FRCR

Question 1

Breast cancer genetic associations

Answer 1

BRCA 1 and 2
Li Fraumini (P53)
Cowdens (GI hamartomatous polyps, breast Ca, follicular thyroid Ca, fibrocystic breast change, glycogenic acanthosis)

Question 2

Inflammatory breast cancer

Answer 2

Mimics mastitis clinically
Invades dermal lymphatics
Most commonly invasive ductal subtype
Skin thickening, trabecular thickening, generalised increased density

Question 3

Breast microcalcification

Answer 3

<0.5mm

Question 4

Male breast cancer risks

Answer 4

Klinefelters, radiation

Question 5

Gynaecomastia

Answer 5

Due to imbalance between estrogens and testosterone
Testes shoudl be examined
Physiological
Endocrine (hypo or hyperthyroid)
Systemic disease: renal failure cirrhosis
Testicular tumours: germ cell, sertoli, leydig
Non-testicular neoplasm: lung, liver, renal cell
Pharma: anabolics, dig, spironolactone, marijuana, cimetidine

Question 6

Benign appearing breast lesions differential

Answer 6

Cyst, papilloma, fibroadenoma, fat necrosis, well-circumscribed carcinoma

Question 7

Ultrasound benign features breast

Answer 7

.

Question 8

Bilateral axillary lymphadenopathy

Answer 8

Lymphoproliferative
Granulomatous - sarcoid, TB
Collagen vascular - RA
HIV

Question 9

Axillary node levels

Answer 9

1 - inferior and lateral to pec minor
2 - deep to
3 - superior to

Question 10

Diffuse bening microcalc

Answer 10

Plasma cell mastitis / duct ectasa - inspisatted calcified secretions
Vasular
Milk of calcium (tea cupping in cyst)

Question 11

Ultrasound malignant features

Answer 11

.

Question 12

Fat necrosis

Answer 12

Trauma, surgery. Spontaneous with diabetes, collagen vascular disease.

Question 13

Benign breast calc

Answer 13

Fibrocystic change most common - tea-cupping or egg-shell
Plasma cell mastitis, fat necrosis, other dilated duct benign calc
Popcorn calc fibroadenoma older patients.
Parallel lines - vascular