Deck 18: Breast

Question 1

Which of the following statements about breast cancer is correct?

A) Breast cancer is the leading cause of cancerrelated deaths in women in the United States.
B) Breast cancer usually occurs in the setting of familial (inherited) cancer syndromes.
C) The incidence of breast cancer is about the same all over the world.
D) In the United States, breast cancer is usually detected at an early stage.
E) Breast cancer is usually diagnosed in premenopausal women.

Answer 1

Breast cancer is diagnosed most frequently in the United States women. In the United States after lung cancer, it the second most chief reason of the death caused due to the cancer. Breast cancer is usually diagnosed at the age of sixty one. Breast cancer is very rare at the age of thirty or below. Occurrence of the breast cancer varies geographically.
Industrialized western nations are more prone to the breast cancers.
Countries like Denmark, Japan and China has the lower breast cancer death rate. Women with late menopause, early menarche and who had not breastfeed their newborns are more likely to develop of the breast cancer. Higher socioeconomic status, increasing age, lack of physical activity, alcohol consumption and prior exposure to the radiation also poses the high risk of breast cancer in women.
Hence, the options A, C, D and E are incorrect.
Mutation in either of the BRCA genes is the strongest factor behind the occurrence of the breast cancers. Other than the BRCA genes many other genes associated with the breast cancer only arises in the familial cancer syndromes just like Cowden syndromes, Li-Fraumeni and Peutz-Jeghars syndrome. Genetic testing of these genes against the specific mutations is available for the persons, who have strong familial history associated with the cancers.
Hence, the correct answer is option .

Question 2

The milk-producing part of the breast is called the

A) nipple.
B) lactiferous duct.
C) lobule.
D) adipose tissue.
E) areola.

Answer 2

Nipple is the part of the breast. It is visible on the surface of the breast as the raised projection, which is conical in shape. Nipple serves as the opening for various lactiferous ducts in it. Breast milk is passed through the nipple to the mouth of the suckling infant. Nipple on stimulation for the breastfeeding allows the lactiferous ducts to drain the milk through the compression of the smooth muscle fibers.
Lactiferous ducts usually form a branched tree pattern, which connects the mammary gland lobules to the nipple tip. They also called as the galactophorous ducts. They are responsible for the transfer of the milk to the nipples. Adipose tissue serves as insulator in the breast. Adipose tissue helps in cushioning of the breast from the damage. It is also responsible for the shape of the breast.
Areola is the area, which surrounds the nipple in circular pattern. It is found to be raised above the surface of the skin. It is very rich in the sebaceous glands. These sebaceous glands secrete the sebum for the lubrication of the nipple and areola as they are very much prone to chaffing.
Hence, the options A, B, D and E are incorrect
Milk producing glands of the breast are known as the alveoli or the lobules. Lobules produce the milk from the water and nutrients. They extract water from the blood and nutrients from the food for the production of the breast milk for infants. The structure of these milk producing glands shares the resemblance with the grapes bunches.
Hence, the correct answer is option .

Question 3

A 25-year-old woman notes a round, movable, painless lump in her breast. A biopsy would most likely show

A) lobular carcinoma.
B) duct ectasia.
C) intraductal papilloma.
D) fibroadenoma.
E) phyllodes tumor.

Answer 3

Lobular carcinoma is one of the types of breast cancer only. It affects the breast's milk producing lobules. It affects the milk producing ducts first. Lobular carcinoma can be classified as invasive lobular carcinoma and carcinoma in-situ. Their detection is not possible until they become very large.
Duct ectasia is a type of the chronic inflammation, which affects one or more major breast ducts. This usually occurs at the time of menopause. This inflammation causes the filling of the duct with the necrosis and inflammatory debris, which can extrude out of the nipples. It can produce scar or lump in the breast tissue.
Intraductal papilloma is referred as the localized growth of the epithelial type of cells within the large duct of breast around the slender fibro vascular cores. It causes the blood, serous and small mass discharge from the nipples. Surgical removal is the only treatment to this disorder.
Phyllodes tumor is the malignant form of the stromal tumor. It shows the leaf like proliferation within the breast tissue. It grows really quick. Wide surgical excision is required for its removal.it usually affects the women from the age group of forty to fifty years.
Hence, the options A, B, C and E are incorrect.
Fibroadenoma is non-cancerous type of tumor of the breast. It usually affects the women of the age group below thirty years. Fibroadenoma are usually painless. They move easily on touch. They feel like rubbery or smooth lump of definite shape in the breast.
Hence, the correct answer is option .

Question 4

Which of the following statements about mammography is correct?

A) Mammography cannot be used reliably in older women because fibrous tissue increases with age.
B) Dense areas with irregular outlines and clusters of calcifications are concerning for breast cancer.
C) Mammography cannot detect lumps that are not palpable.
D) Mammography can be used to differentiate between solid lesions and fluid-filled cysts.
E) Mammography is no better than ultrasound in detecting cancer.

Question 5

A positive sentinel lymph node

A) means the cancer is widely metastatic.
B) means the patient has to have a mastectomy rather than lumpectomy.
C) is usually detected by palpation of a lump in the axilla.
D) means the patient will require hormone therapy.
E) needs to be followed with dissection of the remaining axillary lymph nodes.