Mammography Board Review Questions And Answers With Verified Solutions

Mammography Board Review Questions And Answers With Verified Solutions lymphedema ANS skin thickening (of the breast usually indicates cancer, but may also be because of a breast abscess located behind the nipple, mediastinal blockage due to sarcoidosis (advanced stages), Hodgkin disease, lung cancer, bronchial cancer with mediastinal metastases, right heart failure, advanced gynecologic malignancy, or postoperative or postradiation lymphedema. the 2 main classifications of breast cancer ANS 1) Ductal 2) Lobular Ductal carcinoma ANS accounts for 90% of all breast cancer cases lobular carcinoma ANS accounts for 5-10% of all breast cancer cases medullary breast carcinoma ANS account for less than 10% of the total breast cancer cases MRI ANS NOT used as a screening tool because of cost and the developing nature of MRI technology. MRI is useful for evaluating ruptures, leaks, free silicone, in the surrounding breast tissue, or the formation of silicone granulomas. Tumor margins and extent of tumor spread are often better defined on the MRI. Chemotherapy ANS involves the use of drugs to treat cancer that may have spread beyond the breast. Chemo treatments last 3-6 months depending on the intensity of the drug of the drug and how far the cancer has spread. American Cancer Society guidelines ANS -Women aged 40 and older should have a screening mammogram and CBE every year -women between ages 20 and 39 should have CBE every 3 years - Women aged 20 and older should perform a BSE every month - All lumps or suspicious areas and any changes in the nipple or skin of the breast should be reported to a healthcare provider CBE (Clinical Breast Examination) ANS an examination of the breast by a healthcare professional such as a physician, a nurse-practitioner, nurse or physician assistant and should be performed -every year after age 40 -every 3 years between ages 20 and 39 ACS guidelines ANS -all women over age 20 should perform a BSE every month BSE ANS The first step is to look fro changes, either while standing or sitting. A check should be made for indentations, retracted nipples, dimpling, or prolonged skin conditions. The next step is to feel for changes using light, medium, and firm pressure and three fingers in either a circular, up and down line, or wedge pattern. Sign of breast cancer (BSE) ANS -changes in size, texture, color of breast - prolonged skin irritation - redness or scaliness - dimpling - nipple retraction Evaluation of suspected breast cancer ANS 1) complete medical history 2)clinical examination 3)imaging and biopsies When BSEs should be performed ANS one week after menstrual period ends How BSEs should be performed ANS A BSE should be done either sitting or standing in front of a mirror; standing upright makes it easier to examine while lying down. Fingers glide more easily over wet skin so breast should be checked while in the shower (large-breasted women should examine their breast while lying on their side) BSE standing ANS standing upright makes it easier to examine the upper and outer parts of the breast Clinical Breast Examination ANS attention should be given to any lumps, whether they are attached to the skin or deeper tissue. Breast cancer will leave the breast via the lymph nodes; therefore any obvious enlargement of nodes in axilla (under the arm) or above the collarbone must be evaluated. ACR dose recommendations ANS -the average glandular dose on the mammogram should be: - no greater than 0.3 rads (300 mrad or 3mGy) with grid -no greater than 0.1 rad (100 mrad or 1 mGy) without grid Average glandular dose per view ANS 0.1-0.2 rads per view Grade ANS A pathologist looks at the tissue sample under a microscope and assigns a grade to it. The grade helps to predict the patient's prognosis-the lower the grade the slower growing the cancer Five-year survival rate ANS refers to the percent of patients who live at least 5 years after their cancer is diagnosed. 5 year rates are used to produce a standard way of discussing prognosis and is considered to be a more accurate way to describe the prognosis for patients with a particular type and stage of cancer. Major factors affecting dose ANS - the x-ray beam energy-- the higher the kVp and HVL the lower the patient dose -the compression-- greater compression will result in decreased exposure and therefore decreased dose - patients breast tissue type and thickness-- denser glandular breast requires more exposure that fatter breast high frequency generators ANS rectify the input to produce a direct current (DC) voltage waveform, and essentially provide a constant potential with about 1 % ripple. The high frequency allows more efficient energy x-ray beam and the result is a higher x-ray output for a given kVp and mA setting.