Welcome to your 🎗️ Breast Disorders, Breast Examination & Cancer Counselling Arena — 40 MCQs
1.
A 38-year-old woman reports that her mother and maternal aunt developed breast cancer at relatively young ages. What is the most appropriate counselling consideration?
2.
A 39-year-old woman with breast cancer reports that her sister developed ovarian cancer at 42 years and her mother had bilateral breast cancer before menopause. Genetic counselling identifies a pathogenic BRCA1 variant. Which advice is most appropriate for her adult first-degree relatives?
3.
During a systematic breast examination, the clinician palpates the breast and then extends the examination into the axilla. What is the primary purpose of axillary palpation?
4.
A 26-year-old woman presents with a newly detected palpable breast lump. Which imaging investigation is generally preferred as the initial assessment in this age group?
5.
A 45-year-old woman has recently received a diagnosis of breast cancer. During counselling, she says, "I am frightened that surgery will change my appearance and affect my marriage." Which response best demonstrates patient-centred counselling?
6.
A 44-year-old woman has a palpable breast lump that is suspicious on clinical examination. Mammography reports no definite abnormality. What is the most appropriate next principle?
7.
A 35-year-old woman presents with bilateral milky nipple discharge and menstrual irregularity. She is not pregnant or breastfeeding. There is no palpable breast mass, and she reports taking an antipsychotic medication. Which initial investigation is most relevant to the suspected mechanism?
8.
During breast examination, a clinician observes the patient sitting with both arms raised. What is the main purpose of this manoeuvre?
9.
A 51-year-old woman presents with intermittent sticky greenish nipple discharge from several ducts, associated with periareolar discomfort and nipple inversion. Examination reveals no dominant suspicious mass. Ultrasonography shows dilated retroareolar ducts. Which condition is the most likely explanation?
10.
A 40-year-old woman undergoes breast ultrasonography for a palpable lump. Imaging demonstrates a well-defined, anechoic lesion with a thin wall, posterior acoustic enhancement and no solid component. She has no concerning clinical findings. Which interpretation is most appropriate?
11.
A 60-year-old woman has a breast lump associated with nipple retraction and peau d'orange. Which mechanism most directly produces the orange-peel appearance?
12.
A 42-year-old woman presents with a new palpable breast lump. The clinician plans clinical examination, imaging and tissue sampling. What is this combined diagnostic approach called?
13.
A 47-year-old woman is referred for a palpable breast lump. The examiner uses a systematic radial technique, beginning near the nipple and extending toward the periphery along successive lines. Which additional area should be included to avoid missing breast tissue during examination?
14.
A 43-year-old woman presents with a palpable breast lump. Mammography shows a spiculated lesion, while ultrasonography demonstrates an irregular hypoechoic mass. Core biopsy reports benign fibrocystic changes. What is the most appropriate interpretation of these results?
15.
A woman with a suspicious breast mass undergoes axillary examination. Which lymph node group is particularly important because it commonly receives lymphatic drainage from the breast?
16.
A 46-year-old woman presents with a painless breast lump that has enlarged over four months. Examination reveals a 3-cm firm, irregular lesion in the upper outer quadrant. Mammography is suspicious, but fine-needle aspiration yields insufficient cells for interpretation. What is the most appropriate next step to establish the diagnosis?
17.
A 52-year-old woman has undergone surgery for hormone receptor-positive breast carcinoma. Her oncologist recommends adjuvant tamoxifen. Which mechanism best explains the therapeutic benefit of this medication?
18.
A 47-year-old woman presents with a new breast lump. Which feature in her family history would raise concern about inherited breast cancer susceptibility?
19.
A 57-year-old woman presents with a firm subareolar mass and recent nipple inversion. During examination, the surgeon asks her to press both hands firmly against her hips. This produces localized dimpling over the lesion. Which anatomical process best explains this finding?
20.
A 52-year-old woman undergoes investigation of a suspicious breast mass. Which procedure provides tissue architecture for histopathological diagnosis?
21.
A 34-year-old woman develops a tender, fluctuant breast swelling with fever after several days of lactational mastitis. What is the most likely complication?
22.
A 62-year-old woman presents with a suspicious breast mass and a palpable ipsilateral axillary lymph node. Core biopsy confirms invasive carcinoma. The surgeon plans treatment after evaluating the extent of regional disease. Which investigation most directly helps assess the abnormal axillary node?
23.
A breastfeeding woman develops fever, breast pain and a localized area of erythema. Which condition best explains these findings?
24.
A 31-year-old woman presents with a rapidly enlarging, painless breast mass. Examination reveals a 7-cm, well-circumscribed, mobile lesion. Ultrasonography demonstrates a heterogeneous solid mass with cleft-like spaces. Core biopsy suggests a fibroepithelial tumour with increased stromal cellularity. Which diagnosis best explains these findings?
25.
A woman has recently been diagnosed with breast cancer and appears distressed during counselling. Which communication approach is most appropriate?
26.
A woman with a newly detected breast lump asks whether clinical examination alone can confirm that the lesion is benign. Which response reflects the appropriate diagnostic principle?
27.
A 54-year-old woman presents with progressive breast enlargement, diffuse erythema, warmth and skin thickening involving more than one-third of the breast. She has no fever and has not improved after antibiotics. Biopsy demonstrates carcinoma. Which management principle is most appropriate?
28.
A 59-year-old woman undergoes mammography after noticing a change in breast contour. Imaging reveals a cluster of fine pleomorphic microcalcifications without a discrete palpable mass. Which underlying pathological condition is an important consideration?
29.
A 56-year-old woman undergoes breast-conserving surgery for early breast cancer. Histology confirms complete excision with clear margins. The multidisciplinary team recommends postoperative radiotherapy. What is the principal purpose of this treatment?
30.
A 33-year-old woman attends the surgical clinic after a road traffic accident. Six weeks later, she develops a firm, irregular breast lump at the site of previous bruising. Mammography shows an oil cyst with peripheral calcification. Which pathological process best explains the findings?
31.
A 48-year-old woman presents with spontaneous, unilateral, blood-stained nipple discharge from a single duct. Which benign lesion is a recognized cause?
32.
A 49-year-old woman reports spontaneous bloody discharge from one nipple. Clinical examination is unremarkable, and initial mammography and targeted ultrasonography show no definite lesion. The discharge persists. What is the most appropriate management principle?
33.
A 63-year-old woman with a confirmed invasive breast carcinoma is scheduled for surgery. Examination reveals no clinically enlarged axillary nodes, and preoperative axillary assessment is negative. Which procedure is commonly used to evaluate the first draining lymph node while limiting unnecessary axillary dissection?
34.
A 58-year-old woman has persistent unilateral nipple eczema that has not improved with topical treatment. Which underlying condition should be considered?
35.
A 38-year-old breastfeeding woman presents with localized breast pain, fever and erythema. Ultrasonography shows a 4-cm fluid collection containing internal echoes. She has already received appropriate antibiotics for 48 hours without improvement. Which intervention is most appropriate?
36.
A 55-year-old woman notices a progressively enlarging, painless breast lump. Examination reveals an irregular, hard mass with reduced mobility. Which diagnosis should be considered first?
37.
A 29-year-old woman reports cyclical bilateral breast pain and nodularity that become more prominent before menstruation. Which diagnosis is most likely?
38.
A 49-year-old woman has been diagnosed with breast cancer and asks why receptor testing is performed on the tumour tissue. What is its main clinical purpose?
39.
A 23-year-old woman presents with a painless, freely mobile, firm breast lump that has remained unchanged for six months. Which is the most likely diagnosis?
40.
A 61-year-old woman has completed treatment for breast cancer. At follow-up, she reports new arm swelling on the operated side after axillary surgery and radiotherapy. Examination shows non-pitting swelling without erythema or fever. Which explanation and management approach is most appropriate?
