Breast Imaging: A Core Review (13 page)

A. Inferior

B. Lateral

C. Medial

D. Superior

27
 Which of the following is correct about human epidermal growth factor receptor 2 (HER2)?

A. HER2 positive breast cancers usually demonstrate rapid growth and spread.

B. HER2 negative breast cancers are more aggressive than HER2 positive cancers.

C. Approximately 60% of newly diagnosed breast cancer is HER2 positive.

D. ER negative, PR negative, and HER2 negative cancers have a better prognosis.

E. HER2 positive breast cancers are more responsive to hormonal treatment.

28a
 Screening breast MRI was performed on a high-risk patient with history of right breast cancer and mastectomy. Based on the following images, what is the best BI-RADS assessment to assign this patient’s breast MRI?

A. 0

B. 2

C. 3

D. 4

E. 5

28b
 What is the best follow-up recommendation for this patient?

A. Focused ultrasound

B. Surgical referral

C. MRI-guided biopsy

D. 6-month follow-up MRI

E. Annual follow-up MRI

29
 A 52-year-old female presents with a painless, swollen, and erythematous left breast.

Based on the images above, what is the most appropriate next step?

A. Recommend follow-up imaging after antibiotic treatment

B. Biopsy

C. Breast MRI

D. Annual screening mammography

30
 Which of the following is true regarding breast-specific gamma imaging (BSGI)?

A. BSGI is less sensitive in women with dense breasts.

B. BSGI cannot distinguish and differentiate between scar tissue and recurrence in a patient with a history of breast cancer with lumpectomy.

C. BSGI uses technetium-99m-sestamibi.

D. BSGI has lower lifetime attributable risk of mortality when compared to radiation exposure from a four-view screening digital mammogram.

E. BSGI does not involve whole body radiation exposure.

31
 Match the anatomic structure to the appropriate numerical location on the sonographic image of a normal breast.

A. Cooper’s ligament

B. Subcutaneous fat

C. Pectoralis muscle

D. Skin

32
 Based on the images below, what is the most likely location on the craniocaudal (CC) view for the lesion shown?

A. Lateral and posterior

B. Medial and posterior

C. Lateral and anterior

D. Medial and anterior

33
 What is the initial imaging modality for evaluation of a palpable breast lesion in a 29-year-old male patient?

A. Ultrasound

B. Mammography

C. Contrast-enhanced MRI

D. Contrast-enhanced CT

E. Breast-specific gamma imaging

34
 Which of the following is considered a second-degree relative?

A. Father

B. Daughter

C. Aunt

D. Sister

35
 Which of the following is true of surveillance and treatment for breast cancer in treated Hodgkin’s survivors?

A. Peak incidence of breast cancer is 25 to 30 years after treatment.

B. No significant increased risk of breast cancer if treated before the age of 30.

C. Preferred treatment in these patients is mastectomy in conjunction with radiation.

D. If treated for Hodgkin’s before the age of 30, begin annual screening mammography 8 years after radiation exposure.

36
 Which of the following is a risk factor for breast cancer?

A. Family history of breast cancer in cousin

B. Late menarche

C. First childbirth after age 30

D. Prior history of chemotherapy

37
 Which of the following concerning interval cancers is correct?

A. Breast cancer found during regular interval mammographic examinations with prior mammogram prospectively having been interpreted as negative

B. Increases ductal histology

C. Incidence of interval cancers has no relation to density of breast tissue.

D. Interval cancers can be mammographically occult or a new mammographic finding.

38
 With regards to the nipple on screening mammographic views, which of the following statements is correct?

A. Nipple should be in profile on both MLO and CC projections of both breasts.

B. Nipple should be in profile on either CC or MLO projection of both breasts.

C. Nipple does not need to be in profile on either CC or MLO projections.

D. Nipple should be in profile for one breast but need not be in profile for the other breast.

39
 Regarding the use of compression while obtaining mammographic images, which of the following statements is correct?

A. It helps maintain the nipple in the midline on the images.

B. It is less painful during the second half of the menstrual cycle.

C. It reduces the amount of radiation needed.

D. It helps reduce the number of technical recalls.

ANSWERS AND EXPLANATIONS

1
 
Answer D.

Reference: Saslow D, Boetes D, Burke W, et al. American Cancer Society guidelines for breast screening with MRI as an adjunct to mammography.
CA Cancer J Clin
2007;57:75–89.

Recommendations for Breast MRI Screening as an Adjunct to Mammography