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MCQs On Breast Imaging:

Breast Anatomy and Development:

1. The Breast is a modified apocrine sweat gland. 2. The major artery to the breast is internal mammary

artery. 3. Azygos vein drains the breast4. The terminal duct lobular unit is the basic functional unit

of the breast 5. The level of lymph nodes involvement is related to

pectoralis Major muscle 6. The breast extends lateraly till the anterior axillary line

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(X ) Pectoralis minor

(X) Mid axillary line

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Regarding Mammography:

1. The skin is thickest over the upper outer quadrant 2. The craniocaudal view shows more breast tissue than the

mediolateral view.

3. The pectoral muscle is not visualised in the craniocaudal view

4. Intramammary Lymph nodes are seen in the upper outer quadrant

5. Marked stromal proliferation is seen in the secretory phase of the menestrual cycle.

6. The breast completely lies in the superficial fascia

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(X ) Craniocaudal view shows less breast tissue

(X) Proliferative phase due to estrogen effect

Regarding Breast Ultrasound:

1. The skin is a three layered structure

2. Coopers ligaments produce acoustic shadow

3. The Fat appear hypoechoic

4. The breast is uniformly bright due to the

fibroglandular tissue

5. The ducts are clearly visualised

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(X ) heterogenous

Regarding Mammography :

1. Microcalcification is calcification less than 1mm

2. Microcalcification is specific for carcinoma

3. Microcalcification is not seen in traumatic fat necrosis

4. Spiculated masses are carcinomas until proved by biopsy

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(X) this is a recognisable feature

(X ) not specific

(X ) less than 0.5 mm

The following pattern of calcifications are definitely benign:

1. Egg shell calcification

2. Floating calcification

4. Pleomorphic branching calcifications

4. Pop corn calcification

5. Tram line calcifications(√ ) Blood vessel

(√ ) Fibroma

(√ ) Milk Calcium Cyst

(√ ) Cyst

(X) Feature of invasive ductal carcinoma

Groups of breast microcalcifications areseen in :

1. Fibroadenoma 2. Fat necrosis 3. Radiotherapy4. Ductal carcinoma 5. Sclerosing adenitis

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Regarding Ductal Carcinoma :

1. Constitutes 40% of all breast carcinoma2. May be associated with lobular

carcinoma3. Mammographic appearance is larger

than the clinical size 4. Arises from the large ducts epithelium5. Usually the tumour shows well defined

margin , homogenous density and no acoustic shadowing

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Ductal Carcinoma

•It constitutes 80% of all breast cancers•Arises from epithelium of medium and small sized ducts•It can be associated with invasive tubular and lobular carcinomas.•The clinical size is bigger due to desmoplastic reaction•Usually the tumour has ill-defined margin , heterogenous density and acoustic shadow

Lesions producing spiulated mass in mammography :

1. Fat necrosis

2. Sclerosing adenosis

3. Fibroadenosis

4. Abscess

5. Hamartoma (X )

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Common US features of typical breast Carcinoma:

1.Sharp margin 2.Hypoechoic 3.Long axis is perpendicular to skin 4.Hypoechoic rim of tissue5.Echogenicity same as adjacent

fibroglandular tissue but less than fat

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Common US features of typical breast Carcinoma:

• Irregular margin• Hypoechoic compared to adjacent

fibroglandular tissue and fat• Long axis is perpendicular to skin• Hyperechoic rim of tissue (tumour,

desmoplastic compressed breast tissue)• Posterior acoustic shadowing.

High incidence of breast cancer recurrence is seen in :

1. Estrogen receptor positive

2. Comedo carcinoma

3. Age > 40 years

4. More intraductal component

5. Negative margin

(X) Age < 40 years

(X) Positive Margin

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(X) Estrogen Receptor Negative

Regarding Benign Breast Disease:

1. Breast abscess is most commonly located in

the upper outer Quadrant.

2. Breast abscess is most commonly due to

streptococcus

3. Skin retraction is a common presentation of

fat necrosis

4. Hyalinised fibroadenoma is a common

feature

(X) Staphylococcus aureus

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(X) Retroareolar

(X) Rare

Regarding Lymph node involvement in Breast cancer:

1. 40% of women have axillary lymph adenopathy at time

of diagnosis

2. Involved lymph nodes are rounder and more reflective

than normal at US

3. Internal mammary lymph nodes are more often involved

than axillary lymph nodes of the inner quadrant tumors.

4. Internal mammary lymph nodes are usually resected at

mastectomy

5. Supraclavicular nodal spread confers a poor prognosis

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(X) Axillary lymph nodes are more comonly involved

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(X) Larger,more rounded and less reflective

Regarding Male Breast cancer:

1. Most cases occur in patients with Kleinfilter

2. Frequently bilateral

3. Mammographic calcifications are fewer than

in female breast cancer.

4. It is more common on left side

5. Gynaecomastia is a predisposing factor

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(X) Larger,more rounded and more scattered

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Thank You