Quiz 3: Special investigations of the breast

Please choose the one, most correct answer to each question or statement.

1. The aim of special investigations of the breast is:
   • To use surgery to make a diagnosis
   • To use a mammogram alone to make a diagnosis
   • To use a mammogram and ultrasound scan together to make a diagnosis
   • To make a diagnosis without having to do surgery
2. What is the triple test to investigate for breast cancer?
   • Clinically examine the breast, axilla and abdomen
   • Clinical assessment, imaging and cytology
   • Mammogram, ultrasound scan and biopsy
   • Chest X-ray, mammogram and needle aspiration
3. When can an accurate diagnosis be made with the triple test?
   • When all three tests are in agreement
   • When two of the three tests are abnormal
   • When any one test is abnormal
   • An accurate diagnosis cannot be made with the triple test
4. A mammogram makes use of:
   • Ultrasound
   • X-rays
   • Large magnets
   • Radio waves
5. Population screening is aimed at:
   • Everyone in the population
   • Only a certain section of the population who may develop the problem being screened for
   • Only people in the population at high risk for that problem
   • Only for people who have early clinical signs of that problem
6. Population mammogram screening for breast cancer:
   • Is available for most women in South Africa
   • Is available for all women over the age of 50 years
   • Is available for all women in some provinces only
   • Is not available to women who cannot afford private medical care
7. Women with a strong family history of breast cancer should have regular mammograms starting:
   • From puberty
   • 25 years of age
   • At the age of 40 years or 10 years before the earliest age when a family member presented with breast cancer, whichever came first
   • At the age of 50 years or when they reach menopause, whichever comes first
8. A woman with any breast complaint should have a mammogram if she is over the age of:
   • 15 years
   • 25 years
   • 40 years
   • 70 years
9. Which important abnormality on a mammogram suggests cancer?
   • Dense breasts
   • Microcalcifications
   • Multiple small cysts
   • Fatty breasts
10. Is a mammogram painful?
    • It may be uncomfortable but should not be painful
    • It is only painful in older women who have soft breasts
    • It is not painful unless a woman is bruised
    • It is painful. That is why mammograms are not repeated every year
11. Does a mammogram commonly cause cancer?
    • Yes
    • Only if they are repeated every year
    • Only if there is a strong family history of cancer
    • No
12. What should be done if a mammogram shows a mass?
    • It is essential that an ultrasound scan is done
    • In private practice an MRI scan should be done
    • The mammogram should be repeated in 3 months to assess whether the mass has increased in size or not
    • The mass must be investigated
13. How reliable is a mammogram in detecting cancer?
    • All cancers will be detected
    • 15% of cancers will not show up on a mammogram
    • 25% of cancers will not show up on a mammogram
    • A mammogram is not reliable, especially in older women
14. An ultrasound scan is particularly useful in:
    • Younger women
    • Women with small breasts
    • Women with fatty breasts
    • Older women
15. Which method is very useful at determining whether a lump is a cyst or a solid mass?
    • Clinical examination
    • A mammogram
    • An ultrasound scan
    • An MRI scan
16. What is cytology?
    • A combination of a mammogram and ultrasound scan
    • An examination of cells obtained by fine needle biopsy
    • An examination of tissue obtained by core biopsy needle
    • A method of assessing whether cells from a cancer have hormone receptors
17. What is an advantage of cytology?
    • It does not give false positive or false negative results
    • It is accurate in diagnosing ductal carcinoma in situ
    • It is safe and cannot cause a pneumothorax
    • It is simple and the results can be obtained the same day
18. Fine needle aspiration:
    • Requires a general anaesthetic in an operating theatre
    • Requires a local anaesthetic
    • Is not commonly used as it is technically difficult
    • Is a very helpful way to investigate a breast lump
19. What is a core biopsy (Tru-cut) needle?
    • A special device to obtain a small sample of tissue
    • A needle for performing fine needle aspiration
    • A cutting needle used in an open excision
    • A special needle to mark the lump in a stereotactic biopsy
20. What are the advantages of an excision biopsy?
    • It does not require local or general anaesthesia
    • It is cheap
    • It gives a definite diagnosis
    • It does not cause a cosmetic abnormality