TheoryMammography ARRT
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30 free Mammography ARRT questions
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Breast Anatomy
The upper outer quadrant (UOQ) of the breast contains the greatest volume of glandular tissue. Approximately what percentage of breast cancers originate in this quadrant?
Correct — A. About 50% of breast cancers arise in the upper outer quadrant because it contains the largest amount of glandular tissue of any single quadrant, including the axillary tail of Spence. -
Breast Anatomy
The axillary tail of Spence is an extension of breast tissue that projects toward which anatomical region?
Correct — B. The axillary tail (tail of Spence) is a projection of glandular tissue that extends from the upper outer quadrant toward the axilla, passing through an opening in the deep fascia known as the foramen of Langer. -
Breast Anatomy
The sebaceous glands located on the areola that enlarge during pregnancy and lactation are called:
Correct — D. Montgomery glands (tubercles of Montgomery) are modified sebaceous glands on the areola; they secrete an oily substance that lubricates and protects the nipple-areola complex, and they become more prominent during pregnancy and lactation. -
Breast Anatomy
On a mammogram, a normal nipple typically appears as a:
Correct — A. The nipple is imaged as a rounded or dome-shaped soft-tissue density at the anterior skin surface of the breast; it must be in profile on at least one view to avoid being mistaken for a mass or to prevent missing a retraction. -
Breast Anatomy
Smooth muscle fibers within the nipple are responsible for nipple erection. These fibers are oriented in which arrangement?
Correct — C. The nipple contains smooth muscle fibers arranged in both circular (sphincter-like) and longitudinal orientations, enabling erection in response to tactile, thermal, and hormonal stimuli and facilitating milk ejection during lactation. -
Breast Anatomy
Normal breast skin thickness on a mammogram is generally less than:
Correct — B. Normal breast skin measures less than 3 mm in thickness on mammography. Skin thickening greater than 3 mm can be a sign of edema, inflammatory carcinoma, lymphatic obstruction, or radiation change. -
Breast Anatomy
Cooper's ligaments (suspensory ligaments of the breast) function primarily to:
Correct — A. Cooper's ligaments are fibrous suspensory bands that attach the breast parenchyma to the overlying dermis and to the deep fascia, providing structural support and giving the breast its shape. Invasion by carcinoma causes skin dimpling (peau d'orange). -
Breast Anatomy
On a mammogram, Cooper's ligaments are visualized as:
Correct — C. Cooper's ligaments appear as thin, curvilinear, or tent-shaped lines within the subcutaneous and retroglandular fat on mammography. They become more apparent when the fat content of the breast is high. -
Breast Anatomy
Breast edema caused by lymphatic obstruction produces skin thickening and a reticular trabecular pattern on mammography primarily because:
Correct — B. When lymphatic drainage is obstructed (by tumor, radiation, or infection), interstitial fluid accumulates in the periductal and periligamentous spaces, thickening Cooper's ligaments and the skin and creating the characteristic trabecular or reticular pattern seen on mammography. -
Breast Anatomy
The retromammary space (retromammary bursa) lies between which two structures?
Correct — A. The retromammary space is a layer of loose areolar tissue and fat lying between the deep (posterior) surface of the breast and the pectoralis major fascia, allowing some mobility of the breast on the chest wall. -
Breast Anatomy
The superficial fascia of the breast has two layers. The posterior (deep) layer separates the breast from which structure?
Correct — D. The deep layer of the superficial fascia forms the posterior boundary of the glandular breast and lies just anterior to the retromammary fat pad and the pectoralis major fascia, defining the posterior margin of the breast proper. -
Breast Anatomy
How many lobes does the mature female breast typically contain?
Correct — B. The adult breast typically contains 15–20 lobes arranged radially around the nipple, each lobe composed of multiple lobules. Each lobe drains via a separate lactiferous duct that opens at the nipple. -
Breast Anatomy
The smallest functional unit of the breast that is capable of milk secretion is the:
Correct — C. The terminal duct lobular unit (TDLU) consists of the terminal duct and the lobule (acini) it drains; it is the basic secretory unit of the breast and is the site of origin for most breast carcinomas and benign proliferative lesions. -
Breast Anatomy
Most invasive breast carcinomas arise from which histologic structure within the breast?
Correct — A. The TDLU is the origin of the vast majority of breast carcinomas, both ductal and lobular types, as well as most benign proliferative conditions (fibroadenoma, ADH, LCIS), because it is the most mitotically active epithelial compartment. -
Breast Anatomy
The lactiferous sinuses (ampullae) are located just beneath the:
Correct — D. The lactiferous sinuses are dilated segments of each lactiferous duct located immediately beneath the areola; they serve as reservoirs for milk during lactation before it is expressed through the nipple openings. -
Breast Anatomy
How many lactiferous duct orifices typically open at the nipple?
Correct — B. Each of the 15–20 breast lobes has its own lactiferous duct, but not all open separately at the nipple surface; functional studies suggest 5–10 main orifices are patent in most women, as some ducts converge or are vestigial. -
Breast Anatomy
On galactography (ductography), a smooth, well-defined intraluminal filling defect within a single lactiferous duct most likely represents:
Correct — C. An intraductal papilloma classically appears as a smooth, well-defined filling defect within a single duct on galactography and is the most common cause of spontaneous unilateral nipple discharge in women under 50 years of age. -
Breast Anatomy
During the luteal phase of the menstrual cycle, lobular acini undergo changes that result in:
Correct — A. Rising progesterone and prolactin levels in the luteal phase cause lobular acinar cells to enlarge, perilobular stroma to become edematous, and overall breast density to increase, which is why mammography is ideally performed in the follicular phase. -
Breast Anatomy
Lobular involution, the natural regression of breast lobules with age, has which effect on mammographic appearance?
Correct — D. Lobular involution is the postmenopausal process in which glandular lobules are progressively replaced by fat and fibrous tissue. Complete lobular involution is associated with decreased mammographic density and reduced breast cancer risk. -
Breast Anatomy
The primary arterial blood supply to the medial breast comes from which vessel?
Correct — B. The internal mammary (internal thoracic) artery, a branch of the subclavian artery, provides the principal blood supply to the medial and central breast via its anterior perforating branches passing through the intercostal spaces. -
Breast Anatomy
The lateral thoracic artery, a branch of the axillary artery, primarily supplies blood to which region of the breast?
Correct — C. The lateral thoracic artery descends along the lateral thoracic wall and provides branches that supply the lateral breast, particularly the upper outer quadrant and the axillary tail of Spence. -
Breast Anatomy
On contrast-enhanced MRI, which feature of tumor neovascularity is most characteristic of malignancy in the kinetic curve analysis?
Correct — A. Malignant lesions typically show rapid initial enhancement (due to angiogenesis and vessel leakiness) followed by washout on delayed images (type III curve), whereas benign lesions more often show persistent or plateau enhancement. The washout pattern has the highest positive predictive value for malignancy. -
Breast Anatomy
What percentage of breast lymphatic drainage flows toward the axillary lymph nodes?
Correct — D. Approximately 75–97% of breast lymph drains to the axillary lymph nodes, making them the primary regional nodal basin for breast cancer staging and sentinel lymph node biopsy. -
Breast Anatomy
The axillary lymph nodes are divided into three levels based on their relationship to which muscle?
Correct — B. Axillary lymph nodes are classified into Levels I (lateral/inferior to pectoralis minor), Level II (posterior to pectoralis minor), and Level III (medial/superior to pectoralis minor, also called the infraclavicular or apical nodes). -
Breast Anatomy
The Rotter (interpectoral) lymph nodes are located between which two muscles?
Correct — A. Rotter nodes (interpectoral nodes) lie between the pectoralis major and minor muscles and drain toward Level II axillary nodes; they are important to identify during axillary dissection and can be sites of breast cancer metastasis. -
Breast Anatomy
Internal mammary lymph nodes are most commonly located in which intercostal spaces?
Correct — C. The internal mammary (parasternal) nodes lie along the internal mammary vessels predominantly in the first three intercostal spaces, receiving drainage mainly from the medial and central breast. Metastasis here (especially Level III+ disease) worsens prognosis. -
Breast Anatomy
In breast cancer staging, the sentinel lymph node (SLN) is defined as:
Correct — D. The sentinel lymph node is defined as the first node(s) in the lymphatic basin to receive direct drainage from the primary tumor; its pathologic status predicts the status of the remaining regional nodes, allowing selective axillary dissection. -
Breast Anatomy
Sensory innervation to the nipple-areola complex is primarily derived from which nerve?
Correct — B. The nipple-areola complex receives its primary sensory innervation from the lateral cutaneous branch of the 4th intercostal nerve (T4 dermatome), which is important to preserve during mastectomy and reduction mammoplasty to maintain nipple sensation. -
Breast Anatomy
During axillary lymph node dissection, injury to the long thoracic nerve (nerve of Bell) results in which clinical finding?
Correct — A. The long thoracic nerve innervates the serratus anterior muscle; if injured during axillary dissection, the serratus anterior becomes paralyzed, causing the medial border of the scapula to protrude posteriorly, known as winged scapula. -
Breast Anatomy
The embryologic structure from which the breast develops is called the:
Correct — C. The breast develops from the mammary ridge (milk line), an ectodermal thickening that forms bilaterally from the axilla to the inguinal region in the 4th–6th week of fetal development. In humans, only the pectoral pair of buds normally persist.
Mammography ARRT sample questions
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Breast Anatomy Polymastia refers to:
A. Abnormal enlargement of one breast
B. Absence of one or both breasts
C. Failure of normal nipple protrusion
D. Supernumerary (accessory) breast tissue along the milk line ✓
Correct — D. Polymastia is the presence of accessory (supernumerary) breast tissue, which can occur anywhere along the embryonic milk line from axilla to groin. It may contain functional glandular tissue and is a site of potential carcinoma.
Image Quality & QC Which factor most directly determines the spatial resolution of a digital mammography system?
A. kVp setting
B. Compression force applied
C. Detector pixel pitch ✓
D. Antiscatter grid ratio
Correct — C. Spatial resolution in digital mammography is primarily determined by detector pixel pitch (the center-to-center spacing between detector elements). Smaller pixel pitch yields higher spatial resolution and finer detail rendition.
Instrumentation Which component of the mammographic X-ray tube is the source of X-rays?
A. Cathode filament ✓
B. Anode disk
C. Beryllium window
D. Collimator
Correct — A. The cathode filament, when heated by current, emits electrons via thermionic emission. These electrons are accelerated toward the anode, where their deceleration produces X-rays. The anode is the target, not the source of electrons.
MQSA Regulations What is the primary purpose of the Mammography Quality Standards Act (MQSA)?
A. To ensure high-quality mammography for early detection of breast cancer ✓
B. To regulate the price of mammography services
C. To certify radiologists in mammography interpretation
D. To establish insurance reimbursement rates for mammography
Correct — A. MQSA was enacted in 1992 to ensure that all women receive high-quality mammography services to improve the early detection of breast cancer. It establishes standards for equipment, personnel, and quality assurance.
Pathology Which margin characteristic is most associated with a benign breast mass?
A. Circumscribed (well-defined) ✓
B. Spiculated
C. Indistinct
D. Angular
Correct — A. Circumscribed margins indicate a well-defined boundary between the mass and surrounding tissue, which is a hallmark of benign lesions such as cysts and fibroadenomas. Spiculated, indistinct, and angular margins are suspicious for malignancy.
Patient Care Which of the following is the PRIMARY purpose of obtaining informed consent before a mammogram?
A. To ensure the patient understands the procedure, risks, and benefits before agreeing ✓
B. To satisfy the radiologist's scheduling requirements
C. To document the patient's insurance information
D. To confirm the patient has fasted prior to the exam
Correct — A. Informed consent ensures patients voluntarily agree to a procedure after receiving adequate information about its nature, risks, benefits, and alternatives. It protects both the patient's autonomy and the technologist's legal standing.
Positioning & Technique In a standard craniocaudal (CC) view, the X-ray beam is directed:
A. From lateral to medial
B. From medial to lateral
C. From superior to inferior ✓
D. From inferior to superior
Correct — C. The CC view is obtained with the beam directed superiorly to inferiorly (craniocaudal), compressing the breast from top to bottom. This provides a view of the breast from above looking down.
Radiation Safety Which SI unit is used to express absorbed dose of ionizing radiation?
A. Gray (Gy) ✓
B. Sievert (Sv)
C. Becquerel (Bq)
D. Coulomb per kilogram (C/kg)
Correct — A. The gray (Gy) is the SI unit of absorbed dose, defined as 1 joule of energy deposited per kilogram of tissue. The sievert is used for equivalent/effective dose, not absorbed dose.
About the Mammography ARRT test
Pass your Mammo Exam with confidence. Mammography ARRT Prep gives you 750+ realistic practice questions with clear, detailed explanations for every answer.
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Patient Care, Positioning & Technique, Image Quality & QC, Breast Anatomy, Pathology, Instrumentation — and more.
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You will be tested on
- Safe and effective care environment
- Health promotion and maintenance
- Psychosocial and physiological integrity
- Pharmacology, infection control and patient safety
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Topics in this question bank
Safe and effective care environment
Health promotion and maintenance
Psychosocial and physiological integrity
Pharmacology, infection control and patient safety
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