Chapter 23: Breast

Chapter 23: Breast

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A 50-year-old woman sees her physician because she has noticed a bloody discharge from the left nipple. Upon physical examination, there are no palpable masses in the breast. Which of the following is the most likely cause of this discharge?
2. Solitary cyst
3. Fibrocystic change
4. Acute mastitis
5. Intraductal papilloma
6. Carcinoma

ANS: D, Intraductal papilloma is the most likely cause of a bloody discharge from the nipple.

2. Which of the following nonneoplastic breast lesions is associated with the highest risk of mammary cancer?
3. Apocrine cysts
4. Sclerosing adenosis
5. Complex sclerosing lesion
6. Small duct papillomas
7. Atypical ductal hyperplasia

ANS: E, Atypical ductal hyperplasia is associated with a moderate increase in risk of cancer. Thus, of the five microscopic changes listed here, it has the highest risk of cancer. Nonproliferative breast changes such as cysts, as well as fibrosis and adenosis, do not increase the risk of cancer. Proliferative breast disease without atypia, including sclerosing adenosis, radial scars (complex sclerosing lesion), and small duct papillomas are associated with a mild increase in risk.

3. BRCA1 and BRCA2 genes that are mutated in 25% of all women who have familial breast cancer encode proteins. Which of the following functions do these proteins serve?
4. Cell surface receptors for growth factors
5. Growth factors
6. Cytoplasmic signaling molecules
7. DNA repair enzymes
8. Nuclear hormone receptors

ANS: D,  BRCA1 and BRCA2 are tumor suppressor genes that encode nuclear proteins promoting DNA damage repair.

4. Comedocarcinoma of the breast is a type of which of the following carcinomas?
5. Ductal carcinoma in situ
6. Medullary carcinoma
7. Invasive ductal carcinoma
8. Invasive lobular carcinoma
9. Tubular carcinoma

ANS: A, Comedocarcinoma is a type of ductal carcinoma in situ. This preinvasive type of carcinoma is composed of pleomorphic malignant cells forming solid intraductal sheets with central necrosis. If not removed surgically, comedocarcinoma will progress to invasive ductal carcinoma.