Deck 7: Breast

Question 1

Which of the following statements is NOT true of screening mammography?

A) It typically involves an MLO and a CC view.
B) The interpretation always includes a BI-RADS classification.
C) It should be done for women with palpable breast lumps.
D) It may be done by a radiological technologist without direct supervision by a radiologist.

Answer 1

It should be done for women with palpable breast lumps.

Question 2

Which of the following statements pertaining to breast tissue density is TRUE?

A) Sensitivity for detecting cancer is higher in a fatty breast than in a breast with heterogeneously dense breast parenchyma.
B) The designation of a breast as fatty or fibroglandular is the basis of the BI-RADS classification.
C) The sensitivity of breast cancer diagnosis in mammography is highest with extremely dense breast parenchymal patterns.
D) Breast density is an important descriptive term in breast ultrasonography.

Answer 2

Sensitivity for detecting cancer is higher in a fatty breast than in a breast with heterogeneously dense breast parenchyma.

Question 3

Which of the following statements about breast calcifications is TRUE?

A) They are always benign and only significant when associated with a palpable mass.
B) They are always malignant and should be biopsied.
C) Those with a radiolucent center can be confidentially diagnosed as benign.
D) They always require 6-month interval mammography.

Answer 3

Those with a radiolucent center can be confidentially diagnosed as benign.

Question 4

A breast classified with a BI-RADS 0 after screening mammography means:

A) definite malignancy and image-guided biopsy must be scheduled.
B) completely negative (normal), and the patient can/will be reminded to attend yearly screening mammography.
C) additional imaging is indicated, such as diagnostic mammography and/or breast sonography.
D) the likelihood of malignancy is very low and 6-month interval mammography will be scheduled.

Question 5

The tenderness of a palpable breast mass:

A) has no bearing on the diagnostic workup.
B) determines if ultrasonography should be done.
C) is an indication for breast MRI.
D) requires surgical referral.

Question 6

After palpating a tender lump in a breast that is suspicious for an inflamed cyst, you should:

A) aspirate under manual guidance.
B) refer the patient to a surgeon for excision.
C) refer the patient to an imaging facility for diagnosis, with ultrasound-guided aspiration for symptomatic relief if a cyst is confirmed.
D) prescribe antibiotics and get ultrasound if the patient does not improve.

Question 7

MRI of the breast:

A) is widely used for screening women at average risk for breast cancer.
B) is always used with an ultrasound exam.
C) is highly sensitive for detecting suspicious breast calcifications.
D) is typically done with gadolinium-based contrast agents.

Question 8

A definitive diagnosis of a benign breast fibroadenoma that is completely benign and has no malignant potential is typically made by:

A) ultrasound-guided biopsy.
B) gadolinium-enhanced MRI.
C) CT-guided aspiration.
D) dedicated breast PET scan.

Question 9

If one of your patients has a family history that includes a first-degree relative who was diagnosed with premenopausal breast cancer, then she should begin yearly screening mammography:

A) at an age 10 years younger than the age at which her relative was diagnosed.
B) at age 21.
C) at 20 years past her age at first menses.
D) immediately after her first pregnancy.

Question 10

In general, for women with a lifetime risk for breast cancer higher than 20%, an ideal screening program would be:

A) yearly diagnostic mammography.
B) yearly breast MRI and screening mammography.
C) yearly breast ultrasound and screening mammography.
D) yearly breast thermography and screening mammography.

Question 11

Thermography:

A) is an effective means of detecting breast cancer in screening programs.
B) is an effective technique for evaluating a palpable breast mass.
C) can avoid the need for needle biopsy.
D) is safe, but has low sensitivity and specificity for breast cancer diagnosis.