MCQ-Breast

FRCPath Part1 Course

Breast pathology MCQ 1 A breast carcinoma shows 15 % tubule formation, marked variation in nuclear size and shape with multiple nucleoli and 30 mitoses/10HPF. The final grade is: A. Grade 1 B. Grade 2 C. Grade 3 D. Grade 4 MCQ 2 In a sentinel lymph node, a single metastasis measuring 0.3mm is classified as: A. B. C. D.

Isolated tumour cells Micrometastasis Metastasis None of the above

MCQ 3 A 63 year old lady presents with nipple erythema and ulceration. A nipple biopsy reveals large round cells with large nuclei, prominent nucleoli and abundant vacuolated cytoplasm within the epidermis.

The cells are positive for CK7 and negative for S100. What is the most likely diagnosis?

A. B. C. D.

Malignant melanoma Paget’s disease Bowen’s disease Phyllodes tumour

MCQ 4 A HER2 immunohistochemistry score 2+ breast carcinoma means that: A. B. C. D. E.

The tumour should be regarded as negative for HER2 overexpression The HER2 gene is amplified The HER2 gene is not amplified The tumour should be regarded as positive for HER2 overexpression FISH testing should be performed

MCQ 5 A 47 year old lady presents with a left breast lump. Examination reveals a cyst, which partially resolves on aspiration. There is general bilateral breast nodularity. Core biopsy of the area of concern shows breast tissue with ducts lined by large cells with abundant eosinophilic cytoplasm, stromal fibrosis, cyst formation and sclerosing adenosis. Assuming the biopsy is representative, what is the correct biopsy code?

A. B2 B. B3 C. B4 www.oxbridgemedica.com

FRCPath Part1 Course D. B5a E. B5b MCQ 6 A 43 year old woman, previously treated for invasive ductal carcinoma, presents with a breast lump and blue discolouration of the overlying skin. Biopsy shows a tumour composed of irregular spaces lined by pleomorphic cells, abnormal mitoses and infiltration into the surrounding tissue. The tumour cells are negative for AE1/AE3 and positive for CD31 and CD34. What is the most likely diagnosis?

A. B. C. D. E.

Recurrent ductal carcinoma Malignant phyllodes tumour Spindle cell carcinoma Lobular carcinoma Angiosarcoma

EMQ 1 Tubular carcinoma A. DCIS B. LCIS C. Atypical hyperplasia D. Ductal carcinoma E. Phyllodes tumour F. Benign ductal hyperplasia G. Atypical ductal hyperplasia H. Lobular carcinoma I. Radial scar/Complex sclerosing lesion J. Fibroadenoma J. Intraductal papilloma Each of the following patients had a breast biopsy. For each one select the most likely condition from the list of options. Each option may be used once, more than once or not at all.

1. A 45 year old female with a firm lump in the outer quadrant of the breast. The biopsy shows a stellate lesion with 95% angulated tubules, apical snouts and stromal desmoplasia.

2. A 65 year old female with bilateral breast lesions. A biopsy of one shows single file cords of tumour cells with intracytoplasmic spaces.

3. A 43 year old female has a mammographically detected stellate lesion with dense central fibrosis.

Histology shows central fibrosis and elastosis from which ducts radiate out. The ducts are positive for p63 and SMM.

4. A 25 year old female with a circumscribed, encapsulated 2 cm breast lump showing an intracanalicular growth pattern. There is no stromal atypia.

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FRCPath Part1 Course

5. 52 year old female has bloody nipple discharge. Biopsy reveals a localised papillary proliferation of hyperplastic ductal cells on fibrovascular cores within a dilated duct.

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