Chapter 21: Breast

The breast is sonographically divided into three layers. Which one of the following is incorrect?

A) skin, nipple, subareolar

B) pectoralis major

C) subcutaneous region

D) parenchyma

B) pectoralis major

The functional portion of the breast consists of _____ lobes.

A) 3 to 5

B) 5 to 10

C) 15 to 20

D) 25 to 30

C) 15 to 20

Which one of the following form(s) a fibrous "skeleton" that is responsible for maintaining the shape of the breast?

A) acini

B) Cooper's ligaments

C) pectoralis major muscle

D) glandular layer of the breast

B) Cooper's ligaments

As a woman ages, the glandular breast tissue is replaced with:

A) fat

B) cysts

C) fibrous tissue

D) Cooper's ligaments

A) fat

Cooper's ligaments are best characterized as which one of the following?

A) low reflectivity in the retromammary layer

B) high reflectivity in the retromammary layer

C) echogenic line interfaces in the subcutaneous layer

D) homogeneous reflections in the parenchyma

C) echogenic line interfaces in the subcutaneous layer

The retromammary layer is sonographically imaged as which one of the following?

A) hyperechoic

B) dense

C) hypoechoic

D) high reflectivity

C) hypoechoic

The most important signs to look for in determining a cystic lesion of the breast include all of the following except:

A) well-defined borders

B) good through transmission

C) anechoic

D) disruption of architecture

D) disruption of architecture

Clinical findings of lumpy, painful, tender breasts that vary with monthly cycles represent which one of the following?

A) carcinoma

B) fibrocystic disease

C) cysts

D) adenomas

B) fibrocystic disease

The characteristic findings of a papilloma of the breast include all of the following except:

A) well-circumscribed solid mass with microcalcifications

B) sonolucent cystic lesions with a medium-level encapsulated component

C) single or multiple

D) no disruption of architecture

D) no disruption of architecture

The most common solid mass seen in women younger than 30 years of age is the:

A) phyllodes tumor

B) fibroadenoma

C) papilloma

D) medullary carcinoma

E) invasive ductal carcinoma

B) fibroadenoma

The most sonographic characteristic of a fibroadenoma is which one of the following?

A) poorly defined border

B) uniform, low-level homogeneous echoes

C) increased through transmission

D) disruption of architecture

B) uniform, low-level homogeneous echoes

Lymphatic drainage from all parts of the breast generally flows to the ______ lymph nodes.

A) interpectoral

B) axillary

C) supraclavicular

D) internal mammary

B) axillary

The most common malignant neoplasms of the breast is which one of the following?

A) lobular carcinoma in situ

B) invasive ductal carcinoma (IDC)

C) invasive lobular carcinoma

D) ducts carcinoma in situ

B) invasive ductal carcinoma (IDC)

Characteristic findings of breast carcinoma include all of the following except:

A) attenuation of sound

B) irregular margins

C) strong posterior margin

D) inhomogeneous low-level echo pattern with calcifications

C) strong posterior margin

Skin dimpling may be caused by which one of the following?

A) old age

B) refraction of tissue secondary to tumor infiltration

C) enlarged ducts

D) thrombosis of arterial vessels

B) refraction of tissue secondary to tumor infiltration

The most common clinical sign of breast carcinoma is which one the following?

A) skin dimpling

B) skin discoloration

C) palpable lump

D) pain

C) palpable lump

The primary purpose of breast screening examinations is to:

A) evaluate the retromammary region

B) provide a baseline study for fibrocystic disease

C) provide for early detection of breast carcinoma

D) evaluate dense breast parenchyma

C) provide for early detection of breast carcinoma

The midportion of the right medial and left lateral breast would be annotated as which one the following?

A) 3:00

B) 6:00

C) 9:00

D) 12:00

A) 3:00

A normal extension of breast tissue into the axillary region is called ______.

A) lobar neoplasm

B) tail of Spence

C) peau d'orange

D) terminal duct am lobular unit

B) tail of Spence

According to the American Cancer Society, all women should begin annual screening mammography and screening breast ultrasound at the age of ______ years.

A) 20

B) 30

C) 40

D) 50

C) 40

Which one of the following arteries is responsible for supply blood to more than one half of the breast?

A) intercostal

B) thoracodorsal

C) internal mammary

D) lateral thoracic

C) internal mammary

A condition of the male breast in which the ducts elements hypertrophy is called _____.

A) mastitis

B) galactocele

C) gynecomastia

D) Paget's disease

C) gynecomastia

Signs of possible breast cancer include all of the following except:

A) irregular or speculate mammographic mass, solid on ultrasound

B) clustered pleomorphic microcalcifications on mammogram, with or without any abnormality on ultrasound

C) focal distortion on mammogram, and a correlating area of distortion breast ultrasound

D) a smooth low-density mass, solid lesion that has not changed in over 3 years on ultrasound

D) a smooth low-density mass, solid lesion that has not changed in over 3 years on ultrasound

Ultrasound is often of benefit in guiding breast procedures for all of the following except:

A) cyst aspiration

B) fine-needle aspiration cytology (FNAC)

C) drainage procedure

D) large-core needle biopsy of microcalcifications

D) large-core needle biopsy of microcalcifications

Which one of the following statements is false?

A) breast ultrasound is the imaging tool of choice to evaluate a breast mass in a teenage girl

B) ultrasound of the breast is the primary imaging tool of choice in evaluating a breast mass in a pregnant woman

C) breast ultrasound is the primary imaging tool of choice in screening a 45-year-old woman for any evidence of possible breast cancer

D) in the case of a benign fibroadenoma, the sonographic features of a smooth, sharply circumscribed hypoechoic mass with homogeneous echogenicity and a mild posterior acoustic enhancement will usually be seen

C) breast ultrasound is the primary imaging tool of choice in screening a 45-year-old woman for any evidence of possible breast cancer

Ultrasound of the breast is often performed as an adjunctive imaging tool in all of the following situations except:

A) to assess a smooth mammographic mass as cystic or solid

B) to further evaluate a palpable breast lump in a patient with very dense breast tissue and a negative mammogram

C) to further evaluate a palpable breast lump in a patient with breast implants

D) to further evaluate an asymptomatic patient with large fatty replaced breasts and a negative mammogram

D) to further evaluate an asymptomatic patient with large fatty replaced breasts and a negative mammogram

In the case of a cancerous mammographic mass, the correlating sonographic mass will likely show which one of the following features?

A) irregular margin and taller than wide

B) anechoic

C) irregular margin and wider than tall

D) posterior acoustic enhancement

A) irregular margin and taller than wide

In the case of a smooth mammographic that is cystic, the correlating sonographic mass will likely show which one of the following features?

A) irregular margin

B) anechoic and posterior acoustic enhancement

C) taller than wide

D) echogenic and posterior acoustic enhancement

B) anechoic and posterior acoustic enhancement

The advantages of breast ultrasound over mammography in evaluating the breast include all of the following except:

A) limited radiation exposure to the patient

B) differentiation of cystic versus solid smooth masses

C) more comfortable examination for the patient

D) better visualization of juxtathoracic

A) limited radiation exposure to the patient

The advantages of breast ultrasound over mammography in evaluating the breast include which one of the following?

A) can better visualize those often-obscure signs of breast cancer such as microcalcifications

B) can better visualize microcystic adenosis with layering milk of calcium and sclerosing adenoids, as well as variants of benign fibrocystic conditions that contain small calcification as the principle mammographic finding that can be easily overlooked on routine mammographic images

C) can better discriminate Cooper's ligaments within lumen of the small ducts of the terminal ductal lobular units (TDLUs)

D) can better evaluate those hard-to-reach places, such as parasternal tissues and axilla, not well seen on mammography

D) can better evaluate those hard-to-reach places, such as parasternal tissues and ancillary, not well seen on mammography

The darker skin that surrounds the nipple is called the:

a. mammary zone

b. superficial fascia

c. areola

d. cooper’s zone

e. axilla

areola

The acronym MULD stands for:

a. malignant-undecided-left-dominant

b. manage-under-legal-doctor

c. mammo-upper-lateral-dimension

d. magnify-upper-lactiferous-ducts

e. medial-up-lateral-down

medial-up-lateral-down