MCQs breast pathology- benign lesions, stromal tumors

1. Cause for gynecomastia *Multiple answers

A. Alcoholic liver disease
B. Klinefelters syndrome
C. Testicular seminoma
D. Increase in androgens

2. A 20-year-old woman presents with a solitary discrete, freely movable, firm, rubbery,
nontender, well-circumscribed breast lesion. On resection biopsy, the lesion appears similar to
that shown in the figure. The most likely diagnosis is

(A) fibrocystic disease.

(B) fibroadenoma.
(C) medullary carcinoma.
(D) colloid carcinoma.

3. Fibroadenoma arises from

A. Epithelial cells lining the ducts
B. Epithelial cells lining the acini
C. Interlobular stroma
D. Intralobular stroma
4. All of the following are characteristic of fibrocystic changes EXCEP T:
A. Dilated, cystic round to oval spaces lined by slightly attenuated epithelial and myoepithelial
cell layers
B. Sclerotic interlobular stroma
C. Two fold increased risk of developing carcinoma
D. Increased ductules and/or acini per lobule

5. Which of the following is True regarding radial scars?

A. They mimic invasive carcinoma on mammography.
B. Older lesions tend to be densely hyalinized and fibroelastic centrally.
C. Treatment is local excision.
D. All of the above

6. In the differential diagnosis of fibroadenoma versus phyllodes tumor, which of the following
favors phyllodes tumor?
A. It is usually seen between ages of 20 and 30 years of age.
B. It is the most common breast lesion in adolescent girls.
C. The stroma is more cellular with leaf like processes, and very rarely demonstrates a
pericanalicular growth pattern.
D. The ducts are engulfed by a pericanalicular arrangement of cellular stroma.

7. Which of the following is NOT a biphasic tumor?

A. Fibroadenoma
B. Juvenile fibroadenoma
C. Phyllodes rumor
D. Metaplastic carcinoma

8. Which of the following is TRUE regarding papillomas?

A. A myoepithelial layer is absent.
B. True papillomas do not show evidence of apocrine change.
C. Papillomas produce nipple discharge in 80% of cases
D. Absence of fibrovascular core

9. Histological patterns seen in fibroadenoma *Multiple answers

A. Pericanalicular
B. Pseudocanalicular
C. Intracanalicular
D. Intercanalicular

10. Which of the following is NOT a morphologic characteristic of phyllodes tumor?

A. High-grade tumors have a hypercellular stroma, ≥5 mitosis/10 hpf, moderate to severe stromal
atypia, and infiltrating margins.
B. Tumors are classified as benign, low-grade (potential for local recurrence), and high-grade
(potential to metastasize).
C. The stroma tends to be cellular and consists of spindle-shaped fibroblastic and
myofibroblastic cells; the cells tend to condense around the glandular elements.
D. The epithelial component is commonly hyperplastic with irregular tufts overlying stratified
epithelium; marked atypia is often present, reminiscent of intraductal carcinoma.

11. A 48-year-old woman has a tender breast nodule. This is biopsied (see image). What is her
increased risk of breast cancer?
A. No risk
B. 1.5-2 times
C. 4-5 times
D. 9-10 times

12. Which of the following is FALSE regarding gynecomastia?

A. Increased number of ducts lined by epithelial and myoepithelial cells are characteristic.
B. The surrounding cellular stroma is dense and collagenous
C. Lobular structures are enlarged due to adenosis.
D. It generally involves both breasts, but usually is more pronounced in one over the other.

13. Tumor arising from interlobular stroma of breast *Multiple answers

A. Fibroadenoma
B. Angiosarcoma
C. Phyllodes tumor
D. Lipoma