LE 4 (GYNE/BREAST/PROSTATE) 2026 Flashcards
A 42-year-old woman is concerned because her best friend recently underwent a mastectomy for breast cancer. She is asymptomatic and has no family history of breast cancer. The most appropriate next step for this woman is:
A. Observe for the next 12 months
B. Perform a breast ultrasound
C. Perform a mammography
D. Recommend a total executive check-up
C. Perform a mammography
Mammography is the gold standard for breast cancer screening in asymptomatic women starting at age 40, even without a family history. It helps detect early-stage breast cancer before symptoms develop.
A 28-year-old woman accidentally felt a lump in her left breast while taking a shower. The most appropriate next step for this woman is:
A. Observe for the next 12 months
B. Perform a breast ultrasound
C. Perform a mammography
D. Recommend a total executive check-up
B. Perform a breast ultrasound
In women under 30, breast ultrasound is the preferred initial imaging modality for evaluating palpable breast lumps, as younger women typically have denser breast tissue, making mammography less effective.
The main purpose of screening mammography is to:
A. Assess for abnormalities in indeterminate mammograms
B. Evaluate breast abnormalities in symptomatic patients
C. Further assess findings on special mammographic views, breast ultrasound, or MRI
D. Screen asymptomatic women for early breast cancer
D. Screen asymptomatic women for early breast cancer
Screening mammography is specifically designed to detect early, asymptomatic breast cancer in the general population to improve outcomes through early intervention.
Which of the following statements is true?
A. The majority of women who develop breast cancer have a history that places them at higher risk.
B. Not all cancers are visible on mammography.
C. Not all women are at risk of developing breast cancer.
D. Nulliparity or having a first child at an older age decreases the risk of breast cancer.
B. Not all cancers are visible on mammography.
Mammography is highly sensitive but not perfect. Some cancers, especially in dense breasts, may not be visible, requiring additional imaging such as ultrasound or MRI for better evaluation.
Which of the following statements is true based on the American College of Radiology (ACR) guidelines for screening mammography?
A. Mammography is recommended once a year for women at average risk starting at age 40.
B. Women aged 40 and over should undergo screening mammography every 1 to 2 years.
C. Women aged 45-49 should have screening every 2 to 3 years.
D. Younger patients who present with breast masses should first be evaluated with mammography.
A. Mammography is recommended once a year for women at average risk starting at age 40.
According to the American College of Radiology (ACR) and other major guidelines, annual screening mammography should begin at age 40 for women at average risk to improve early detection and reduce mortality.
A 40-year-old woman has a fixed, hard breast mass in the right upper outer quadrant, and mammography reveals dense breasts. What is the recommended next imaging examination?
A. Ultrasound
B. MRI
C. PET
D. Tomosynthesis
A. Ultrasound
For women with dense breasts and a suspicious mass on mammography, ultrasound is the next step to better characterize the lesion (solid vs. cystic) and guide biopsy if necessary.
For a 22-year-old woman with multiple bilateral breast masses and a strong family history of breast cancer, the recommended imaging examination is:
A. CT
B. Mammography
C. MRI
D. Ultrasound
D. Ultrasound
For a young woman with multiple breast masses, ultrasound is the preferred initial modality due to its ability to differentiate between cystic and solid lesions while avoiding unnecessary radiation exposure. MRI may be considered if a high-risk genetic mutation is suspected.
Which of the following statements is true regarding the cranio-caudal (CC) view on mammography?
A. Compression is applied from the superomedial direction
B. Depicts the greatest amount of breast tissue
C. Most useful view in mammography
D. Pectoralis muscle is seen centrally on the film
D. Pectoralis muscle is seen centrally on the film
The purpose of comparing a previous mammogram with the current mammogram is:
A. To detect any changes in the appearance of the breasts
B. To diagnose the presence of malignancy more confidently
C. To establish nipple retraction or skin thickening
D. To verify whether calcifications are dermal or parenchymal in location
A. To detect any changes in the appearance of the breasts
Comparing prior mammograms with current images is essential for detecting interval changes, which may indicate malignancy or other pathology requiring further evaluation.
Of all the different findings assessed in mammography, the most important classic mammographic sign of malignancy is:
A. Architectural distortion
B. Coarse, irregular calcifications
C. Ill-defined margin
D. Spiculated masses
D. Spiculated masses
Spiculated masses are the most characteristic mammographic sign of malignancy, indicating an infiltrative process. These masses have radiating lines extending from a central core, suggestive of cancerous growth.
A mass seen on mammography is almost always considered benign when it presents as:
A. Circumscribed, well-defined margins
B. Mass following needle aspiration or biopsy
C. Microlobulated margins
D. Round mass
A. Circumscribed, well-defined margins
Benign breast masses, such as fibroadenomas and cysts, typically have smooth, well-defined margins, unlike malignant lesions that tend to have irregular or spiculated borders.
Which of the following types of calcifications seen on mammography are considered a primary sign of breast cancer?
A. Branching
B. Clustered pleomorphic calcifications
C. Large, coarse, and irregular in shape
D. Margins jagged and irregular
B. Clustered pleomorphic calcifications
Clustered pleomorphic (varying in size and shape) calcifications are highly suspicious for malignancy and require further evaluation, as they often indicate ductal carcinoma in situ (DCIS).
What is the implication of the Breast Imaging Reporting and Data System (BI-RADS) Category 1 score?
A. Benign finding such as a lipoma, oil cyst, galactocele, or intramammary lymph node
B. Need additional imaging evaluation and/or prior mammograms for comparison
C. No significant findings are present
D. Patient should return for routine screening
C. No significant findings are present
BI-RADS Category 1 means a negative mammogram with no abnormal findings, and the patient should continue routine screening as recommended.
What is the implication of the Breast Imaging Reporting and Data System (BI-RADS) Category 3 score?
A. Need additional imaging evaluation and/or prior mammograms for comparison
B. Patient should return for routine screening
C. Probably benign, initial short-interval follow-up suggested
D. Suspicious abnormality; biopsy should be considered
C. Probably benign, initial short-interval follow-up suggested
BI-RADS Category 3 lesions are likely benign (>98% probability), but a short-term follow-up in 6 months is recommended to ensure stability and rule out malignancy.
What is the implication of the Breast Imaging Reporting and Data System (BI-RADS) Category 6 score?
A. Known to be malignant
B. Lesions that have a very high probability of being malignant and should undergo biopsy
C. Probability of malignancy is approximately 25% to 35%
D. Spiculated masses and pleomorphic clusters of calcifications
A. Known to be malignant
BI-RADS Category 6 is assigned to lesions that have already been confirmed as malignant through biopsy, meaning treatment planning should proceed accordingly.
A 54-year-old woman presents with postmenopausal bleeding, pelvic pain, weight loss, and constipation. The best primary imaging modality to request is:
A. Hysterosalpingography
B. MRI
C. Sonohysterography
D. Ultrasound
B. MRI
A unicornuate anomaly of the uterus with a single fallopian tube is a result of:
A. Arrested Müllerian duct development
B. Failure of complete fusion of the Müllerian ducts
C. Infertility
D. Ipsilateral renal agenesis
A. Arrested Müllerian duct development
A unicornuate uterus results from incomplete development of one of the Müllerian ducts, leading to a single-sided uterine structure with one fallopian tube.
The presence of a midline septum that divides the uterus into two cavities is a result of:
A. Arrested Müllerian duct development
B. Failure of complete fusion of the Müllerian ducts
C. Ipsilateral renal agenesis
D. Recurrent abortion
B. Failure of complete fusion of the Müllerian ducts
A septate uterus forms due to incomplete resorption of the midline septum, which results in two endometrial cavities and is associated with recurrent pregnancy loss.
Most asymptomatic women of child-bearing age who undergo pelvic ultrasound will have findings of masses in the uterine corpus. The most common reason for this is:
A. Adenomyosis
B. Endometrioma
C. Leiomyoma
D. Ovarian cancer
C. Leiomyoma
Leiomyomas (fibroids) are the most common benign uterine tumors in women of reproductive age, often detected incidentally on pelvic ultrasound.
If a postmenopausal woman develops pelvic pain and significant weight loss, the most common gynecologic malignancy to consider is:
A. Cervical cancer
B. Endometrial cancer
C. Ovarian cancer
D. Uterine sarcomas
A. Cervical cancer
Of the different types of germ cell neoplasms of the ovary, the most commonly encountered is:
A. Adenomyosis
B. Cystic teratoma
C. Leiomyosarcoma
D. Malignant mixed Müllerian tumor
B. Cystic teratoma
Mature cystic teratomas (dermoid cysts) are the most common germ cell tumors of the ovary and contain tissues derived from all three germ layers.
Which of the following statements is true regarding ovarian cancer?
A. CA-125 is elevated in the majority of cases
B. The majority are bilateral
C. The majority are germ cell tumors
D. Peak age is premenopausal
A. CA-125 is elevated in the majority of cases
CA-125 is elevated in over 80% of advanced-stage epithelial ovarian cancers, making it a useful tumor marker, although it is not specific for screening due to false positives in benign conditions.
Which of the following is true regarding CA-125?
A. Elevated in very early stages of the disease
B. The majority of all ovarian cancers will show elevated CA-125
C. Recommended as the screening tool for ovarian cancer
D. Level of CA-125 is prognostic of disease survival
C. Recommended as the screening tool for ovarian cancer
A CT scan of a 55-year-old woman diagnosed with ovarian cancer will likely show:
A. Doppler color flow within the papillary projections
B. Lymph node with fatty hilum
C. Nodularity of the ovarian mass
D. Serous clear fluid within the mass
C. Nodularity of the ovarian mass
Ovarian cancer often presents on CT with nodular solid components, irregular thick septations, and peritoneal metastases, distinguishing it from benign ovarian cysts.
