MCQs On Breast Imaging:

(√ ) or (X )
 Breast Anatomy and Development:

1. The Breast is a modified apocrine sweat gland. (√ )

2. The major artery to the breast is internal mammary artery. (√ )
3. Azygos vein drains the breast (√ )
4. The terminal duct lobular unit is the basic functional unit of the
breast (√ )
5. The level of lymph nodes involvement is related to pectoralis
Major muscle
(X ) Pectoralis minor
6. The breast extends lateraly till the anterior axillary line
(X) Mid axillary line
 Regarding Mammography:

1. The skin is thickest over the upper outer quadrant (√ )

2. The craniocaudal view shows more breast tissue than the
mediolateral view.
(X ) Craniocaudal view shows less breast tissue
3. The pectoral muscle is not visualised in the craniocaudal view (√ )
4. Intramammary Lymph nodes are seen in the upper outer
quadrant (√ )
5. Marked stromal proliferation is seen in the secretory phase of the
menestrual cycle.
(X) Proliferative phase due to estrogen effect
6. The breast completely lies in the superficial fascia (√ )
 Regarding Breast Ultrasound:

1. The skin is a three layered structure (√ )

2. Coopers ligaments produce acoustic shadow (√ )

3. The Fat appear hypoechoic (√ )

4. The breast is uniformly bright due to the fibroglandular

tissue (X ) heterogenous

5. The ducts are clearly visualised (√ )

Regarding Mammography :

1. Microcalcification is calcification less than 1mm

(X ) less than 0.5 mm
2. Microcalcification is specific for carcinoma
(X ) not specific
3. Microcalcification is not seen in traumatic fat
necrosis
(X) this is a recognisable feature
4. Spiculated masses are carcinomas until proved by
biopsy (√ )
 The following pattern of calcifications are
definitely benign:

1. Egg shell calcification (√ ) Cyst

2. Floating calcification (√ ) Milk Calcium Cyst

4. Pleomorphic branching calcifications

(X) Feature of invasive ductal carcinoma

4. Pop corn calcification (√ ) Fibroma

5. Tram line calcifications (√ ) Blood vessel

 Groups of breast microcalcifications are
seen in :

1. Fibroadenoma (X )
2. Fat necrosis (√ )
3. Radiotherapy (X )
4. Ductal carcinoma (√ )
5. Sclerosing adenitis (√ )
 Regarding Ductal Carcinoma :

1. Constitutes 40% of all breast carcinoma (X )

2. May be associated with lobular carcinoma (√ )
3. Mammographic appearance is larger than the
clinical size (X )
4. Arises from the large ducts epithelium (X )
5. Usually the tumour shows well defined margin
, homogenous density and no acoustic
shadowing (X )
 Ductal Carcinoma

•It constitutes 80% of all breast cancers

•Arises from epithelium of medium and small sized
ducts
•It can be associated with invasive tubular and
lobular carcinomas.
•The clinical size is bigger due to desmoplastic
reaction
•Usually the tumour has ill-defined margin ,
heterogenous density and acoustic shadow
 Lesions producing spiulated mass in
mammography :

1. Fat necrosis (√ )

2. Sclerosing adenosis (√ )

3. Fibroadenosis (√ )

4. Abscess (√ )

5. Hamartoma (X )
 Common US features of typical breast
Carcinoma:

1. Sharp margin (X )
2. Hypoechoic (√ )
3.Long axis is perpendicular to skin (√ )
4. Hypoechoic rim of tissue (X )
5. Echogenicity same as adjacent fibroglandular
tissue but less than fat (X )
 Common US features of typical breast
Carcinoma:

• Irregular margin
• Hypoechoic compared to adjacent
fibroglandular tissue and fat
• Long axis is perpendicular to skin
• Hyperechoic rim of tissue (tumour,
desmoplastic compressed breast tissue)
• Posterior acoustic shadowing.
 High incidence of breast cancer
recurrence is seen in :

1. Estrogen receptor positive

(X) Estrogen Receptor Negative

2. Comedo carcinoma (√ )
(X) Age < 40 years
3. Age > 40 years

4. More intraductal component (√ )

5. Negative margin (X) Positive Margin

 Regarding Benign Breast
Disease:

1. Breast abscess is most commonly located in the

upper outer Quadrant. (X) Retroareolar

2. Breast abscess is most commonly due to

streptococcus (X) Staphylococcus aureus

3. Skin retraction is a common presentation of fat

necrosis (√ )

4. Hyalinised fibroadenoma is a common feature

(X) Rare
 Regarding Lymph node
involvement in Breast cancer:

1. 40% of women have axillary lymph adenopathy at time of

diagnosis (√ )
2. Involved lymph nodes are rounder and more reflective than
normal at US
(X) Larger,more rounded and less reflective

3. Internal mammary lymph nodes are more often involved than

axillary lymph nodes of the inner quadrant tumors.
(X) Axillary lymph nodes are more comonly involved

4. Internal mammary lymph nodes are usually resected at

mastectomy (X)
5. Supraclavicular nodal spread confers a poor prognosis (√ )
 Regarding Male Breast cancer:

1. Most cases occur in patients with Kleinfilter (X)

2. Frequently bilateral (X)

3. Mammographic calcifications are fewer than in

female breast cancer.
(X) Larger,more rounded and more scattered

4. It is more common on left side (√ )

(X)
5. Gynaecomastia is a predisposing factor
Thank You