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MCQs On Breast Imaging
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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
• 6. The breast extends lateraly till the anterior
  axillary line

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(X ) Pectoralis minor
(X) Mid axillary line
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Regarding Mammography

• 1. The skin is thickest over the upper outer
  quadrant
• 2. The craniocaudal view shows more breast tissue
  than the mediolateral view.
• 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.
• 6. The breast completely lies in the superficial
  fascia

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(X ) Craniocaudal view shows less breast tissue
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(X) Proliferative phase due to estrogen effect
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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
• 5. The ducts are clearly visualised

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(X ) heterogenous
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Regarding Mammography

• 1. Microcalcification is calcification less than
  1mm
• 2. Microcalcification is specific for carcinoma
• 3. Microcalcification is not seen in traumatic
  fat necrosis
• 4. Spiculated masses are carcinomas until proved
  by biopsy

(X ) less than 0.5 mm
(X ) not specific
(X) this is a recognisable feature
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The following pattern of calcifications are
definitely benign

• 1. Egg shell calcification
• 2. Floating calcification
• 4. Pleomorphic branching calcifications
• 4. Pop corn calcification
• 5. Tram line calcifications

(v ) Cyst
(v ) Milk Calcium Cyst
(X) Feature of invasive ductal carcinoma
(v ) Fibroma
(v ) Blood vessel
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Groups of breast microcalcifications areseen in

• 1. Fibroadenoma
• 2. Fat necrosis
• 3. Radiotherapy
• 4. Ductal carcinoma
• 5. Sclerosing adenitis

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Regarding Ductal Carcinoma

• 1. Constitutes 40 of all breast carcinoma
• 2. May be associated with lobular carcinoma
• 3. Mammographic appearance is larger than the
  clinical size
• 4. Arises from the large ducts epithelium
• 5. Usually the tumour shows well defined margin ,
  homogenous density and no acoustic shadowing

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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

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Lesions producing spiulated mass in mammography

• 1. Fat necrosis
• 2. Sclerosing adenosis
• 3. Fibroadenosis
• 4. Abscess
• 5. Hamartoma

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Common US features of typical breast Carcinoma

• 1. Sharp margin
• 2. Hypoechoic
• 3.Long axis is perpendicular to skin
• 4. Hypoechoic rim of tissue
• 5. Echogenicity same as adjacent fibroglandular
  tissue but less than fat

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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.

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High incidence of breast cancer recurrence is
seen in

• 1. Estrogen receptor positive
• 2. Comedo carcinoma
• 3. Age gt 40 years
• 4. More intraductal component
• 5. Negative margin

(X) Estrogen Receptor Negative
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(X) Age lt 40 years
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(X) Positive Margin
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Regarding Benign Breast Disease

• 1. Breast abscess is most commonly located in the
  upper outer Quadrant.
• 2. Breast abscess is most commonly due to
  streptococcus
• 3. Skin retraction is a common presentation of
  fat necrosis
• 4. Hyalinised fibroadenoma is a common feature

(X) Retroareolar
(X) Staphylococcus aureus
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(X) Rare
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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
• 3. Internal mammary lymph nodes are more often
  involved than axillary lymph nodes of the inner
  quadrant tumors.
• 4. Internal mammary lymph nodes are usually
  resected at mastectomy
• 5. Supraclavicular nodal spread confers a poor
  prognosis

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(X) Larger,more rounded and less reflective
(X) Axillary lymph nodes are more comonly
involved
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Regarding Male Breast cancer

• 1. Most cases occur in patients with Kleinfilter
• 2. Frequently bilateral
• 3. Mammographic calcifications are fewer than in
  female breast cancer.
• 4. It is more common on left side
• 5. Gynaecomastia is a predisposing factor

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(X) Larger,more rounded and more scattered
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Thank You