2022 AAPM 64th Annual Meeting
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Session Title: Advances in Breast Cancer Diagnosis and Treatment: Mammography, Breast Biopsy, SBRT, APBI
Question 1: Magnification views in diagnostic mammography are specifically obtained to evaluate which mammographic finding?
Reference:Sickles, EA, D’Orsi CJ, Bassett LW, et al. ACR BI-RADS® Mammography. In: ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology; 2013.
Choice A:Mass
Choice B:Calcifications
Choice C:Architectural distortion
Choice D:Asymmetry
Question 2: A 47-year-old woman presents with a left breast lump that corresponds to a new irregular mass on diagnostic evaluation. What is the appropriate BI-RADS assessment and recommendation?
Reference:D’Orsi CJ, Sickles EA, Mendelson EB, Morris EA, et al. ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology; 2013
Choice A:BI-RADS 1: Negative, routine follow-up
Choice B:BI-RADS 2: Benign, routine follow-up
Choice C:BI-RADS 3: Probably benign, short-interval 6-month follow-up
Choice D:BI-RADS 4: Suspicious, tissue diagnosis
Question 3: Which of the following methods is least effective for registering corresponding lesions in DBT and ABUS images?
Reference:Green CA, Goodsitt MM, Lau JH, Brock KK, Davis CL, Carson PL. Deformable Mapping Method to Relate Lesions in Dedicated Breast CT Images to Those in Automated Breast Ultrasound and Digital Breast Tomosynthesis Images. Ultrasound Med Biol. 2020;46(3):750-765. doi:10.1016/j.ultrasmedbio.2019.10.016
Choice A:Finite Element Analysis
Choice B:Rigid Registration
Choice C:Artificial Intelligence
Choice D:Biomechanical modeling
Question 4: Which of the following is not an advantage to automated breast ultrasound (ABUS)?
Reference:Boca Bene I, Ciurea AI, Ciortea CA, Dudea SM. Pros and Cons for Automated Breast Ultrasound (ABUS): A Narrative Review. J Pers Med. 2021;11(8):703. Published 2021 Jul 23. doi:10.3390/jpm11080703
Choice A:Increased detection of breast cancer in dense breast tissue
Choice B:Higher reproducibility and less operator dependence
Choice C:Inability to adequately image the axilla
Choice D:Increased cancer detection sensitivity when used with screening mammography
Question 5: Tumor recurrence due to positive margins during breast-conserving surgery requires re-excision surgery in 10-50% of patients.
Reference:Reyna, Chantal, and Sarah M. DeSnyder. “Intraoperative Margin Assessment in Breast Cancer Management.” Surgical Oncology Clinics of North America, Changing Paradigms in Breast Cancer Diagnosis and Treatment, 27, no. 1 (January 1, 2018): 155–65. doi.org/10.1016/j.soc.2017.08.006.
Choice A:True
Choice B:False
Question 6: What’s the advantage of preoperative partial breast radiosurgery as opposed to traditional postoperative partial breast irradiation?
Reference:Horton JK, Blitzblau RC, Yoo S, Geradts J, Chang Z, Baker JA, Georgiade GS, Chen W, Siamakpour-Reihani S, Wang C, Broadwater G, Groth J, Palta M, Dewhirst M, Barry WT, Duffy EA, Chi JT, Hwang ES. Preoperative single-fraction partial breast radiation therapy: A novel phase 1, dose-escalation protocol with radiation response biomarkers. Int J Radiat Oncol Biol Phys 2015;92:846-55. DOI: 10.1016/j.ijrobp.2015.03.007
Choice A:Flexible scheduling for surgery and radiotherapy.
Choice B:Patient is in better health condition before surgery.
Choice C:Intact breast tumor is a lot smaller than postoperative seroma.
Choice D:No difference is found between preoperative and postoperative.
Question 7: Which of the following is NOT a correct description of the GammaPod system design and workflow?
Reference:Yu CX, Shao X, Zhang J, Regine W, Zheng M, Yu YS, Deng J, Duan Z. GammaPod—A new device dedicated for stereotactic radiotherapy of breast cancer. Medical physics. 2013 May;40(5):051703. DOI: 10.1118/1.4798961
Choice A:GammaPod uses a prone patient setup to minimize the effects of respiratory motion.
Choice B:GammaPod uses vacuumed breast cups to immobilize the breast tissue.
Choice C:GammaPod uses multiple co-planar, conically shaped beams to achieve conformal dose coverage.
Choice D:GammaPod uses a moving couch to achieve dose painting.
Question 8: Which of the following is a correct description of the GammaPod treatment and workflow?
Reference:Zhang-Velten E, Zhang Y, Radpour S, Gu X, Kim DN, Alluri P, Nwachukwu C, Chiu T, Lu W, Parsons D, Tan J, et. al, A How-To Compendium for GammaPod Treatments, Clinical Workflow, and Clinical Program at an Early Adopting Institution. Practical Radiation Oncology. 2022 Feb 10. DOI: 10.1016/j.prro.2022.01.006 Paulosky K, Ruff S, Becker SJ, Guerrero M, McAvoy S, Nichols EM. Abstract P3-19-22: Clinical and cosmetic outcomes of adjuvant stereotactic partial breast irradiation using the GammaPod. Cancer Research. 2022 Feb 15;82(4_Supplement):P3-19. doi.org/10.1158/1538-7445.SABCS21-P3-19-22
Choice A:GammaPod acquires a new CT scan for each fractional treatment, but the same target contours are used across all treatment fractions.
Choice B:A full workflow of daily GammaPod treatment includes breast cup fitting, CT simulation, treatment planning, 2nd dose calculation and plan delivery.
Choice C:GammaPod can treat primary breast cancers at all locations, without constraints.
Choice D:Skin reaction (blister) is seen in conventional tangential beam radiotherapy, but not in GammaPod treatments.
Question 9: According to our cost analysis (Int J Radiat Oncol Biol Phys 95(1):49-51, 5/2016), what is the most expensive delivery option for breast radiation treatment?
Reference:Ovalle V, Strom E, Godby J, Shaitelman S, Stauder M, Amos R, Kuerer H, Woodward W, Hoffman K, Proton Partial-Breast Irradiation for Early-Stage Cancer: Is It Really So Costly?, Int J Radiat Oncol Biol Phys 95(1):49-51, 2016 DOI: 10.1016/j.ijrobp.2015.07.2285
Choice A:Proton APBI
Choice B:Multi-lumen brachytherapy
Choice C:Single Lumen brachytherapy
Choice D:3D External beam
Choice E:IMRT Whole Breast Irradiation
Question 10: What is not an advantage of proton APBI compared to standard 3D conformal radiation with photons?
Reference:Strom E, Amos R, Shaitelman S, Kerr M, Hoffman K, Smith B, Tereffe W, Stauder M, Perkins G, Amin M, Wang X, Poenisch F, Ovalle V, Buchholz T, Babiera G, Woodward W. Proton partial breast irradiation in the supine position: Treatment description and reproducibility of a multibeam technique, Practical Radiation Oncology (2015) 5, e283-e290 DOI: 10.1016/j.prro.2015.01.010
Choice A:shorter treatment course
Choice B:reduced dose to uninvolved normal breast
Choice C:reduced dose to heart and lung
Choice D:less hyperpigmentation of the skin
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