b.

Presence of perivascular abscess

Breast c. Presence of lymphocytic invasion
d. Presence of vascular invasion
1. The lobules are distended and filled with uniform cells with
14. Clinical significance of congenital nipple retraction, EXCEPT:
abundant cytoplasm. The basement membrane of each acinus is
a. Presence of breast cancer
intact. Lobular carcinoma in Situ
b. Associated with subareolar abscess
2. Bloody nipple discharge in a woman in her perimenopausal period.
c. Associated with congenital anomalies in the lungs
Intraductal papilloma
d. Associated with duct ectasia
3. This malignant tumor does not metastasize but do predispose to
15. Clinical presentation of acute mastitis is similar to which of the
the development of invasive carcinoma in which the tumor cells
following malignant tumor of the breast:
infiltrate the stroma in linear arrangement. Infiltrating lobular
a. Mucinous carcinoma
carcinoma
b. Papillary carcinoma
4. Positive estrogen-receptor assay is important in choosing the type
c. Inflammatory carcinoma
of therapy and prognosis. Invasive ductal carcinoma
d. Paget’s disease
5. Small masses in the region of the nipple, most often not palpable.
16. A breast lesion which usually appears during lactation is
Intraductal papilloma
a. Intraductal papilloma
6. Ill-defined diffusely increase density and nodularities with
b. Paget’s disease of the nipple
scattered, poorly demarcated white areas and several cystic
c. Adenosis
spaces. Lobular carcinoma in situ
d. Abscess
7. Subareolar mass in postmenopausal woman. Duct ectasia
17. A 34 year-old woman was in an automobile accident in which her
8. A solitary mass, easily movable, encapsulated well demarcated
right breast struck the steering wheel. Within a month a 3.0cm,
from the surroundings breast tissue, rubbery in consistency and
firm mass developed in the breast. The likeliest diagnosis is
with gray-white, firm surface on out section. Fibroadenoma
a. Abscess
9. Do not form a palpable mass and often are discovered as an
b. Carcinoma
incidental findings when a breast biopsy is performed for other
c. Fat necrosis
reasons. Lobular carcinoma in situ
d. Fibrocystic diseases
10. Necrotic adipose tissue with areas of saponification and
18. A 60y/o woman had a hard, fixed 2.0cm in right breast. This is
calcification associated with lymphocytes, plasma cells and foamy
most likely
macrophages. Fat necrosis
a. Fibroadenoma
11. Histologic component of fibrocystic changes associated with
b. Carcinoma
increased risk of ductal carcinoma:
c. Fibrocystic diseases
a. Fibrosis
d. Periductal mastitis
b. Cysts
19. A 45y/o woman noted bleeding from her left nipple. A 2.5 cm
c. Adenosis
subareolar mass was felt. Nipple bleeding may occur in all of the
d. Hyperplasia
following, EXCEPT
12. Mutation in this gene is present in about half of women with
a. Medullary carcinoma
hereditary breast cancer:
b. Intraductal papilloma
a. BRCA 2
c. Intraductal carcinoma
b. TP53
d. Paget’s disease of the breast
c. BRCA 1
20. A 65y/o woman had a hard fixed 2.0cm mass in her left breast.
d. APC
Clinically and on mammography it was diagnosed as a carcinoma.
13. Which of the following is the clinical significance of ductal
The most common type of breast carcinoma is
carcinoma-in-situ of the breast:
a. Papillary carcinoma
a. Absence of metastasis
1
 b. Lobular carcinoma d. Elastic production by the neoplastic cells
c. Infiltrating ductal carcinoma, NOS 28. Which of the following is the most important factor to predict
d. Intraductal carcinoma, comedo type breast carcinoma?
21. A 25y/o woman felt a rubbery, movable 2.0cm, mass in her right a. Presence of carcinoma in situ
breast. The likeliest diagnosis is b. Lymph node metastasis
a. Fibrocystic disease c. Mitotic activity
b. Intraductal carcinoma d. Cell type
c. Malignant phylloides tumor 29. Besides staging of breast cancer, which of the following factors
d. Fibroadenoma may not play a role in the prognosis?
22. All of the following appear to be risk factors in the development of a. Histologic grade
breast carcinoma EXCEPT: b. Progesterone receptor
a. Menopausal or postmenopausal estrogen therapy c. Location of the tumor/involved quadrant
b. High fat intake in the diet d. Estrogen receptors
c. Early and frequent pregnancies 30. A 23y/o woman presents with a rubbery, freely movable 2.0cm
d. Having a mother and/or sister with breast carcinoma mass in the upper outer quadrant of the left breast. A biopsy of
23. Which pathological changes carry the highest risk for developing this lesion would most likely histologically reveal
breast carcinoma? a. A mixture of fibrous tissue and ducts
a. Adenosis b. Necrotic fat surrounded by lipid-laden macrophages
b. Cystic dilatation of the duct c. Duct ectasia with inspissations of breast secretions
c. Atypical ductal hyperplasia d. Large number of chronic inflammatory cells, mostly
d. Stromal fibrosis lymphocytes
24. Of the different histological types of carcinoma of the breast, 31. Which of the following is considered to indicate the greatest risk of
which is the most likely to be bilateral? subsequent carcinoma of the breast?
a. Colloid carcinoma a. Intraductal papillomatosis
b. Lobular carcinoma b. Sclerosing adenosis
c. Tubular carcinoma c. Epithelial hyperplasia
d. Papillary carcinoma d. Marked apocrine metaplasia
25. Of the many different types of breast carcinoma, which is the one 32. All of the following factors have shown an association with
with worst prognosis? gynecomastia EXCEPT
a. Infiltrating ductal scirrhous carcinoma a. Leydig cell tumor
b. Phylloides tumor, low grade b. Sertoli cell tumor
c. Papillary carcinoma c. Alcoholic cirrhosis
d. Mucinous carcinoma d. Seminomas
26. Which is the most common benign tumor of the breast? 33. The most important factor related to the prognosis of breast
a. Fibroadenoma cancer is
b. Tubular adenoma a. Presence of estrogen receptors
c. Intraductal papilloma b. Histologic type and grade
d. Phylloides tumor, benign c. The status of axillary lymph nodes
27. What does carcinoma of the breast with abundant desmoplastic d. The size of the tumor
reaction indicate? 34. Clinical risk factor for development of carcinoma of the female
a. Mucin production by neoplastic cells breast include all of the following, EXCEPT
b. Stromal collagenation in reaction to the neoplastic cells a. Early menopause
c. Stromal calcification due to tumor necrosis b. Early menarche

2
 c. History of endometrial carcinoma d. Fibroadenoma
d. Nuliparity
35. A menopausal woman is given a diagnosis of lobular carcinoma of
the breast. True statement regarding this lesion include all the Matching:

following EXCEPT Acute mastitis

Mammary duct ectasia
a. Biopsies of the contralateral breast is indicated
b. It tends to be multifocal Periductal mastitis

c. Epidermal infiltration is characteristic Fat necrosis

Granulomatous mastitis
d. A single file pattern of infiltration is characteristic
36. Apocrine metaplasia is commonly seen in this least condition:
46. Early weeks of nursing
a. Fibrocystic change b. Phylloides tumor c. Fibroadenoma D.
47. Painful erythematous subareolar mass
Gynecomastia
48. Staphylococcus aureus
37. A history of breast trauma is common in the clinical history
49. Intracanalicular and pericanalicular histologic patterns are
a. Mammary duct ectasia b. Fat necrosis c. Foreign
morphologically seen in:
body reaction d. Abscess
a. Fibroadenoma
38. The areola is covered by what type of epithelium?
b. Fibrocystic change
a. Stratified squamous epithelium b. Cuboidal epithelium
c. Mammary duct eclasia
c. Pagetoid cells d. Myoepithelial cells
d. Lactating adenoma
39. Cirrhosis can lead to this breast condition in males
50. This condition is commonly seen during nursing periods
a. Fibroadenoma b. Fibrocystic change c. Phylloides
a. Mammary duct ectasia
tumor d. Gynecomastia
b. Acute mastitis
40. The presence if inspissated breast secretion is microscopically seen
c. Chronic masititis
in this lesion?
d. Foreign body granuloma
a. Comedocarcinoma
51. Associated with increased risk of having breast malignancy
b. Mammary duct ectasia
a. Multiparity
c. Large duct papilloma
b. Use of contraceptives
d. Fat necrosis
c. Late menarche
41. Risk of developing breast cancer is low
d. Obesity
a. Early menarche with late menopause b. Multiparity c.
52. This lesion clinically present as subareolar mass:
Nuliparity d. Obesity
a. Colloid CA
42. Tumor size less than 2.0cm
b. Mammary duct ectasia
a. Stage I b. Stage II c. Stage III d. Stage IV
c. Paget’s disease
43. Hormone implicated in the development of breast cancer
d. Intraductal papilloma
a. Progesterone b. Estrogen c. Androgen d.
HCG A 46y/o single and obese female noted a palpable lump on the upper
44. Poor prognostic factor outer quadrant of her left breast described as non-bender and fixed
a. Younger age (non-movable). Consult to a private surgeon was sought and was
b. Small size of tumor advised to undergo tissue (excision) biopsy of solid mass. Further
c. Well differentiated lesion inquiry on the patient’s history pertinently yielded that her mother had
d. Presence of distant metastasis mastectomy several years ago.
45. Clinically can manifest bloody nipple discharge
a. Large duct papilloma b. Lobular carcinoma c. 53. With the above given information and physical findings of the

Fibrocystic change breast lesion, the mass would most likely be clinically

3
 a. Benign d. A single file pattern of filtration is characteristic
b. Malignant
54. Which of the following information would highly support your
answer in the preceding question
a. Single (nulliparous)
b. Obese
c. Non-tender and fixed lump
d. Mother with history of mastectomy
e. All
f. None
55. Tissue biopsy of the mass revealed a 5.5cm firm solid mass with
??? cut surface and histologically disclose cells in cords and nests
with stromal involvement
a. Fibroadenoma
b. Scirrhous carcinoma
c. Phyllodes tumor
d. None
56. The next course of action to undertake based on the histologic
features (from preceding question)
a. Lumpectomy with wide marginal resection
b. Quarterly mammographic monitoring
c. Radical surgery with axillary LN dissection
d. Hormonal treatment
e. None of the above
57. Stage of the disease in the absence of an axillary lymph node
involvement
a. Stage 0
b. Stage I
c. Stage II
d. Stage III
e. Stage IV
58. The most important factor related to the prognosis of breast
cancer is
a. Presence of estrogen receptors
b. Histologic type and grade
c. The status of axillary lymph nodes
d. The size of the tumor
59. A menopausal woman is given a diagnosis of lobular carcinoma of
the breast. True statement regarding this lesion include all of the
following EXCEPT
a. Biopsies of the contralateral breast is indicated
b. It tends to be multifocal
c. Epidermal infiltration is characteristic

4
60. The lowest incidence of breast cancer is found in women who:
a. Were pregnant at an early age
b. Had early menarche
c. Had late menopause
d. Were nulliparous
61. Which of the following histologic patterns of breast carcinoma is
associated with best prognosis?
a. Invasive tubular
b. Invasive ductal
c. Invasive lobular
d. Medullary
62. Which of the following statements is true for breast cancer in
men?
a. It is often bilateral
b. It has a better prognosis than breast cancer in women
c. It is only 1% as common as breast cancer in women
d. It is often preceded by atypical ductal hyperplasia
63. Longer disease-free survival and over-all survival are expected in
women whose breast cancer show a high degree of level of
a. Histologic grade
b. Nuclear grade
c. Estrogen receptors
d. Staging
64. A 34y/o woman was in automobile accident in which her right
breast struck the steering wheel. Within a month a 3.0cm firm
mass developed in the breast. The likeliest diagnosis is
a. Abscess
b. Carcinoma
c. Fat necrosis
d. Fibrocystic disease
65. All of the following are associated with a poor prognosis for breast
cancer EXCEPT
a. Invasion of dermal lymphatics
b. Cytologic anaplasia, high mitotic index and pleomorphism
c. Intraductal carcinoma
d. Lack of circumscription
66. Estrogen receptors are common in
a. Breast tumor of younger rather than older women
b. Tumors that show DNA aneuploidy
c. Histologically well differentiated tumors
d. Tumors that have metastases in the liver

5
67. A tumor measuring 3cm in diameter was removed from the breast 72. A 60y/o woman had a firm, ??? 2.0cm on her right breast. This is
of a 60y/o woman. The pathologist described the cross section as most likely
firm, gritty, and chalky white. Histologically it displayed glandlike a. Fibroadenoma
elements and a strong desmoplastic reaction. Which of the b. Carcinoma
following are compatible with these findings? c. Fibrocystic disease
a. Mucinous carcinoma d. Periductal mastitis
b. Invasive ductal carcinoma NOS
Matching:
c. Medullary carcinoma
d. Colloid carcinoma
73. Klinefelter syndrome: gynecomastia
68. A 51y/o man presents with bilateral enlargement of his breast. PE
is otherwise unremarkable, and the diagnosis of gynecomastia is 74. Wipple cracks/fissure: acute mastitis
made. Which of the following histologic features is most likely to
be seen when examining a biopsy specimen from this breast 75. Calcified cyst: fat necrosis
tissue?
76. Immunocompromised: granulomatous mastitis
a. Atrophic ductal structures with increased numbers of
adipocytes
77. Cheesy nipple secretion: mammary duct ectasia
b. Granulomatous inflammation surroundings ducts with
numerous plasma cells 78. Central necrosis: lobular CA-in-situ
c. Proliferation of ducts in hyalinized fibrous tissue with
periductal edema 79. Marked lympho plasmacytic infiltrates: medullary CA

d. Dilated ducts filled with granular necrotic acidophilic debris

80. Slow growing tumor:colloid CA
69. A 46y/o woman presents with 1.5 cm firm mass in the upper outer
quadrant of her breast. An autopsy reveals many of the ducts to be
81. Single file pattern of tumor cells: invasive lobular CA
filled with atypical cells. In the center of these ducts there is
extensive necrosis. No invasion into the surrounding fibrous tissue 82. Hard cartilaginous consistency: invasive ductal CA
is seen. Which of the following is the most likely diagnosis?
a. Colloid carcinoma 83. Features of invasive breast cancers:

b. Tubular carcinoma
a. skin retraction and dimpling b. PEAU d’ orange
c. Comedo carcinoma
d. Lobular carcinoma in situ 84. Stage I breast carcinoma: a. 2cm mass b. with nodal
70. All of the following factors have shown an association with involvement
gynecomastia EXCEPT
a. Leydig cell tumor 85. Stage 4 breast carcinoma:
b. Sertoli cell tumor
a. 13% 5yr survival rate b. supraclavicular lymph node
c. Alcoholic cirrhosis
involvement
d. Seminomas
71. A 26y/o woman presents with a rubbery, freely movable 2cm mass
86. Male breast lesion: a. lobular hyperplasia b.
in the UOQ on the left breast. Which of the following is the most
gynecomastia
likely diagnosis of the tumor
a. Gynecomastia fibrous type 87. Mucinous carcinoma: a. rapidly enlarging mass b. poor
b. Benign phylloides tumor prognosis
c. Fibroadenoma
d. Fibrocystic changes

6
88. Invasive ductal carcinoma: a. stromal invasion b. stony hard 104. Cell proliferation increase: after ovulation
consistency
105. Epithelial cell death (apoptosis): during menstruation
89. Invasive lobular carcinoma:
106. Secretory glands appear: pregnancy
a. most common breast carcinoma b. infrequently
metastasizes 107. Lobular regression: after cessation of
lactation
90. Ductal carcinoma in-situ:

a. incapable of distant metastasis b. absence of stromal invasion

91. Paget’s disease of the nipple: a. skin involvement b. nipple

ulceration

92. Comedocarcinoma: a. low grade malignant cells b. central

necrosis

93. Risk factors of breast cancer: a. nulliparity b. obesity

94. Phylloides tumor: a. mostly low grade tumors b. highly

recurrent

95. Fibroadenoma:

a. uncommon breast tumor b. contains fibrous and glandular

structures

96. Fibrocystic change: a. apocrine metaplasia b.

malignant tumor

97. Fat necrosis: a. prior surgical intervention b. trauma

98. Lakes of mucin: colloid carcinoma

99. Schirrous pattern: invasive ductal

carcinoma

100. Single file pattern: invasive lobular

carcinoma

101. Malignant epidermal cells: Paget’s disease

102. Central necrosis: comedocarcinoma

103. Lobule relatively quiescent: follicular phase of

menstrual cycle

7
BREAST_MAGKASI 12. 70-80% OF ADENOCARCINOMA OF THE BREAST IS OF WHAT
A- BOTH STATEMENT ARE TRUE TYPE?
B- BOTH STATEMENT ARE FALSE 13. IN BREAST MASSES, WHAT INFORMATION CAN BE OBTAINED
C- THE 1ST IS TRUE, 2ND IS FALSE IN AN ULTRASOUND DIAGNOSTIC AID?
D- 1ST FALSE, 2ND TRUE 14. WHEN IS FNAB OF BREAST MASS NOT AN IDEAL DIAGNOSTIC
1. MORTALITY IS LOWERED BY DOING RADICAL MASTECTOMY IN AID?
BREAST CANCER AND THE MOST IMPORTANT PROGNOSTIC 15. NAME OF ONE BENIGN, NONPROLIFERATIVE EPITHELIAL
FACTOR IN BREAST CANCER IS THE LYMPH NODE SPREAD. BREAST LESION.
2. THE MAMMOGRAPHIC IMAGE IS COMPLICATED BY A
SILICONE BREAST IMPLANT AND THE IMPLANT CAN
COMPLICATE BY GROWTH OF FIBROUS CAPSULE AROUND.
3. BREAST CANCER LESS THAN 5CMS WITH 3 INVOLVED
AXILLARY LYMPH NODE IS CLASSIFIED AS STAGE III AND STAGE
III BREAST CANCER HAS A 5YR SURVIVAL OF ABOUT 45%.
4. MOST OF BREAST CANCERS OCCUR IN THE OUTER UPPER
QUADRANT OF THE BREAST AND ENLARGED INVOLVED
LYMPH NODES UNDER THE PECTORALIS MINOR ARE USUAL
MISSED DURING AXILLARY INSPECTION.
5. THE SPECIFICITY OF FNAB AS A DIAGNOSTIC PROCEDURE FOR
BREAST MASS IS 100% AND THE SAMPLE OBTAINED FROM
THE NEEDLE LUMEN MUST BE FIXED AT ONCE FOR
HISTOPATHOLOGIC EXAMINATION.
6. GYNECOMASTIA INDICATES HYPERESTRINISM IN THE ADULT
MALE AND THIS IS ASSOCIATED WITH FINDINGS OF
INCREASED NUMBER OF LOBULES IN THE BREAST.
7. LOBULAR CARCINOMA-IN-SITU (LCIS) PROCEDURES
ESTROGEN AND PROGESTERONE RECEPTORS AND IT IS
TREATED BY PROPHYLACTIC MASTECTOMY AND TAMOXIFEN.
8. THE MOST COMMON BENIGN BREAST TUMOR IF FEMALES IS
FIBROADENOMA BUT WHEN THERE IS STROMAL OVER
GROWTH AND INFILTRATIVE BORDERS, CELLULARITY AND
NUCLEAR PLEOMORPHISM, IT IS ALREADY CONSIDERED AS
PHYLLODES TUMOR.
9. LYMPHOPLASMATIC INFILTRATES AROUND THE TUMOR IS A
CONSTANT FINDING IN PAGET’S DISEASE OF THE BREAST AND
COLLOID CARCINOMA CARRIES A BETTER PROGNOSIS THAN
INFLAMMATORY CARCINOMA.
10. 70-80% OF BREAST CANCERS ARE POSITIVE FOR ESTROGEN
RECEPTORS BUT THOSE BREAST CANCERS WITH NO
ESTROGEN RECEPTORS SHOW BRCA1 MUTATION
11. A PALPABLE BREAST MASS MAY BE NEGATIVE IN A
MAMMOGRAM DUE TO