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Breast Cancer & Related Breast Conditions_1: MSRA MCQs

  1. A 52-year-old woman presents with a painless hard lump in the upper outer quadrant of her left breast. Examination reveals an immobile mass with skin dimpling. What is the most likely diagnosis?

Choose the correct answer

  • A) Fibroadenoma

  • B) Breast abscess

  • C) Breast carcinoma

  • D) Mammary duct ectasia

✅ Answer: C) Breast carcinoma 


Explanation: Painless, hard, irregular immobile mass with skin dimpling is classic for breast cancer. Upper outer quadrant is the commonest site.



  1. Which of the following is NOT part of the triple assessment for a breast lump?

Choose the correct answer

  • A) Clinical examination

  • B) Mammography/Ultrasound

  • C) CA-125 blood test

  • D) Core biopsy/FNA

✅ Answer: C) CA-125 blood test


 Explanation: Triple assessment includes clinical, imaging, and histological assessment.



  1. Which of the following breast lesions is associated with microcalcifications on mammography?

Choose the correct answer

  • A) Fibroadenoma

  • B) DCIS

  • C) LCIS

  • D) Mastitis

✅ Answer: B) DCIS 


Explanation: Ductal carcinoma in situ often shows microcalcifications.



  1. A 34-year-old woman has a first-degree relative diagnosed with breast cancer at age 38. What is the appropriate action?

Choose the correct answer

  • A) Reassure, no referral needed

  • B) Refer to genetics/breast clinic

  • C) Start annual mammograms immediately

  • D) Start tamoxifen prophylaxis

✅ Answer: B) Refer to genetics/breast clinic 


Explanation: Breast cancer in a 1° relative < 40 y warrants referral.



  1. Which hormonal therapy increases the risk of endometrial cancer?

Choose the correct answer

  • A) Aromatase inhibitors

  • B) Tamoxifen

  • C) Trastuzumab

  • D) GnRH agonists

✅ Answer: B) Tamoxifen 


Explanation: Acts as estrogen agonist in uterus increasing endometrial cancer risk.



  1. A woman has green, thick nipple discharge with peri-areolar discomfort. What is the most likely diagnosis?

Choose the correct answer

  • A) Intraductal papilloma

  • B) Mammary duct ectasia

  • C) Paget’s disease

  • D) Fibrocystic disease

✅ Answer: B) Mammary duct ectasia


 Explanation: Green or foul discharge with duct dilation; no malignancy risk.



  1. Which of the following is TRUE about LCIS?

Choose the correct answer

  • A) Presents with nipple discharge

  • B) Shows microcalcifications on mammogram

  • C) Marker of increased bilateral breast cancer risk

  • D) Requires mastectomy in all cases

✅ Answer: C) Marker of increased bilateral breast cancer risk 


Explanation: LCIS is a risk marker rather than direct precursor.



  1. A patient develops unilateral painless arm swelling months after axillary node clearance. What is the most likely cause?

Choose the correct answer

  • A) DVT

  • B) Lymphoedema

  • C) Cellulitis

  • D) Hypoalbuminaemia

✅ Answer: B) Lymphoedema 


Explanation: Common post-node dissection; non-pitting swelling.



  1. Which receptor positivity indicates better prognosis and hormonal responsiveness in breast cancer?

Choose the correct answer

  • A) HER2

  • B) ER and PR

  • C) CK7

  • D) Ki-67

✅ Answer: B) ER and PR 


Explanation: ER+/PR+ cancers respond well to hormonal therapy.



  1. What is the first-line management for Paget’s disease of the nipple?

Choose the correct answer

  • A) Topical steroids

  • B) Oral antibiotics

  • C) Surgical excision of nipple-areolar complex

  • D) Chemotherapy alone

✅ Answer: C) Surgical excision of nipple-areolar complex


Explanation: Breast-conserving surgery with removal of affected area ± reconstruction.



  1. Which breast cancer treatment carries risk of cardiotoxicity?

Choose the correct answer

  • A) Tamoxifen

  • B) Anastrozole

  • C) Trastuzumab

  • D) Docetaxel

✅ Answer: C) Trastuzumab


 Explanation: HER2 targeted therapy; monitor cardiac function.



  1. Which procedure involves blue dye and radio-isotope to identify lymph node spread?

Choose the correct answer

  • A) Axillary clearance

  • B) Sentinel node biopsy

  • C) Wide local excision

  • D) Mastectomy

✅ Answer: B) Sentinel node biopsy 


Explanation: Determines need for further axillary clearance.



  1. A 56-year-old woman presents with peau d’orange appearance over breast. What is the underlying pathology?

Choose the correct answer

  • A) Venous congestion

  • B) Lymphatic obstruction

  • C) Sebaceous cysts

  • D) Epidermal hyperplasia

✅ Answer: B) Lymphatic obstruction


 Explanation: Causes dermal edema giving orange peel appearance.



  1. Which of the following statements about male breast cancer is TRUE?

Choose the correct answer

  • A) Usually ER negative

  • B) Associated with BRCA2 mutations

  • C) Common in underweight males

  • D) More common than female breast cancer

✅ Answer: B) Associated with BRCA2 mutations 


Explanation: Rare; linked to BRCA2, Klinefelter’s syndrome.



  1. Breast screening in the UK is offered to women of which age group?

Choose the correct answer

  • A) 40-60 years

  • B) 45-65 years

  • C) 50-70 years

  • D) 55-75 years

✅ Answer: C) 50-70 years


 Explanation: Every 3 years via NHS Breast Screening Programme.



  1. What is the first imaging modality for breast lumps in women under 40?

Choose the correct answer

  • A) Mammography

  • B) MRI

  • C) Ultrasound

  • D) CT scan

✅ Answer: C) Ultrasound 


Explanation: Dense breast tissue in younger women; ultrasound preferred.



  1. Which breast cancer type presents with diffuse erythema, swelling, and rapid progression?

Choose the correct answer

  • A) DCIS

  • B) LCIS

  • C) Inflammatory breast cancer

  • D) Paget’s disease

✅ Answer: C) Inflammatory breast cancer 


Explanation: Aggressive; poor prognosis.



  1. What is the main side effect of aromatase inhibitors?

Choose the correct answer

  • A) Thrombosis

  • B) Endometrial cancer

  • C) Osteoporosis

  • D) Cataracts

✅ Answer: C) Osteoporosis 


Explanation: Due to estrogen depletion in post-menopausal women.



  1. Which breast lesion often causes blood-stained nipple discharge?

Choose the correct answer

  • A) Intraductal papilloma

  • B) Duct ectasia

  • C) Fibroadenoma

  • D) LCIS

✅ Answer: A) Intraductal papilloma 


Explanation: Single duct discharge; important differential from cancer.



  1. What is the management for recurrent troublesome mammary duct ectasia?

Choose the correct answer

  • A) Continue reassurance

  • B) Tamoxifen

  • C) Microdochectomy or total duct excision

  • D) Mastectomy

✅ Answer: C) Microdochectomy or total duct excision 


Explanation: Surgery if persistent or troublesome discharge.

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