SAM question set – Susan Holley, AAPM meeting Spring 2015
1.
Which of the following statements is FALSE?
a. Breast cancer is a rare disease.
b. Breast cancer mortality has decreased since the introduction of screening
mammography.
c. Breast MRI has a very high sensitivity for breast cancer.
d. A screening mammogram consists of 4 images, 2 of each breast.
e. Breast specific gamma imaging (BSGI) is inappropriate for screening due to the relatively
high radiation dose to the breast and colon.
Answer: a. Breast cancer is not a rare disease. The American Cancer Society reports that approximately
1 in 8 women will develop breast cancer.
(http://www.cancer.org/research/cancerfactsstatistics/breast-cancer-facts-figures)
2. Which of the following imaging modalities does NOT require that the patient have an
intravenous line (IV)?
a. Mammography
b. Breast specific gamma imaging (BSGI)
c. Breast MRI
d. Contrast-enhanced mammography
Answer: a. Mammography uses ionizing radiation, but does not use intravenous material to obtain
images. By contrast (no pun intended), BSGI uses radioactive tracer, MRI uses intravenous gadolinium
contrast, and contrast enhanced mammography uses an iodinated contrast agent.
3. Which two mammographic descriptors indicate that a patient has “dense” breast tissue?
a. Almost entirely fat/scattered fibroglandular densities
b. Scattered fibroglandular densities/Heterogenously dense
c. Heterogenously dense/Extremely dense
d. Almost entirely fat/Extremely dense
e. Extremely dense/Homogenously dense
Answer: c. Women with heterogeneously dense and extremely dense tissue mammographically are
considered “dense.” These women are at relatively increased risk of breast cancer compared to women
with fatty tissue/scattered fibroglandular densities.
4. Which of the following statements is FALSE?
a. A stereotactic core needle biopsy is typically performed to sample calcifications.
b. An ultrasound guided core needle biopsy has more possible contraindications than a
stereotactic core needle biopsy.
c. An ultrasound guided core needle biopsy is typically performed to sample a breast mass.
d. An imaging-guided needle localization can be performed to guide the surgeon’s excision.
e. A breast MRI can be performed to evaluate for extent of disease in a patient with a
known cancer.
Answer: b. An ultrasound guided core needle biopsy has fewer contraindications than a stereotactic
core needle biopsy, not more. Besides inability to hold still or massive anticoagulation, there are
virtually no contraindications for ultrasound guided biopsy. By comparison, stereotactic biopsy cannot
be performed if the patient’s weight exceeds table limits or if the patient cannot lie prone/is debilitated.
5. What is the approximate number of breast cancers detected per 1000 women screened?
a. 100
b. 15
c. 10
d. 6
e. 2
Answer: d. The absolute number will vary somewhat depending on the population being screened and
the total denominator being considered, but cancer detection rates should be approximately 6/1000.