BREAST SONOGRAPHY EXAM REVIEW
LATEST UPDATE 2025 WITH COMPLETE
QUESTIONS AND CORRECT ANSWERS
RATED A+
The medial aspect of the breast is best evaluated in what
position? Correct Answer Supine
For larger breasted patients, how can you better evaluate a lateral
lesion? Correct Answer Steep oblique or decubitus position
How can you stimulate the cranio-caudal mammographic view
Correct Answer Sitting or upright position
What transducer pressure should be used and why? Correct
Answer Moderate
Improve sound transmission
Improve detail or resolution
Decrease tissue depth for better penetration
May eliminate some artifacts
Radial and antiradial scan planes correlate with Correct Answer
The direction of the ductal system
Radial= parallel to the ducts
Antiradial= perpendicular to the ducts
Which is the AIUM recommended scan plane for breast imaging?
Correct Answer Radial
Sagittal and transverse scan planes correlate to Correct Answer
Conventional sagittal and transverse scan planes
,Why scan a solid lesion in both planes? Correct Answer Allows
visualization of the tumor or ductal extensions branching outward
or toward the nipple
Most ultrasound departments use which method to scan the
breast? Correct Answer Clock method
This is more detailed than the quadrant method
In addition to the clock method, some sonographers also use the
Correct Answer 123 and ABC methods to provide a more exact
location
123 method Correct Answer Describes the location of a lesion in
comparison to its distance from the nipple
Location 1= near the nipple
Location 2= mid distance from the nipple
Location 3= in the periphery
ABC method Correct Answer Describes the depth of the lesion
Location A= superficial
Location B= mid depth (mammary layer)
Location C= near the chest wall
A stand off pad allows for Correct Answer Improved focusing and
greater detail in the superficial layers of the breast
Fixed elevation plane focus is moved more superficially
A stand off pad improves imaging of: Correct Answer Superficial
tumors or cysts
Superficial vessels
Superficial ducts
Types of stand off techniques include: Correct Answer
Commercially produced gel pads
Water bag
Large glob of gel
Stand off transducer attachments
What is the ideal stand off pad thickness for breast imaging?
Correct Answer 1 cm
This places the elevation plane focus of a 10 MHz transducer at
approximately 0.5 cm depth within the breast
The echogenicity of the breast tissue will vary with: Correct
Answer The amount and location of fat and fibrous tissue
Due to patient age, functional state of the breasts and body
habitus
Which patients will have hyperechoic breast tissue? Correct
Answer Young women with more dense fibroglandular tissue
Lactating patients with more dense tissue
Extremely thin patients with more dense tissue
Which patients will have isoechoic breast tissue? Correct Answer
Older women and obese women with more fatty replacement
The breast is composed of 3 major tissue types seen by
sonography Correct Answer Fat
Epithelium
Stromal tissue
Where are these 3 types of tissue located? Correct Answer Fat-
superficial, intraparenchymal, retromammary
, Epithelium- TDLU and acini
Stromal tissue- loose stromal tissue (intralobular and periductal)
and dense stromal tissue (interlobular and Cooper's ligaments)
Echogenicity of the skin Correct Answer Hyperechoic
Thickness of 0.5 - 2 mm
May see slight increase in echogenicity at the gel/skin interface
(sound beam entrance) and the skin/superficial fat interface (exit)
Echogenicity of fat Correct Answer Medium gray
Found within the superficial layer, parenchymal layer and
retromammary layer
Echogenicity of Cooper's ligaments Correct Answer Hyperechoic
Considered part of the dense connective tissue
Where are Cooper's ligaments best seen?? Correct Answer In
the subcutaneous fat layer as a thin, wavy linear structure
May produce shadowing artifact
Which part of the breast are all structures compared to in
echogenicity? Correct Answer Mid-level echogenicity of fat
Echogenicity of glandular epithelium Correct Answer Isoechoic to
mildly hypoechoic
Consists of TDLUs and acini found within the parenchymal layer
Echogenicity of dense fibroglandular tissue Correct Answer
Hyperechoic
Fibroglandular tissues are a combination of glandular epithelium
and both loose and dense connective tissue in the parenchymal
layer
Echogenicity of lactiferous ducts Correct Answer Hypoechoic
If dilated and fluid filled, ducts may appear anechoic
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