Breast MCQ - Part I - Surgery - with answers

1. A 50 years old mother of two breast fed children presents with a lump in her right breast. There is no
personal or family history of breast cancer. The report on ultrasound and mammogram reads 'suggestive of malignancy. FNAC report reads C4. What is the next appropriate step in the management?

a. Perform a core biopsy
b. Excisional biopsy
c. Lumpectomy
d. Wide local excision
e. incisional biopsy


2. 30year old female ,4days after the delivery of her first baby, presented with pain and swelling of upper outer quadrant of the left breast. On examination the area is reddish. Which of the following is/are true

a) commonly caused by lactobacillus
b) diagnosed by USS
c) treat with cloxacillin
d) need to rest the breast until the pain subsidies
e) IM pethidine can be given for pain


3. 23 year old married women came to take an advice for nipple retraction since childhood. There are no palpable lumps. She wish to Breast feed her children. What is the most appropriate initial management option.

a) refer her to a surgeon for surgery
b) perform biopsy of nipple
c) request USS of breast
d) prescribe her a suction device
e) reassure her that this will resolve during pregnancy


4. 25-year-old woman complained of painless lump in l/breast for 2/52 her grandmother had breast CA @60uears.on examination well defined mobile lump 2cm in size @ the upper outer quadrant/breast is normal and lymphadenopathy. The next step of management

a) Perform FANC
b) Reassure and review in 6/12
c) Arrange mammogram
d) Arrange USS breast
e) Schedule her for excision of the lump


5. Risk factors for breast cancer includes

a) Hx of Breast CA on contralateral side of the breast
b) family history
c) breast feeding
d) null parity
e) OCP


6. 25yr female present with lump in right breast on EX lump was mobile, well demarcated non tender and 3*5cm in size. Mother Rx for breast CA .appropriate step in Mx

a) mammogram
b) USS
c) FANC
d) incision biopsy
e) reassurance and review in 6months


7. A 35 yr old female T4N1Mx breast carcinoma. What is the most appropriate initial treatment ?

a) Breast conservative surgery
b) salvage mastectomy
c) neo adjuvant chemotherapy
d) total mastectomy
e) tamoxifen therapy


8. A 35yr old came female came with blood stained nipple discharge from the R breast. On examination there is no lump. She has no past hx or family hx of breast carcinoma. On examination there was no palpable lump in the breast. What is the most likely diagnosis?

a) Duct ectasia
b) Intraductal papilloma
c) Phylloid tumor
d) Atypical duct hyperplasia
e) Fibrocystic disease


9. Regarding the Breast carcinoma

a) BRCA tumour suppressor genes
b) Due to mutation of BRACA gene.
c) Most of the breast carcinoma has family inheritance
d) Women with mutated gene can undergo prophylactic mastectomy
e) Patient with Breast carcinoma need to refer to genetic service


10. 56yr old patient undergone wide local excision and axillary clearance. Resu its came as stage 1 invasive ductal CA. Two core biopsies were taken, but came as normal. What is the next management?

a. Tamoxifen
b. Radiotherapy to axilla
c. Radiation to the breast
d. Reassure and follow up the patient
e. 6 cycles of chemotherapy


11. 28yr old female R quadrant Breast lump. USS done, no significant finding. 2 core biopsies also done and they are normal. What is the next step of management?

a) Repeat core biopsy
b) Breast MRJ
c) Excision biopsy
d) PET scan
e) Wide local excision


12. 50yr old lady had undergone wide local excision and sentinel nod biopsy. Hist report revealed complete excision of invasive ductal carcinoma and sentinel node contained to metastatic features.ER receptor negative. What is the most appropriate next step of Mx

a) Aromatase inhibitor
b) Chemotherapy
c) Radiotherapy for whole Breast
d) Systemic therapy
e) Mastectomy

Answers 

1. d

2. a) F b) T c) T d) T e) F

3. d

4. d

5. a) T b) T c) F d) T e) T

6. b

7. c

8. b

9. a) T b) T c) T d) T e) -

10. d

11. c

12. b