Breast lumps

Question 1

Movable lump that is not painful

Answer 1

Fibroadenoma

Most common benign breast lump

Can be left

20-30

Question 2

Lump in pre-menopausal women

Disappears after menopause

Answer 2

Breast cyst

• Aspiration under a US

Question 3

Lumpy breast

Cyclic mastalgia

Nipple discharge

Answer 3

Mammary displasia/fibroadenosis

Due to imbalanced response to endogenous sex hormones

30-50

Question 4

Traumatic fat necrosis

Answer 4

Due to trauma which woman can’t recall

Resembles cancer

Surgical removal, if doesn’t go away by itself

Question 5

Spontaneous discharge or bleeding from one nipple only!!!

Firm non-tender lamp

Answer 5

Intraductal papilloma 40-50

Excision of the milk duct and breast segment

Question 6

Breast triple exam

Answer 6

1 clinical exam
2 imaging
3 biopsy - FNA or core needle biopsy

Always needle! Not excision!

Question 7

A 1st° relative had breast cancer before 50

Answer 7

Start screening from 40 every year until 49

From 50 every two years

Question 8

Mammary duct ectasia

Answer 8

Around menopause

=periductal mastitis

Calcification
Green yellow sticky discharge

Skin changes
Inverted nipple

Excision

Question 9

Painful breast mass after menopause

Answer 9

Mammary duct ectasia

Question 10

Breast cancer with one metastasis

Answer 10

Radiotherapy

If more mets- chemo or hormone therapy

Question 11

Early life obesity protects against

Answer 11

Pre-menopausal breast cancer but increases post menopausal breast cancer

Question 12

Testing for breast cancer during pregnancy

Answer 12

Ultrasound is preferred over mammography

Question 13

Breast cancer investigation between 35 and 40

Answer 13

Both Ultrasound and mammography

Question 14

Surgery for paget disease

Answer 14

Wide local excision

Question 15

If breast cancer suspected but FNA showed benign lesion,

next step

Answer 15

Excision biopsy

Question 16

Most common side-effect of aromatise inhibitors

Answer 16

Vaginal dryness

Question 17

Quickest and most effective biopsy to diagnose cancer

Answer 17

FNA

Question 18

If FNA is done before imaging

Answer 18

Wait two weeks

Question 19

For patients on HRT GP visits for breast check

Answer 19

Every six months

Question 20

Breast disease caused by vitamin A deficiency

Answer 20

Periductal mastitis

Question 21

Difference between paget disease and eczema of nipple

Answer 21

Paget disease is not itchy

Question 22

Self-breast examination

Answer 22

Is not recommended due to false positives

Question 23

Paternal aunt has breast cancer and ovarian cancer

Answer 23

Genetic counselling required

Question 24

Breast screening between 40 and 49

Answer 24

Available on request

Question 25

A smoker on OCP with family history of breast cancer and high BMI next step

Answer 25

Lose weight

Question 26

What proportion of breast cancer patients have an identifiable genetic cause?

Answer 26

5%

Question 27

Patient 35 with family history of breast cancer on the pill

Answer 27

Remain on the pill six monthly clinical review annual mammography and ultrasound

Question 28

The most common type of breast cancer

Answer 28

Infiltrating ductal carcinoma

Question 29

Common management of early breast cancer

Answer 29

Wide excision

Question 30

Breast cancer at 15 weeks gestation

Answer 30

Proceed with surgery

Question 31

Radiation after excision which reduces local recurrence at 5 years to

Answer 31

5 to 10%

Question 32

Vertebral lesion after mastectomy

Answer 32

Radiation

Question 33

Vaginal bleeding in patient on Tamoxifen for breast cancer

Answer 33

D & C

Question 34

Chest pain and shortness of breath inpatient on tamoxifen

Answer 34

Due to tamoxifen