Breast Disease

Question 1

Enumrate the rosk factors of breast cancer? (13)

Answer 1

1- Family history of at least two first degree relative with BRAC1 or 2 in age less than 50 with bilteral cancer.
2- late pregnency ( full term prgenency less than 20 years is protective)
3- early menerach ( lesss than 12)
4- late menpouse( more than 55)
5- nulliparty
6- radiation
7- hormonal or contraceptive pills
8- increase agem
9- previous hx of cancer or carcinoma in citu
10- previous biobsy showing of non milgnant abnormalities
11- obesity
12- high social status
13 - alcohol

Question 2

Differential of painful breast ?

Answer 2

A) inflammatory cancer
B) fibrocystic cyclic pain
C) absess
D) mastitis
E) ductal ectasia

Question 3

Differential of painless mass?

Answer 3

A) breast cancer 
B) traumatic fat necrosis
C) pholid tumor
D) intraductal papiloma
E) fibroedenoma

Question 4

Fibroadenosis chartierized by all the follwing except?
A) pain without mass
B) pain in 2ed half of menstural cycle.
C) treated by bromcriptin or danzol
D) located in lower quirter

Answer 4

D)

Located in upper quarter

Question 5

Mobile lumb with smooth surface , not likely to be ?
1- Fibroadenoma
2- Fibrodentic cyst
3- breast cancer

Answer 5

3 breat cancer

They are fixed and hard

Question 6

If px come with firm poorly defined lump , which information will make you urgently refer the patient?

Answer 6

• Male with unilteral mass
• Female older thsn 30
• Fanily history of breast cancer
• History of brest cancer
• Other features suggest mailgnsncy

Question 7

diagnosis of a discrete breast mass (Lumps):

Answer 7

1- Cyst
2- Fibroadenoma
3- Focus of fibrocystic change or fibroadenosis
4- Fat necrosis (rare)
5- Carcinoma.

Question 8

Any breast disease the best investigation is?

Answer 8

Triple assessment

Examination, imaging and biopsy

Question 9

Types of breast biopsy?

Answer 9

Needle:

• fine
• core needle ( perferred)
• Excision biobsy done if needlr equivocal or negative
• Punch biopsy differentie paget from eczema

Question 10

Explain the patho of peaud orange ?

Answer 10

It is formed by combination of cutbous inciltration by the tumor and skin edem.

Question 11

Slit like nipple discharge commonly assosiated with? 
1- physological change as lactation
2- carcinoma
3- duct actasia 
4- chronic periductal mastitis

Answer 11

3-4

Carcinoma usually circumferntial rather than slit like

Question 12

Which from the following is not risk factor of breast cancer?

1) obesity
2) alcohol
3) smoking
4) radiation
5) high social staus

Answer 12

3) smoking

Question 13

Inflammatory carcinoma commonly seen in? 
A) smoker
B) old age female 
C) postive family history
D) as multifocal in MRI

Answer 13

B) old age female

Question 14

Which one is characterstic features of inflammatory cancer?
A) painful, enlarged swelling ews breast without palaple mass
B) painless mass with inverted nipple
C) cyclic painful mass with milky discharge

Answer 14

A)

Question 15

Which from the following cancer involve dermal lymphatic space ?

Answer 15

Inflmmatiry cancer causinf paud orange appearnce.

Question 16

Most common breast cancer? 
1- Incasive ductal carsinoma
2- Invasive lobular carcinoma 
3-Inflmmatory carsinoms
4-Papilary carcinoma

Answer 16

Invasive ductal carcinoma

Question 17

Best test to detect lobular cancer: 
1- US
2- mamogram
3- MRI
4- CT

Answer 17

3- mri