ARRT Mammography Practice Questions (2026) — Free Sample Questions with Answers

Answer: B

Drinking two or more alcoholic drinks a day: Alcohol use is a lifestyle (social) factor that the patient can change.

Early menarche and late menopause: Correct. A long lifetime exposure to estrogen from early menarche and late menopause is an inherent reproductive risk factor.

Long-term combined hormone replacement therapy: Hormone use is listed as a social risk factor in the ARRT outline because it is an exposure that can be changed.

Weight gain and obesity after menopause: Body weight is a lifestyle factor that can be modified.

Inherent: sex, age, reproductive history, genetics, personal history, prior chest radiation, dense tissue. Social: tobacco, body weight, alcohol, access to care, hormone use.

Answer: C

Daily: Daily checks in digital mammography are mainly equipment readiness tasks; the phantom image test is not daily.

Monthly: Monthly tasks include the visual checklist; the phantom image test is done more often.

Weekly: Correct. The mammographer performs and evaluates the ACR DM phantom image weekly, scoring fibers, specks and masses and checking for artifacts.

Quarterly: Quarterly is the frequency for repeat/reject analysis, not the phantom test.

Mammographer QC (ACR 2018 DM manual): phantom image weekly, visual checklist monthly, repeat analysis quarterly, compression force semiannually.

Answer: D

0.3 mm focal spot, grid in place, breast on the IR: This is the setup for a standard contact view, not magnification.

0.3 mm focal spot, grid removed, breast on the IR: Removing the grid for a contact view increases scatter, and the large focal spot blurs a magnified image.

0.1 mm focal spot, grid in place, breast on the IR: Without a magnification stand there is no magnification, and the grid is not needed with an air gap.

0.1 mm focal spot, no grid, magnification stand: Correct. The small focal spot limits geometric blur from the large OID, and the air gap reduces scatter, so the grid is removed.

Magnification mammography: magnification stand (about 1.5–2×), 0.1 mm focal spot, no grid (air gap), with longer exposure time.

Answer: C

To show the implant shell and capsule for signs of rupture: Implant integrity is evaluated mainly by MRI; the ID views aim to show breast tissue, not the implant.

To replace the standard CC and MLO views of each breast: ID views are taken in addition to the standard implant-included CC and MLO views.

To push the implant back and compress the tissue in front: Correct. The implant is pushed posteriorly against the chest wall while breast tissue is pulled forward and compressed for better detail.

To image the axilla and the lymph nodes beside the implant: Axillary evaluation is not the purpose of the implant displaced technique.

Implant screening: CC and MLO with implant included (manual technique) plus CC and MLO implant displaced (ID) views.

Answer: D

Incomplete; additional imaging evaluation is needed: That is category 0.

Suspicious; tissue biopsy should be considered: That is category 4.

Benign; return to routine annual screening: That is category 2.

Probably benign; short-interval follow-up advised: Correct. Category 3 carries a very low (≤2%) likelihood of malignancy and is usually followed in about 6 months.

BI-RADS: 0 incomplete, 1 negative, 2 benign, 3 probably benign, 4 suspicious, 5 highly suggestive of malignancy, 6 known biopsy-proven malignancy.

Answer: B

In the lateral breast: Lateral lesions move lower on the ML compared with the MLO.

In the medial breast: Correct. Going from MLO to ML, medial lesions rise and lateral lesions fall; central lesions stay about the same.

Directly behind the nipple: Central lesions change position very little between the MLO and ML.

In the inferior breast: Moving upward between views reflects medial–lateral position, not superior–inferior location.

Triangulation (MLO → ML): medial lesions rise, lateral lesions sink ("muffins rise, lead sinks"). Line up CC, MLO and ML to estimate depth.