major muscle.

B. On the CC view, the pectoralis major muscle is seen approximately 75% of the time.

C. On the mediolateral oblique (MLO) view, the pectoralis major should be concave anteriorly.

D. On the MLO view, the pectoralis major muscle should be seen above the level of the axis of the nipple.

E. The nipple should be in profile on at least one view.

16
 Federal regulations require that follow-up on surgical and/or pathology results be performed for patients with positive mammograms. How frequently are facilities required to conduct this follow-up?

A. Daily

B. Weekly

C. Monthly

D. Yearly

17
 Failure to inform patients of their results in a timely manner is considered a significant violation. What is the time limit set by the FDA to provide lay summaries to all patients?

A. 7 days

B. 14 days

C. 30 days

D. 60 days

18
 Which organization regulates mammography quality standards in the United States?

A. Food and Drug Administration

B. American College of Radiology

C. Department of Health and Human Services

D. Regulated by each state independently without federal involvement

19
 Ghosting artifact on MRI is caused by:

A. Wrong frequency-encoding direction

B. Wrong phase-encoding direction

C. Poor shimming

D. Patient motion

20
 The definition of positive predictive value 1 (PPV1) is:

A. Percentage of examinations with an abnormal final interpretation that result in a tissue diagnosis of cancer within 1 year

B. Percentage of examinations with a normal initial interpretation that result in a tissue diagnosis of cancer within 1 year

C. Percentage of examinations with an abnormal initial interpretation that result in a tissue diagnosis of cancer within 1 year

D. Percentage of examinations with an abnormal final interpretation where it is known that a biopsy was performed as a result of the abnormal diagnostic examination that result in tissue diagnosis of cancer within 1 year

21
 Which of the following statements concerning BRCA-1 mutation carrier is correct?

A. It is autosomal recessive.

B. It is a tumor suppressor gene on chromosome 17.

C. Lifetime risk of breast cancer is 25% to 35% with the carrier.

D. It is also associated with an increased risk of lung cancer.

22
 What is the benchmark for the Cancer Detection Rate (CDR) according to the fourth edition of BI-RADS?

A. 1–5/1,000

B. 1–10/1,000

C. 2–10/1,000

D. >2.5/1,000

E. >5/1,000

23
 What is the benchmark for the recall rate in screening mammography according to the fourth edition of BI-RADS ?

A. <10%

B. <20%

C. 10% to 15%

D. 5% to 12%

E. 5% to 15%

24
 Which of the following is a requirement for continuing education in mammography?

A. Interpretation of at least 960 mammograms per year

B. 15 hours of CME that are breast specific per year

C. Performance of at least 36 breast biopsies in 36 months

D. Interpretation of at least 100 breast ultrasound examinations in 1 year

25
 Which of the following describes the appropriate positioning for the MLO and CC views on a screening mammogram?

A. The pectoralis muscle must always be present on both the MLO and CC projections.

B. The pectoralis muscle must only be present on the CC projection.

C. The difference between the line from the nipple to the back of the film on CC and the line from the nipple to the pectoralis muscle on MLO is 2 cm.