multiparametric ultrasound diagnosis of breast diseases

1 Copyright 2020 Get Your CEU

Multiparametric Ultrasound Diagnosis of Breast Diseases

Chapter 1

1. Breast pathology is diagnosed in every _____ woman under the age of 30. a. Second b. Third c. Fourth d. Fifth

2. What is the principle diagnostic method for breast cancer for women over the age of 40? a. Ultrasound b. MRI c. Mammography d. Core biopsy

3. Large scale mammography screening cam reduce the mortality rate from breast cancer by _____. a. 3-5% b. 6-11% c. 13-22% d. 15-30%

4. How many new cases of breast cancer are detected globally each year? a. 1,000,000 b. 1,200,000 c. 1,300,000 d. 1,400,000

5. In 2016, what percentage of breast cancers were detected in the late stages (III-IV)? a. 24.2% b. 26.1% c. 28.4% d. 29.6%

6. The value of early diagnosis is that an early cancer stage diagnosis is ________. a. Time sensitive b. Easily identified c. Curable d. Preventable

7. Which of the following are clinical manifestations of breast tumors? a. Asymmetry of breasts b. Asymmetry of nipples c. Deformity and dimpling of the skin d. All the above

8. Clinical examination to detect benign and malignant tumors does not exceed what percentage? a. 20-30% b. 35-40% c. 50-60% d. 70-80%


9. What year were the first x-ray images of the breast performed? a. 1911 b. 1913 c. 1914 d. 1915

10. What is the principle diagnostic method to detect breast pathology in women over 40 years old? a. Ultrasound b. MRI c. Digital mammography d. CT

11. What percentage of tumors may be missed if only a single mammogram projection is done instead of two projections?

a. 6 – 20% b. 7 – 21% c. 9 – 23% d. 11 – 25%

12. Which of the following is not a disadvantage of mammography? a. High diagnostic value b. Ionizing radiation c. Low value in dense and irregular structure of the breast d. Discomfort during the procedure

13. A tumor smaller than _____ at detection is believed to be localized without metastasis. a. 3-4 mm b. 5-7 mm c. 8-10 mm d. 11-13 mm

14. The use of digital tomosynthesis improves diagnosis of diseases that are accompanied by calcifications by what percentage?

a. 3% b. 4% c. 5% d. 6%

15. Which of the following are benefits of breast MRI? a. Operator-independent procedure b. Noninvasive c. Absence of radiation load d. All the above

16. MRI detects _____ times more tumors than mammography. a. 2.7 b. 2.8 c. 2.9 d. 3.0

17. CT has no advantage in early detection of breast cancer compared to mammography. a. True b. False


18. What diagnostic method is based on the use of radiopharmaceuticals in the breast tissue? a. Mammoscintigraphy b. MRI c. Electrical impedance tomography d. Radiothermometry

19. US-guided FNAB in combination with mammography and routine breast US improves early detection of breast cancer by up to what percentage?

a. 86-89% b. 90-93% c. 95-98% d. >99%

20. What is the risk of developing breast cancer within 10 years for a 50-64-year-old woman? a. 1:72 b. 1:36 c. 1:29 d. 1:17

21. What is the risk of breast cancer for a newborn girl in her lifetime? a. 3.3% b. 3.4% c. 3.5% d. 3.6%

22. What percentage of breast cancers are self-detected? a. 75% b. 80% c. 85% d. 90%

23. In 2014, the coverage of mammography screening in the USA was _______%. a. 50 b. 60 c. 70 d. 80

24. What country has the highest mammography screening rate? a. Finland b. Sweden c. Italy d. Spain

25. What is the false negative rate for screening mammography? a. 5-7% b. 5-10% c. 5-15% d. 5-25%

26. For patients 40-49 years old, what percentage of cases of invasive breast cancer are missed with mammography?

a. 20% b. 23% c. 25% d. 27%


27. US screening is not an efficient screening method for which of the following? a. Fibrocystic disease b. Adenosis c. Fibroadenoma d. lipoma

28. Large-scale mammography screening can reduce breast cancer mortality by what percentage? a. 5 – 10% b. 11 – 15% c. 15 – 20% d. 15 – 30%

29. Breast cancer staging consists of how many stages? a. Two b. Three c. Four d. Five

30. Breast composition is divided into how many categories? a. 2 b. 3 c. 4 d. 5

31. The sensitivity of mammography is the lowest in what category of tissue? a. Almost entirely fatty tissue b. Scattered areas of fibroglandular tissue c. Heterogeneously dense tissue d. Extremely dense tissue

Chapter 2

32. What does a BIRADS category of 0 indicate? a. Incomplete b. Negative c. Benign d. Probably benign

33. A Category 3, probably benign finding, indicates a _____ likelihood of malignancy. a. ≤ 1%g b. ≤ 1.5% c. ≤ 2.0% d. ≤ 2.5%

34. Category 5, highly suggestive of malignancy, has what percentage probability of malignancy? a. ≥ 94% b. ≥ 95% c. ≥ 96% d. ≥ 97%

35. Breast ultrasound (US) is performed with what frequency linear probes? a. 5.0 MHz b. 5 - 10 MHz c. 10.0 MHz d. 5 -12 MHz


36. Which of the following is an advantage of US in diagnosing breast pathology? a. Fast b. Cost effective c. Painless d. All the above

37. Which of the following is a disadvantage of US as a screening tool for breast cancer? a. Impossible to image the breast as a whole b. Low diagnostic value in cases of fatty involvement c. Differential diagnosis between solid and cavitary lesions d. A & B

38. The causes of mistakes in breast ultrasound are divided into objective and subjective groups. a. True b. False

39. Which of the following is not categorized as a subjective cause of mistakes in breast US? a. Anatomic b. Lack of experience of personnel c. Limit of the equipment d. A & C

Chapter 3

40. During pregnancy and lactation glandular tissue reaches what thickness? a. 5 – 10 mm b. 15 – 20 mm c. 25 – 30 mm d. 35 – 40 mm

41. The body of the beast consists of how many lobes? a. 5 – 10 b. 15 – 20 c. 25 – 30 d. 35 – 40

42. The breast consists of what type of tissue? a. Adipose b. Glandular c. Connective d. All the above

43. Septa, which is formed by connective tissue, is also called what? a. Jensen’s ligaments b. Miller’s ligaments c. Howe’s ligaments d. Cooper’s ligaments

44. Terminal duct lobular units are not the basic functional units of the breast that produce milk. a. True b. False

45. Which of the following is not an artery that supplies the breast? a. Brachial artery b. Subclavian artery c. Axillary artery d. Intercostal artery


46. More than 90% of the outflow lymph tracts from the breast are _______. a. Subclavian b. Intercostal c. Axillary d. Epigastric

47. The homogenous echogenic layer of normal skin is what thickness? a. .3 – 5 mm b. .4 – 6 mm c. .5 – 7 mm d. .6 – 8 mm

48. In postmenopausal women the glandular tissue does not exceed ______. a. 2 mm b. 3 mm c. 4 mm d. 5 mm

49. What classification of polymastia and polythelia is defined as a fully formal accessory breast with the areola and the nipple?

a. Type I b. Type II c. Type III d. Type IV

50. What is the most prevalent branching pattern of the main lactiferous duct? a. Magistral b. Scattered c. Duplicated d. Looped

51. Blood flow velocity in the internal thoracic artery is how many times higher than the lateral thoracic artery?

a. 1.3 – 1.9 times b. 1.4 – 2.0 times c. 1.5 – 2.1 times d. 1.6 – 2.2 times

52. The US pattern of the pre and menopausal breast is characterized by a smaller amount of subcutaneous fat.

a. True b. False

53. What linear probe is most appropriate to image a child’s breast? a. 3 MHz b. 5 MHz c. 7 MHz d. > 7.5 – 10 MHz

54. What is the complete absence of the breast, including the nipple-areolar complex called? a. Aplasia b. Amastia c. Athelia d. Hypoplasia


55. A benign tumor of fatty tissue with expansive growth is defined as what? a. Fibroadenoma b. Hemangioma c. Hypomastia d. Lipoma

56. Breast cysts are found in what percentage of girls? a. 6% b. 7% c. 8% d. 9%

Chapter 4

57. What is the incidence of breast disease in fertile women? a. 5 – 55% b. 10 – 65% c. 15 – 70% d. 20 – 75%

58. Ultrasound is not valuable evaluating breast trauma with hematomas. a. True b. False

59. What percentage of the time can ultrasound precisely differentiate cysts? a. 80% b. 85% c. 90% d. 100%

60. At what age do fibroadenomas often occur? a. 11 – 13 b. 14 – 15 c. 16 – 18 d. 19 – 21

61. What percentage of mastitis is lactational? a. 90% b. 92% c. 94% d. 96%

62. Which of the following is not an US feature of mastitis? a. Thickening of the skin over the area of inflammation b. Increase in echodensity of subcutaneous fat c. Indistinct margin between the deep layer of derma and adjacent structures d. Excellent differentiation of the structure of the breast parenchyma

63. What is a blood accumulation in soft tissue and/or parenchyma of the mammary gland called? a. Cyst b. Hematoma c. Fibroadenoma d. None of the above


64. Fibrocystic disease (FBD) affects what percentage of women? a. 25 – 50% b. 27 – 57% c. 30 – 63% d. 34 – 69%

65. Breast cancer develops ______ times more often on the background of benign disease. a. 1 – 2 b. 3 – 5 c. 4 – 6 d. 5 – 7

66. What is the accuracy of US in the diagnosis of FBD? a. 93.2% b. 94.1% c. 95.4% d. 96.1%

67. Which of the following are US features of nodular mastopathy? a. Various dimensions b. Irregular shape c. Indistinct borders d. All the above

68. What is the most frequent feature of FBD? a. Cystic lesions b. Lobules c. Fibrosis d. None of the above

69. The elasticity index of a breast cyst is typically within what range? a. 1.0 – 1.5 b. 2.0 – 2.5 c. 3.0 – 3.5 d. 4.0 – 4.5

70. What percentage of breast cysts don’t have a solid component? a. 80% b. 85% c. 90% d. 95%

71. What is defined as a benign, mostly solitary fibroepithelial tumor located with a lactiferous duct? a. Simple cyst b. Cystic lesion c. Nodular mastopathy d. Intraductal papilloma

72. What percentage of intracystic masses are papillary cancer? a. 15% b. 20% c. 25% d. 30%


73. What is a retention breast cyst called? a. Duct ectasia b. Focal fibrosis c. Radial scar d. Galactocele

74. Sclerosing adenosis accounts for what percentage of all benign breast changes? a. 27% b. 28% c. 29% d. 30%

75. Focal fibrosis is observed in what percentage of 40-49-year-old women? a. 50% b. 55% c. 60% d. 65%

76. Gigantomastia is characterized when the weight of the breasts are _____ higher than the overall body weight.

a. 2% b. 3% c. 4% d. 5%

Chapter 5

77. Fibroadenoma (FA) constitutes up to what percentage of all benign breast masses? a. 87% b. 90% c. 95% d. 97%

78. What is a benign tumor originating from adipose tissue called? a. Juvenile fibroadenoma b. Lipoma c. Phyllode tumor d. Intraductal tumor

79. Usually a FA does not exceed ______cm. a. 2 b. 3 c. 4 d. 5

80. Fibroadenomas usually demonstrates which of the following US features? a. Solid breast lesion of decreased or usual echodensity b. Always accurate contours c. Smooth or lobulated borders d. All the above

81. A malignant phyllodes tumor occurs what percent of the time? a. 5 – 30% b. 10 – 35% c. 15 – 40% d. 20 – 45%


82. Juvenile fibroadenomas are more often ______ than the typical adult fibroadenomas. a. Cystic b. Unilateral c. Bilateral d. Slow growing

83. Lipomas account for what percent of all breast tumors? a. 5% b. 7% c. 9% d. 11%

84. Intraductal papilloma is not associated with abnormal discharge from the nipple. a. True b. False

85. Atheroma accounts for only _____ of all breast lesions. a. 0.2% b. 0.3% c. 0.4% d. 0.5%

Chapter 6

86. What is the accuracy rate of contrast-enhanced ultrasound in the detection of breast cancer? a. 85% b. 86% c. 89% d. 91%

87. According to Sencha, the irregular shape characteristic on US accounts for what percentage of breast cancers?

a. 95.8% b. 96.8% c. 97.8% d. 98.8%

88. Which of the following is the best US imaging modality to diagnose breast disease? a. 2D b. B-mode c. Doppler d. A & B

89. Grayscale imaging supplies basic information on the character of pathological process, which decreases the number of unspecified diagnoses.

a. True b. False

90. Nodular type breast cancer is up to ____ of breast cancers. a. 80% b. 85% c. 90% d. 95%


91. What percentage of breast cancers originate from the upper-outer quadrant of the breast? a. 40% b. 50% c. 60% d. 70%

92. By US 69% of breast cancers are what size when they are detected? a. < 0.5 cm b. 0.5 – 1.0 cm c. 1.1 – 3.0 cm d. > 3.0 cm

93. What is the most common type of infiltrative breast cancer? a. Edematous b. Inflammatory c. Mastitis-like d. Erysipeloid

94. Which of the following is not a characteristic of infiltrative breast carcinoma? a. Thinning of the skin b. Loss of structural definition c. Dilation of the lactiferous ducts d. Enlargement of regional lymph nodes

95. Paget’s cancer accounts for what percentage of breast neoplasms? a. 0.2 – 3% b. 0.3 – 4% c. 0.5 – 5% d. 0.6 – 6%

96. What percentage of 2 cm tumors exhibit vascularity? a. 35.2% b. 37.4% c. 38.1% d. 39.6%

97. Vessels within malignant breast lesions often have which of the following characteristics? a. Irregular caliber b. Looped c. Spiral d. All the above

98. What type of imaging allows the ability to obtain angle-independent images of smaller vessels with more accurate contours?

a. Power-doppler imaging b. Pulsed- wave doppler c. Color doppler mapping d. B-mode

99. 3D images are not an advantage over other imaging methods. a. True b. False


100. What type of scan enables reconstruction of images that include several adjacent fields of view? a. Doppler scan b. B-mode scan c. Panoramic scan d. Duplex scan

101. The multi-slicing techniques transforms a 3D US image using _____ consecutive sections. a. 0.3 – 3mm b. 0.4 – 4mm c. 0.5 – 5mm d. 0.6 – 6mm

102. What is the most common elastography in daily practice? a. Compression b. Quasistatic c. Dynamic d. Transient

103. Which of the following is not required to obtain reliable US elastography? a. Probe positioned perpendicularly to the skin b. Compression time of 10 – 15 seconds c. Periodic compressions d. Scanned area should contain normal breast tissue

104. To obtain electrograms with minimal distortion the location examined should not be deeper than what?

a. 1 – 2 cm b. 3 - 4 cm c. 5 – 6 cm d. 7 – 8 cm

105. Contrast-enhance echography of breast tumors has been used since what year? a. 1969 b. 1976 c. 1983 d. 1990

106. With the use of contrast agents, the number of detected vessels visualized increases from 36% to _____.

a. 94% b. 95% c. 96% d. 97%

107. An advanced technology of contrast echography with 40% glucose has been introduced to improve the visualization of vessels and differentiation of tumors.

a. True b. False

108. What is the TNM for a tumor more than 5 cm? a. T b. TX c. TO d. T3


109. In the tumor, nodular, metastasis (TNM) system TX is what classification? a. Primary tumor cannot be assessed b. No evidence of primary tumor c. Carcinoma in situ d. Tumor 2 cm or less

110. What is the regional lymph node classification of metastasis in movable ipsilateral axillary lymph nodes?

a. NX b. N0 c. N1 d. N2

111. On the metastasis scale what does MO mean? a. Distant metastasis b. Distant metastasis cannot be assessed c. No distant metastasis d. Possible distant metastasis

112. What is a breast cancer classification of C50.3 in the international classification of diseases? a. Nipple and areola b. Central position of the breast c. Upper-inner quadrant d. Lower-inner quadrant

113. When was the BI-RADS (breast imaging-reporting and data system) developed? a. 1960s b. 1970s c. 1980s d. 1990s

114. The majority of which of the following modalities are classified using BI-RADS terminology? a. Mammography b. Ultrasound c. MRI d. A & B

115. What does a BI-RAD6 classification mean? a. Benign b. Suspicious c. Negative d. Proven malignancy

116. Lobular cancer in situ is most prevalent between what ages? a. 45 – 50 years b. 55 – 60 years c. 65 – 70 years d. 75 – 80 years

117. Invasive ductal cancer accounts for what percentage of all breast cancers? a. 55% b. 59% c. 62% d. 65%


118. Which of the following is not an US feature of invasive lobular cancer? a. Focal lesion b. Regular shape c. Hypoechoic pattern d. lumpy

119. Invasive lobular accounts for what percentage of all invasive breast carcinomas? a. 3 – 9% b. 4 – 10% c. 5 – 15% d. 10 – 25%

120. Which cancer is rare and with a relatively good prognosis? a. Sarcoma b. Mucinous c. Invasive lobular d. Ductal

121. Which of the following is a rare cancer belonging to the infiltrative ductal cancer group? a. Medullary breast carcinoma b. Tubular breast carcinoma c. Mucinous cancer d. Breast sarcoma

122. Papillary cancer is a rare cancer affecting mostly _____ women. a. Young b. Middle age c. Elderly d. None of the above

123. Intraductal breast cancer accounts for ____ of all cancers of the breast. a. 2% b. 3% c. 4% d. 5%

Chapter 7

124. How thick does glandular tissue get in the second trimester of pregnancy? a. 10 – 15 mm b. 15 – 20 mm c. 20 – 25 mm d. 25 – 30 mm

125. In what percent of pregnant women are US findings used to diagnose and stage breast cancer? a. 80% b. 85% c. 90% d. 95%

126. MRI with contrast is usually recommended during pregnancy. a. True b. False


127. What is the radiation dose to the fetus for a pregnant woman undergoing a radioisotope scan? a. 0.00194 Gy b. 0.00198 Gy c. 0.00200 Gy d. 0.00205 Gy

128. What is the first-line tests for palpable breast masses in pregnant or breast-feeding women? a. Mammography b. Core needle biopsy c. Breast ultrasound d. Breast MRI

129. Which of the following is a benign pathology associated with pregnancy and lactation? a. Gestational and secretory hyperplasia b. Galactocele c. Gigantomastia d. All the above

130. Which of the following is the most common cancer during pregnancy? a. Cervical cancer b. lymphoma c. lung cancer d. A & B

131. At what age are women the most vulnerable to pregnancy associated (PA) breast cancer? a. 27 – 31 years of age b. 32 – 38 years of age c. 39 – 42 years of age d. 42 – 45 years of age

132. What is the ten-year survival for patients with gestational breast cancer? a. 40% b. 45% c. 50% d. 55%

133. A six-month delay of diagnosing breast cancer during pregnancy increases the risk of metastasis by what percentage?

a. 2.3% b. 4.2% c. 5.1% d. 5.7%

134. Which of the following is not a typical sign of breast cancer associated with pregnancy? a. A mass in the parenchyma b. Decreased echogenicity c. The strain ratio < 2.7 d. Often metastasis to regional lymph nodes

135. There is a ______ risk of fetal malformation due to chemotherapy in the first trimester. a. 5 – 7% b. 8 – 12% c. 9 – 14% d. 10 – 20%


136. Lactating adenoma is the most common breast mass in pregnancy. a. True b. False

137. What is the incidence rate for lactating mastitis? a. 2.3 – 20% b. 4.1 – 27% c. 6.6 – 33% d. 7.2 – 40%

138. The most common cause of mastitis and abscesses are staphylococcus aureus and streptococcus. a. True b. False

139. What percentage of mastitis associated with lactation is complicated by a breast abscess? a. 3.6 – 8% b. 4.8 – 11% c. 5.8 – 13% d. 6.2 – 17%

140. What is the most common benign lesion of the breast in lactating women? a. Idiopathic granulomatous mastitis b. Lactating adenoma c. Lactation calcification d. Galactocele

141. What is the minimal time between breast cancer treatment and pregnancy? a. 1 – 1.5 years b. 2 – 3 years c. 3.5 – 4 years d. > 4 years

Chapter 8

142. What percentage of the time are breast diseases combined with pathology in other organs? a. 70% b. 75% c. 77% d. 79%

143. What is the incidence of a primary diagnosis of breast cancer and endometrial cancer? a. 16.7% b. 18.3% c. 26.7% d. 38.3%

144. Cancer of multiple locations (three or more organs) is observed in what percentage of patients? a. 7.2% b. 7.4% c. 7.6% d. 7.8%

145. In the BRCA syndrome, what is the predominant cancer? a. Ductal carcinoma in situ b. Metastatic breast cancer c. Medullary breast cancer d. Inflammatory breast cancer


146. What percent of cases occur with both breast cancer and cervical cancer? a. 9.9% b. 10.2% c. 10.5% d. 11.2%

147. Breast diseases are diagnosed in ____ of patients with gynecological conditions. a. 20 – 30% b. 40 – 50% c. 50 – 80% d. 85 – 95%

148. What percentage of fibroadenomas have both progesterone and estrogen receptors? a. 10% b. 15% c. 20% d. 25%

149. The increased breast cancer risk from oral contraceptives are no longer evident _____ years after discontinuation?

a. 3 years b. 5 years c. 7 years d. 10 years

150. Breast cancer occurs 65.7% of the time with what other cancer? a. Esophageal b. Colorectal c. Lung d. Stomach

151. Patients with breast cancer should also have which of the following organs examined? a. The second breast b. Uterus c. Lung d. A & B

Chapter 9

152. Gynecomastia accounts for what percentage of all pathologic processes developing in the male breast? a. 73% b. 74% c. 75% d. 76%

153. Due to lack of awareness, what percentage of men are initially treated in the nonoperable stage of the disease?

a. 5 – 10% b. 15 – 20% c. 30 – 40% d. > 50%


154. Because of late diagnosis, what percentage of patients have regional or remote metastasis? a. 50% b. 60% c. 70% d. 80%

155. Breast cancer in _____ of male patients is not diagnosed at all. a. 5% b. 10% c. 15% d. 20%

156. In men with estrogen and progesterone receptors which of the following is true? a. Estrogen receptors are present in 65-100% of malignant tumors b. Clinically significant levels are observed in 85% of cases c. The rate of receptor-positive tumors does not increase with age d. All the above

157. Which of the following is not an indication for mammography in men? a. Age > 50 years b. Suspicion or clinical features of breast cancer c. Other chronic breast diseases, especially nodular d. All the above

158. What is the most valuable method to verify breast cancer in men? a. Cytology b. Histology c. Mammography d. A & B

159. What percentage of male patients were correctly diagnosed with breast cancer during their first physician visit?

a. 5 – 30% b. 10 – 40% c. 15 – 48% d. 20 – 52%

160. Breast tissue at birth is identical in boys and girls. a. True b. False

161. What is absent in the male breast and therefore not detected on US? a. Interior leaf of the facia b. Lactiferous ducts c. Cooper’s ligament and glandular tissue d. Nipple and areola

162. Before puberty in boys, the breast does not consist of which of the following? a. Adipose tissue b. Fibrous stomal component c. Glandular tissue d. A & B,

163. Gynecomastia is not a common abnormality in men. a. True b. False


164. Patients with gynecomastia have a _____ higher rate of cancer than the general population. a. < 2 times b. 2 – 4 times c. 3 – 5 times d. 4 – 6 times

165. What percentage of newborns have gynecomastia that resolves within weeks? a. 30 – 60% b. 40 – 70% c. 50 – 80% d. 60 – 90%

166. Which classification of gynecomastia is drug induced? a. Persistent gynecomastia b. Senile gynecomastia c. Iatrogenic gynecomastia d. None of the above

167. Which of the following is not a type of gynecomastia? a. Nodular b. Treelike c. Diffuse glandular d. Depressed

168. Of all men, 53.7% have what type of gynecomastia? a. Depressed b. Nodular c. Diffuse d. Treelike

169. Which of the following accounts for 4.6% of all benign breast lesions? a. Lipoma b. Fibroadenoma c. Abscess d. A & B

170. True breast cysts in men are rare. a. True b. False

171. Which of the following is not an US feature of mastitis in men? a. Thickening of skin over the area of inflammation b. Decrease in echogenicity of subcutaneous fat c. Hardening of connective tissue d. One or several cystic cavities

Chapter 10

172. What are regional barriers that prevent the spread of both infection and cancer cells? a. Lymph nodes b. White blood cells c. Red blood cells d. Membranes


173. What is the incidence of breast cancer metastasis in regional lymph nodes for both men and women? a. 5 – 60% b. 9 - 70% c. 15 – 75% d. 19 – 80%

174. What lymph node zone consists of a large number of lymph nodules which produce immune cells? a. Paracortex b. Hilum c. Cortical d. Medulla

175. Axillary lymph nodes located between the medial and lateral edges of the pectorales minor muscle and interpectoral lymph nodes are classified into what level?

a. Level I b. Level 2 c. Level 3 d. Level 4

176. Which of the following is not a feature of a normal axillary lymph node? a. Length > 10 mm b. Oval c. Mixed echogenicity d. Even borders

177. What percentage of stage T3 breast cancer metastasizes to axillary lymph nodes? a. 2% b. 9% c. 11% d. 15%

178. Which of the following is defined as the first sentinel lymph nodes? a. First lymph node from the breast b. First and second lymph nodes from the breast c. First three lymph nodes from the breast d. First four lymph nodes from the breast

Chapter 11

179. What percentage of newly diagnosed breast cancers are treated with breast-sparring surgery? a. 40 – 60% b. 50 – 70% c. 60 – 80% d. 70 – 90%

180. A few decades ago, the average life expectancy for a patient diagnosed with disseminated breast cancer was ____.

a. 8 – 10 months b. 12 – 15 months c. 18 – 24 months d. 25 – 36 months


181. What is the current average life expectancy for patients with disseminated breast cancer? a. 42 months b. 51 months c. 62 months d. 70 months

182. What percent of breast cancers are detected at stage IV? a. 7% b. 8% c. 9% d. 10%

183. Which of the following is known as the classic radical mastectomy? a. Patey – Dyson mastectomy b. Halsted – Meyer mastectomy c. Jensen – Howe mastectomy d. Miller – Puckett mastectomy

184. What percent of women are treated today with breast sparing surgery? a. 40 – 60% b. 50 – 70% c. 60 – 80% d. 70 – 90%

185. Diffuse suspicious microcalcifications on mammography is not an absolute contraindication for skin-sparing mastectomy.

a. True b. False

186. In breast sparing surgery at least a margin of _____ is needed to be considered negative. a. 2 mm b. 3 mm c. 4 mm d. 5 mm

187. What is the most common postsurgical complication for breast reconstruction? a. Bleeding b. Lymphorrhea c. Infection d. All the above

188. A Hematoma is often difficult to differentiate with a seroma. a. True b. False

189. What is the most common technology in breast reconstruction? a. Use of implants b. Use of patients’ own tissue c. Combined use of implants and patients’ tissue d. None of the above

190. Breast endoprosthesis is the safest type of augmentation, but still causes complications in ____ of cases.

a. 27.6% b. 28.6% c. 29.2% d. 29.8%


191. What is defined as a focus of chronic aseptic lymphocytic inflammation? a. Fibrous capsular contraction b. Lipogranulomas c. Hematoma d. Geleoma

192. What is the most beneficial method for diagnosing endoprosthesis ruptures? a. US b. MRI c. Mammography d. CT

Chapter 12

193. Of the invasive image guided procedures, what is the least invasive and most highly feasible method? a. Core needle biopsy b. Fine needle aspiration biopsy with cytology c. Vacuum biopsy d. Ductography

194. Which of the following is an indication for a core needle biopsy? a. Suspected malignancy of unknown origin b. Impalpable breast tumors c. Calcifications d. All the above

195. For masses over 1 cm in size core needle biopsy is informative in what percentage of cases? a. 70% b. 80% c. 90% d. 100%

196. Fine needle aspiration biopsy (FNAB) using US produces enough material to analyze in what percent of cases?

a. 50 – 60% b. 60 – 70% c. 85% d. 90%

197. What is the most performed FNAB technique? a. Use of special adapters b. Special puncture probes c. US assisted GPS navigation d. “Free hand”

198. In ductography procedures up to _____ mL of contrast solutions is used. a. 4 b. 6 c. 8 d. 10

199. After ductography contrast is not removed. a. True b. False


200. What is an endoscopic study of the lactiferous ducts called? a. FNAB b. Ductoscopy c. Pneumocytography d. Minimally invasive modality

201. In sentinel node lymph node biopsy, what are the most important nodes? a. First 1 – 3 nodes b. 4th and 5th nodes c. 6th and 7th nodes d. 8th and 9th nodes

202. What is the survival rate of patients with 0–1 affected lymph nodes? a. 97.1% b. 98.2% c. 99.1% d. 99.7%

multiparametric ultrasound diagnosis of breast diseases

Documents