1.	Breast carcinoma:

A.	Is than common in women who give birth before the age of 18 years than after 30 years of age.
B.	Is more commonly found in the lower quadrant of the breast.
C.	Has a better prognosis if of a tubular, rather than ductal, type.
D.	Has a better prognosis if positive for estrogen receptors.
E.	May be associated with microcalcifications.

2.	The terminal ductal lobular unit:

A.	Contains myoepithelial cells.
B.	Contains lactiferous ducts.
C.	Secretes glycoproteins in the non-pregnant state.
D.	Is present in the male breast.
E.	Produces milk.

3.	The following changes in the breast are associated with an increased risk of developing breast cancer:

A.	Atypical epithelial hyperplasia.
B.	Apocrine metaplasia.
C.	Sclerosing adenosis.
D.	Fibrosis.
E.	Florid epithelial hyperplasia without atypia.

4.	Fat necrosis in the breast:

A.	Occurs more frequently in pre-menopausal women than in post-menopausal women.
B.	Is commoner in thin, rather than obese, women.
C.	May clinically mimic carcinoma.
D.	Is thought to be caused by trauma.
E.	May lead to calcification.
1.	Breast carcinoma:

A.	True.
B.	False. The most common site is the upper outer quadrant.
C.	True.
D.	True.
E.	True.

2.	The terminal ductal lobular unit:

A.	True.
B.	False. The lactiferous ducts are large ducts which converge upon the nipple; there are 15 – 20 of them in each breast.
C.	True. The epithelial cells in the terminal ductal lobular unit are producing glycoproteins all the time.
D.	False.
E.	True. The milk is produced by the epithelial cells lining the acini in the terminal ductal lobular unit.

3.	The following changes in the breast are associated with an increased risk of developing breast cancer:

A.	True. 5x risk of developing breast cancer.
B.	False.
C.	False. 
D.	False.
E.	True. 2x increased risk. 

4.	Fat necrosis in the breast:

A.	False. More common in post-menopausal women.
B.	False. More common in obese women.
C.	True. May present as a discrete immobile lump with ill-defined margins.
D.	True.
E.	True.

5.	Fibroadenomas:

A.	Are rare tumors of the breast.
B.	Have a peak incidence in the third decade of life.
C.	Are usually multiple.
D.	May grow rapidly during pregnancy.
E.	May be diagnosed by fine-needle aspiration cytology.

6.	Mammary duct ectasia:

A.	May cause nipple retraction.
B.	Is characterized histologically by acute inflammation without fibrosis.
C.	Is most frequent in women in the third decade of life.
D.	Has a positive association with nulliparity.
E.	May produce a blood-stained nipple discharge.

7.	Gynaecomastia:

A.	Occurs most frequently in the third decade of life.
B.	Has histological appearances which include stromal edema and epithelial proliferation.
C.	Is associated with endocrine disturbances.
D.	Has been associated with treated prostatic cancer.
E.	May occur with chlorpromazine administration.

8.	Duct papillomas:

A.	Are the commonest cause of nipple discharge.
B.	Arise from lobular epithelium.
C.	When solitary, are not premalignant.
D.	Arises most frequently in the second decade of life.
E.	Are more common than fibroadenomas.

5.	Fibroadenomas:

A.	False.
B.	True.
C.	False.
D.	True. 
E.	True.

6.	Mammary duct ectasia:

A.	True. Fibrosis around the ectatic ducts may lead to nipple retraction.
B.	False. The inflammation is chronic with marked fibrosis.
C.	False. Occurs predominantly after the age of 30 years.
D.	False. Women with duct ectasia are usually parous.
E.	True. This sign is a mimic of intraduct carcinoma. 

7.	Gynaecomastia:

A.	False. Occurs most frequently at puberty and in old age.
B.	True.
C.	True. It is associated with hyperthyroidism, pituitary disorders, and adrenal or testicular tumors.
D.	True. Stilboestrol has been used to treat prostatic carcinoma and this may produce gynaecomastia.
E.	True.

8.	Duct papillomas:

A.	True. Other causes of nipple discharge include duct ectasia and intraduct carcinoma.
B.	False. They arise from the epithelium lining large ducts, usually within 40mm of the nipple.
C.	True.
D.	False. They have a peak incidence in middle-aged women.
E.	False.

9.	Intralobular carcinoma:

A.	Usually presents as a discrete lump.
B.	Occurs predominantly in post-menopausal women.
C.	Rarely progresses to invasive carcinoma.
D.	Is characterized by distended acini without invasion.
E.	Has a comedo variant.

10.	Paget’s disease of the breast:

A.	Presents clinically with eczema or erosion of the nipple.
B.	Is associated with underlying carcinoma.
C.	Occurs in about 20% of all breast carcinomas.
D.	Is characterized by malignant cells in the epidermis with pale cytoplasm.
E.	May affect the skeletal system.

11.	Phyllodes tumors:

A.	Occur in a younger age group than fibroadenomas.
B.	Present as a discrete lump.
C.	Are distinguished from fibroadenomas by a less cellular stroma.
D.	Metastasize predominantly by the lymphatic route.
E.	Were previously known as giant fibroadenomas.

12.	Radial scars:

A.	Are detected more commonly in pre- than post- menopausal women.
B.	May be detected radiographically.
C.	Often contain invasive carcinoma.
D.	When smaller than 10mm are named complex sclerosing lesions.
E.	Contain foci of epithelial proliferation.

9.	Intralobular carcinoma:

A.	False. It rarely presents as a lump. It is often found incidentally in biopsies taken for other reasons.
B.	False. Usually found in pre-menopausal women.
C.	False. 
D.	True.
E.	False. It occurs in intraduct carcinoma.

10.	Paget’s disease of the breast:

A.	True.
B.	True. This carcinoma may be of intraduct or invasive type.
C.	False. Occurs in about 2% of breast carcinomas.
D.	True. These cells may contain intracytoplasmic mucin which can be demonstrated by special histological stains.
E.	False.

11.	Phyllodes tumors:

A.	False. Median age is 45 years.
B.	True.
C.	False. The stroma of a phyllodes tumor is more cellular than that of a fibroadenoma and may show cellular pleomorphism and increased numbers of mitotic figures.
D.	False. They metastasize predominantly by the hematogenous route.
E.	True.

12.	Radial scars:

A.	False.
B.	True.
C.	False.
D.	False.
E.	True.