Breast

Question 1

Which of the following statements about normal breast anatomy is true?

A. The breast typically contains 10 lobes.
B. Cooper ligaments are only found in the upper quadrants of the breast.
C. The upper inner quadrant of the breast contains the most breast tissue.
D. The tail of Spence extends across the anterior axillary fold.

Answer 1

D. The tail of Spence extends across the anterior axillary fold.

Question 2

Which of the following changes in the breast is NOT associated with pregnancy?

A. Accumulation of lymphocytes, plasma cells, and eosinophils within the breast.
B. Enlargement of breast alveoli.
C. Release of colostrum.
D. Accumulation of secretory products in minor duct lumina.

Answer 2

C. Release of colostrum

Question 3

The breast receives its blood supply from all of the following EXCEPT

A. Branches of the internal mammary artery
B. Branches of the superior epigastric artery
C. Branches of the posterior intercostal arteries
D. Branches of thoracoacromial artery

Answer 3

B. Branches of the superior epigastric artery

Question 4

Which of the following statements is INCORRECT?

A. Level I lymph nodes are those that are lateral to the pectoralis minor muscle.
B. Level II lymph nodes are located deep to the pectoralis minor muscle.
C. Level III lymph nodes are located medial to the pectoralis minor muscle.
D. Level IV lymph nodes are the ipsilateral internal mammary lymph nodes

Answer 4

D. Level IV lymph nodes are the ipsilateral internal mammary lymph nodes

Question 5

Concerning breast development before and during pregnancy, which hormonal activity pairing is INCORRECT?

A. Estrogen: Initiates ductal development
B. Progesterone: Initiates lobular development
C. Prolactin: Initiates lactogenesis
D. Follicle stimulating hormone: Cooper ligament relaxation

Answer 5

D. Follicle stimulating hormone: Cooper ligament relaxation

Question 6

Concerning gynecomastia, which of the following is true?

A. During senescence gynecomastia is usually unilateral.
B. During puberty gynecomastia is usually bilateral.
C. Is not associated with breast cancer except in Ehlers-Danlos patients.
D. Is classified as per a three-grade system.

Answer 6

D. Is classified as per a three-grade system.

Question 7

Inflammatory conditions of the breast include all of the following EXCEPT

A. Necrotizing viral mastitis
B. Zuska disease (recurrent preductal mastitis)
C. Mondor disease (superficial breast thrombophlebitis)
D. Hidradenitis suppurativa

Answer 7

A. Necrotizing viral mastitis

Question 8

Lesions with malignant potential include all of the following EXCEPT

A. Intraductal papilloma
B. Atypical ductal hyperplasia
C. Sclerosing adenosis
D. Atypical lobular hyperplasia

Answer 8

C. Sclerosing adenosis

Question 9

Risk factors for the development of breast cancer include (except???)

A. Early menarche
B. Nulliparity
C. Late menopause
D. Longer lactation period

Answer 9

D. Longer lactation period

Question 10

Drugs useful in breast cancer prevention include (except???)

A. Raloxifene
B. Tamoxifen
C. Aspirin
D. Aromatase inhibitors

Answer 10

C. Aspirin

Question 11

Which of the following is true regarding breast cancer metastasis?

A. Metastases occur after breast cancers acquire their own blood supply.
B. Batson plexus facilitates metastasis to the lung.
C. Natural killer cells have no role in breast cancer immunosurveillance.
D. Twenty percent of women who develop breast carcinoma metastases will do so within 60 months o treatment.

Answer 11

A. Metastases occur after breast cancers acquire their own blood supply.

Question 12

All of the following are true concerning breast LCIS EXCEPT

A. Develops only in the female breast.
B. Cytoplasmic mucoid globules are a distinctive cellular feature.
C. Frequency of LCIS cannot be reliably determined.
D. The average age at diagnosis is 65 to 70 years.

Answer 12

D. The average age at diagnosis is 65 to 70 years

Question 13

Which of the following concerning breast cancer staging is correct?

A. Stage I tumors have no metastases to either lymph nodes or distant sites.
B. Stage III tumors include some with distant metastases (M1 disease).
C. Inflammatory carcinoma is considered T4 disease.
D. N4 disease includes metastases to highest contralateral axillary nodes.

Answer 13

C. Inflammatory carcinoma is considered T4 disease.

Question 14

Factors that determine the type of therapy offered to patients afer diagnosis of breast cancer include all of the following EXCEPT

A. Whether or not a therapy has been proven effective in clinical trials
B. Stage of disease
C. General health of patient
D. Biologic subtype

Answer 14

A. Whether or not a therapy has been proven effective in clinical trials

Question 15

Which of the following statements about the management of distal carcinoma in situ (DCIS) is true?

A. DCIS treated by mastectomy has a local recurrence rate of 2%.
B. Extensive DCIS should be treated with tamoxifen followed by lumpectomy.
C. Specimen mammography is only useful for patients with small amounts of DCIS.
D. Postoperative tamoxifen is useful in DCIS patients whose tumors are estrogen-receptor (ER) negative.

Answer 15

A. DCIS treated by mastectomy has a local recurrence rate of 2%.

Question 16

All of the following are true about accelerated partial breast irradiation (APBI) EXCEPT

A. APBI is delivered in an abbreviated fashion and a lower total dose than standard course of whole breast radiation.
B. Suitable patients for APBI include women older than or equal to 60 years.
C. Suitable patients for APBI include patients whose tumor margins are greater than or equal to 2 mm.
D. Suitable patients for APBI include those with multifocal disease.

Answer 16

D. Suitable patients for APBI include those with multifocal disease.

Question 17

Patients not suitable for sentinel lymph node (SLN) biopsy include all of the following EXCEPT

A. Inflammatory carcinoma of the breast.
B. Prior axillary surgery.
C. Biopsy-proven distant metastases.
D. Lower inner quadrant of breast primary carcinoma

Answer 17

D. Lower inner quadrant of breast primary carcinoma

Question 18

Which of the following is true concerning breast cancer during pregnancy?A. Metastases to lymph nodes occur in approximately 75% of patients.
B. Approximately 50% of breast nodules developing during pregnancy are malignant.
C. Mammography is especially useful in localizing small lesions.
D. There is risk of chemotherapy teratogenicity if used during the second, but not the third, trimester o pregnancy.

Answer 18

A. Metastases to lymph nodes occur in approximately 75% of patients