Breast Disease Diagnosis and Management practice questions

Question 1

A 59-year-old woman has no palpable breast mass, but screening mammography shows a small cluster of suspicious microcalcifications. Which diagnosis is most concerning?

Accepted Answer

Ductal carcinoma in situ (DCIS)

Answer

Acute mastitis

Answer

Simple breast cyst

Answer

Breast lipoma

Question 2

Which findings belong in the differential diagnosis of a mammographic cluster of calcifications? Select all that apply.

Accepted Answer

Benign secretory calcifications

Accepted Answer

Vascular calcifications

Accepted Answer

A calcifying fibroadenoma

Accepted Answer

Fat necrosis

Accepted Answer

Sclerosing adenosis or fibrocystic change

Accepted Answer

Atypical ductal hyperplasia

Accepted Answer

DCIS or invasive carcinoma with an in situ component

Answer

An uncomplicated simple cyst with no calcification

Answer

Acute lactational mastitis

Answer

A noncalcified lipoma

Question 3

Which steps are appropriate in the diagnostic workup of newly detected clustered breast calcifications? Select all that apply.

Accepted Answer

Obtain diagnostic mammography with magnification views.

Accepted Answer

Compare with prior mammograms for stability or change.

Accepted Answer

Assign a BI-RADS assessment after the diagnostic evaluation.

Accepted Answer

For suspicious calcifications, obtain stereotactic or mammography-guided core-needle sampling.

Accepted Answer

Confirm calcifications in the biopsy specimen when sampling is performed.

Accepted Answer

Use targeted ultrasound when an associated mass, distortion, or nodal abnormality is suspected.

Answer

Order breast MRI routinely before completing diagnostic mammography.

Answer

Proceed directly to definitive cancer surgery without image-guided tissue diagnosis.

Question 4

If biopsy confirms ductal carcinoma in situ, which management principles are appropriate? Select all that apply.

Accepted Answer

Breast-conserving surgery is commonly followed by radiation therapy.

Accepted Answer

Mastectomy may be considered for extensive or multicentric DCIS or when acceptable margins cannot be achieved.

Accepted Answer

Hormone-receptor testing can help determine whether endocrine therapy may reduce future breast events.

Answer

Sentinel lymph-node biopsy is mandatory with every lumpectomy for pure DCIS.

Answer

Cytotoxic chemotherapy is standard first-line treatment for pure DCIS.

Answer

All patients should receive observation alone without surgery.

Breast Disease Diagnosis and Management practice questions

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Breast Disease Diagnosis and Management practice questions

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