Stereotactic Breast Procedure Certification

Practical Examination

Note: The practical exam may only be taken after an applicant successfully passes both the clinical application and the written exam components.

Each applicant for stereotactic certification will be asked to perform several stereotactic biopsies on phantoms using the table the applicant works on in his or her practice. Working with a stereotactic applications technologist, the applicant will be expected to conduct vacuum-assisted biopsies on a phantom from obtaining a scout image through a specimen image where appropriate. At the completion of the exam, the applicant will have successfully performed several stereotactic biopsies on phantoms by demonstrating a thorough command of the stereotactic technology, including image evaluation, image optimization, and recognition of targeting problems and their solutions.

Written Examination

The written stereotactic exam covers a combination of areas, including (1) basic principles of stereotaxis, (2) targeting issues and management of technically difficult lesions, (3) sampling accuracy, (4) clinical-pathologic correlation, (5) patient management and quality assurance, and (6) radiation physics and safety. There are more questions on radiation physics and safety than any other topic, so it is important that applicants review the Radiation Physics and Safety document which can be accessed here. All questions on this topic are taken from the document. Attendance at a basic stereotactic course or review of the syllabus from a previous course would also be helpful for the other topics on the exam.

Sample Questions

1. Post acquisition changes of the digital stereotactic image such as "zoom" magnification, reverse imaging, or changes in contrast do not increase the radiation dose to the patient.

   1. True
   2. False

2. In "target on scout" procedures, the angle between the stereo images is:

   1. 45 degrees
   2. 30 degrees
   3. 15 degrees
   4. 10 degrees

3. Stereotactic biopsy of a cluster of calcifications is done. The calcifications are well sampled, but there are still a few additional calcifications remaining in the breast at the location of the biopsy. Which of the following requires further diagnostic biopsy?

   1. Fibroadenoma
   2. Atypical hyperplasia
   3. Florid hyperplasia of the usual variety
   4. Fat necrosis

4. A lesion is seen in the extreme medial position of the right breast on the craniocaudad mammogram. Compared to the lesion's position on the MLO view, on a straight lateral view you would expect it to be:

   1. almost unchanged
   2. higher
   3. lower
   4. not enough data given to determine the position