Ch. 23 Mammography

____% of men's cancer deaths are from breast cancer

.22%

The ratio of benefit (lives saved) to risk (possible deaths) caused because of radiation induced breast cancer is

1,000 to 1

Women's risk of breast cancer include

1. Age 2. Family history 3. Genetics 4. Early menstruation 5. Late menopause 6. Late age at birth of first child or no children

What are the two leading causes of death from cancer in women

1. Lung Cancer 2. Breast Cancer

Breast cancer is how much more common in women that men

100 times

The x-rays mot useful for enhancing differential absorption in breast tissue & for maximum contrast range from ___to___keV

17 to 24 keV

Mammography was first attempted in what year

1920's

In what year did the U.S. Gov. mandate regulations in mammography to set standards for image quality, patient dose, personnel qualifications,& exam procedures

1992

Compression is ___-___ lbs of force for a breast exam

25-45 lbs of force

How many new cases of breast cancer are found each year & how many deaths do they cause in the U.S

260,000 new cases 40,000 deaths

The x-ray beam should be filtered with ___to ___mm of molybdenum or rhodium to accentuate the characteristic x-ray emission

30 to 60 mm

Screening women in the ___to___ year age group is beneficial in reducing mortality

40 to 49

Breast cancer is one of the leading causes of death among women between the ages of ___&____

40-50 years old

Screening mammography in patients ____years or older reduces cancer mortality

50 years

1 out of every ___ women will develop breast cancer during her lifetime

8

Approximately ___% of breast cancer is ductal & may have deposits of microcalifications smaller then approx___mm

80% ; 500 mm

With early detection more than ___ % of women diagnosed with early stage disease will survive

90%

First radio graphic exam of the breasts before age 40 used for comparison with future mammograms

Baseline Mammogram

In conventional radiography, subject contrast is great because of large differences in mass density & atomic number in

Bone, muscle, fat, lung tissue

When vigorous compression is used all tissue is brought closer or farther to the image receptor

Closer

Exam performed on patients with symptoms or elevated risk factors. Two or three views of each breast may be required

Diagnostic mammography

Normal breasts consist of three principal tissues

Fibrous, glandular, & adipose (fat)

Young breasts are dense & more difficult to image because of_________ tissue, older breasts are more _____ & easier to image

Glandular ; Fatty

Which breast tissue is most sensitive to cancer radiation

Glandular tissue

Colors on a mammogram Hypo= Hyper=

Hypo=dark colors Hyper=light colors

Post menopausal breasts are characterized by a degeneration of fibroglandular tissue & increase in adipose tissue which appears dark on film & requires____ radiation exposure

Less

High or low kVp must be used to maximize the photoelectric effect to enhance differential abs absorption & contrast resolution

Low kVP

Hybrid imaging includes what two exams

MRI & PET exam

A prime example of soft tissue radiography

Mammography

Molybdenum & rhodium k-characteristic x-rays have energy that is most effective for Brest imaging. All manufactured mammography imaging systems have target filter combinations of

Mo- Mo Mo- Rh Rh- Rh

Mammography became clinically acceptable with the introduction of___ as the target & filter

Molybdenum

Compression immobilzes the breast & reduces

Motion blur

In soft tissue radiography only ___&____ are imaged

Muscle & Fat *Have similar effective atomic numbers & similar mass densities

L-shell x-rays are all absorbed and contribute only to ___ dose * not to the image

Patient dose

At low x-ray energy ___ absorption predominates over ___scattering

Photoelectric ; Compton

Mammographic exam performed on a symptomatic women sight he use of a two-view protocol; usually medial lateral oblique & cranial caudal to detect an unsuspected cancer

Screening Mammography

Clues that it is cancer in a mammogram

Sharp edges

Soft tissue radio graphic techniques are designed to enhance differential absorption in ____ tissues

Similar

Compression improves spatial resolution & contrast resolution & reduces patient dose *T/F

True

Compression is important in conventional radiology & mammography with several advantages * T/ F

True

Compression reduces absorption blur & scatter radiation *T/F

True

Early detection of breast cancer leads to more effective treatment

True

If a malignancy is present it appears as a distortion of normal ductal & connective tissue patterns

True

Radiation can cause as well as detect breast cancer

True

A compressed breast riser near the chest wall is less likely to be_____exposed and tissue near the nipple is less likely to be_____exposed

Under exposed; Over exposed

A compressed breast has more ___thickness

Uniform

The optimum degree of compression is

Unknown *The more vigorous the compression the better the image & lower the dose. But the higher the level of patient discomfort

The incidence of breast cancer is highest in what quadrant of the breast

Upper lateral quadrant

X-ray mammography requires low kVp. As kVp is reduced, the penetrability of the x-ray beam is reduced, which requires an increase in___

mAs