Quiz 4: Benign changes of the breast

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

1. What does ANDI stand for?
   • A new diagnostic investigation
   • Abnormal deep inflammation
   • Aberrations of normal development and involution
   • Aggressive necrotizing disseminated infection
2. What does benign mean?
   • It only occurs in older people
   • It will get better without treatment
   • It cannot be detected on physical examination
   • It is not malignant
3. What is a common cause of a benign breast lump?
   • Cancer
   • A cyst
   • Fat necrosis due to trauma
   • Pregnancy
4. Who usually gets fibroadenomas?
   • Young women under the age of 35 years
   • Children before the age of puberty
   • Older women between 35 and 50 years
   • Women after menopause
5. What does a fibroadenoma feel like on examination?
   • It is soft
   • It is hard and fixed to the skin
   • It is lumpy and the edge is difficult to feel
   • It is firm, round and moves around under your fingers
6. What tends to happen to fibroadenomas if they are not removed?
   • They rapidly grow bigger
   • They grow in size from 1 to 3 cm then stay that size
   • They steadily become smaller over a few weeks
   • They rapidly multiply into many small fibroadenomas
7. Are fibroadenomas associated with an increased risk of cancer?
   • Fibroadenomas are easy to diagnose and are not associated with breast cancer
   • There is a slightly increased risk of cancer if a fibroadenoma develops in older women
   • There is a high risk of a fibroadenoma becoming malignant in younger women
   • Most fibroadenomas will become malignant over time
8. What causes breast cysts?
   • Eating raw meat containing tape worm eggs
   • Previous bruising due to trauma
   • Shrinkage of the lobes of the breast
   • Previous breastfeeding
9. Breast cysts usually present in:
   • Early adolescence
   • Young women before their first pregnancy
   • Mature women between 25 and 35 years
   • Women over the age of 40 years
10. Which breast cysts should be drained?
    • Cysts which are easily palpable on examination
    • All breast cysts especially if they are small and only found on a mammogram
    • Only cysts which are painful and present during pregnancy
    • There is no need to drain breast cysts as they are never malignant
11. What is mastalgia?
    • Very large breasts in a young woman
    • A breast infection caused by Staphylococcus
    • Breast pain and tenderness which is worse before, and much better after, a menstrual period
    • A particularly aggressive form of breast cancer
12. How should mastalgia be treated?
    • Mastectomy
    • Hormone replacement therapy
    • Apply steroid cream
    • Buy a well-fitted bra
13. What is ductal ectasia?
    • Dilatation of the ducts under the nipple as part of the normal ageing process
    • A common cause of bleeding from both nipples during breastfeeding
    • A form of early cancer which has not yet spread beyond the ducts
    • A common cause of breast pain in young women
14. Periductal mastitis can result in:
    • Cancer
    • Severe breast pain and swelling
    • Enlarged lymph nodes in the armpit
    • An inverted nipple
15. What investigation should be done if a woman has ductal ectasia or periductal mastitis?
    • Any nipple discharge should be cultured so that the correct antibiotic can be chosen
    • All women over 40 years should have a mammogram
    • The affected area should be biopsied to exclude tuberculosis
    • No investigations are needed as complications are uncommon
16. Paget’s disease:
    • Is a benign condition due to involution of the breast in older women
    • Looks like eczema of the nipple and is a sign of breast cancer
    • Is a rare form of breast lump caused by leprosy
    • Presents as a keratin pearl on the nipple and needs no treatment
17. A biopsy of the nipple or areola:
    • Is usually done with a Tru-cut needle
    • Is done under local anaesthetic with a punch biopsy tool
    • Is best done by a surgeon under general anaesthetic
    • Can be done with a fine needle aspiration
18. When should a nipple discharge be investigated?
    • If it is bloody
    • If there is a small amount of green discharge from one nipple
    • If it is milky and from both breasts during late pregnancy
    • If a little thick discharge can be squeezed out of a nipple
19. What is a common cause of a greenish nipple discharge?
    • Cancer
    • Paget’s disease of the nipple
    • Duct ectasia
    • Fibroadenomas
20. Can breast cancer present like an infection?
    • No, as breast cancer is not caused by an infection
    • Breast cancer is more likely if the woman had nipple infection during her pregnancies
    • Breast cancer is more likely if the woman has had a breast abscess before
    • Inflammatory breast cancer can mimic a breast infection