Deck 21: Breast

Question 1

As a woman ages, the glandular breast tissue is replaced with:

A) fat.
B) cysts.
C) fibrous tissue.
D) Cooper's ligaments.

Answer 1

A

Question 2

The retromammary layer is sonographically imaged as which one of the following?

A) Hyperechoic
B) Dense
C) Hypoechoic
D) High reflectivity

Answer 2

C

Question 3

The midportion of the right medial and left lateral breast would be annotated as which one of the following?

A) 3:00
B) 6:00
C) 9:00
D) 12:00

Answer 3

A

Question 4

A condition of the male breast in which the ductal elements hypertrophy is called ______________.

A) mastitis
B) galactocele
C) gynecomastia
D) Paget's disease

Question 5

The most common solid benign tumor of the breast is which one of the following?

A) Fibrocystic disease
B) Fibroadenoma
C) Papilloma
D) Lipoma

Question 6

Which one of the following form(s) a fibrous "skeleton" that is responsible for maintaining the shape of the breast?

A) Acini
B) Cooper's ligaments
C) Pectoralis major muscle
D) Glandular layer of the breast

Question 7

The breast is sonographically divided into three layers. Which one of the following is incorrect?

A) Skin, nipple, subareolar
B) Pectoralis major
C) Subcutaneous region
D) Parenchyma

Question 8

The most common clinical sign of breast carcinoma is which one of the following?

A) Skin dimpling
B) Skin discoloration
C) Palpable lump
D) Pain

Question 9

The most common malignant neoplasm of the breast is which one of the following?

A) Lobular carcinoma in situ
B) Invasive ductal carcinoma (IDC)
C) Invasive lobular carcinoma
D) Ductal carcinoma in situ

Question 10

Skin dimpling may be caused by which one of the following?

A) Old age
B) Retraction of tissue secondary to tumor infiltration
C) Enlarged ducts
D) Thrombosis of arterial vessels

Question 11

Clinical findings of lumpy, painful, tender breasts that vary with monthly cycles usually represent which one of the following?

A) Carcinoma
B) Fibrocystic disease
C) Cysts
D) Adenomas

Question 12

Cooper's ligaments are best characterized as which one of the following?

A) Low reflectivity in the retromammary layer
B) High reflectivity in the retromammary layer
C) Echogenic line interfaces in the subcutaneous layer
D) Homogeneous reflections in the parenchyma

Question 13

The functional portion of the breast consists of _________ lobes.

A) 3 to 5
B) 5 to 10
C) 15 to 20
D) 25 to 30

Question 14

Lymphatic drainage from all parts of the breast generally flows to the ________ lymph nodes.

A) interpectoral
B) axillary
C) supraclavicular
D) internal mammary

Question 15

Which one of the following arteries is responsible for supplying blood to more than half of the breast?

A) Intercostal
B) Thoracodorsal
C) Internal mammary
D) Lateral thoracic

Question 16

The most important signs to look for in determining a cystic lesion of the breast include all of the following except:

A) well-defined borders.
B) good through transmission.
C) anechoic.
D) disruption of architecture.

Question 17

The primary purpose of breast screening examinations is to:

A) evaluate the retromammary region.
B) provide a baseline study for fibrocystic disease.
C) provide for early detection of breast carcinoma.
D) evaluate dense breast parenchyma.

Question 18

Select the sonographic characteristic of a fibroadenoma.

A) Poorly defined border
B) Uniform, low-level homogeneous echoes
C) Increased through transmission
D) Disruption of architecture

Question 19

Characteristic findings of breast carcinoma include all of the following except:

A) attenuation of sound.
B) irregular margins.
C) strong posterior margin.
D) inhomogeneous low-level internal echo pattern with calcifications.

Question 20

A normal extension of breast tissue into the axillary region is called ______________.

A) lobar neoplasm
B) tail of Spence
C) peau d'orange
D) terminal ductal lobular unit

Question 21

In the case of a mammographic mass that is highly suggestive of malignancy, the correlating sonographic mass will likely show which one of the following features?

A) Irregular margin and taller than wide
B) Anechoic
C) Irregular margin and wider than tall
D) Posterior acoustic enhancement

Question 22

OBJ: Identify the sonographic characteristics associated with benign and malignant breast masses.
In the case of a smooth mammographic mass that is highly suggestive as cystic, the correlating sonographic mass will likely show which one of the following features?

A) Irregular margin
B) Anechoic and posterior acoustic enhancement
C) Taller than wide
D) Echogenic and posterior acoustic enhancement

Question 23

Which one of the following statements is false?

A) Breast ultrasound is the imaging tool of choice to evaluate a breast mass in a teenage girl.
B) Ultrasound of the breast is the primary imaging tool of choice in evaluating a breast mass in a pregnant woman.
C) Breast ultrasound is the primary imaging tool of choice in screening a 45-year-old woman for any evidence of possible breast cancer.
D) In the case of a benign fibroadenoma, the sonographic features of a smooth, sharply circumscribed hypoechoic mass with homogeneous echogenicity and a mild posterior acoustic enhancement will usually be seen.

Question 24

The advantages of breast ultrasound over mammography in evaluating the breast include which one of the following?

A) Can better visualize those often-obscure signs of breast cancer such as microcalcifications
B) Can better visualize microcystic adenosis with layering milk of calcium and sclerosing adenosis, as well as variants of benign fibrocystic conditions that contain small calcifications as the principle mammographic finding that can be easily overlooked on routine mammographic images
C) Can better discriminate Cooper's ligaments within lumen of the small ducts of the terminal ductal lobular units (TDLUs)
D) Can better evaluate those hard-to-reach places, such as parasternal tissues and axilla, not well seen on mammography

Question 25

Ultrasound of the breast is often performed as an adjunctive imaging tool in all of the following situations except:

A) to assess a smooth mammographic mass as cystic or solid.
B) to further evaluate a palpable breast lump in a patient with very dense breast tissue and a negative mammogram.
C) to further evaluate a palpable breast lump in a patient with breast implants.
D) to further evaluate an asymptomatic patient with large fatty replaced breasts and a negative mammogram.

Question 26

Characteristics of possible breast cancer include all of the following except:

A) irregular or spiculated mammographic mass, and solid on ultrasound.
B) clustered pleomorphic microcalcifications on mammogram, with or without any abnormality on ultrasound.
C) focal distortion on mammogram, and a correlating area of distortion on breast ultrasound.
D) a smooth low-density mass on mammogram, and solid lesion that has not changed in over 3 years on ultrasound.

Question 27

The advantages of breast ultrasound over mammography in evaluating the breast include all of the following except:

A) limited radiation exposure to the patient.
B) differentiation of cystic versus solid smooth masses.
C) more comfortable examination for the patient.
D) better visualization of juxtathoracic deep tissues.

Question 28

Ultrasound is often of benefit in guiding breast procedures for all of the following except:

A) cyst aspiration.
B) fine-needle aspiration cytology (FNAC).
C) drainage procedures.
D) large-core needle biopsy of microcalcifications.