ARDMS Breast Specialty Examination Practice Questions
Review
SECTION 1: BREAST ANATOMY AND PHYSIOLOGY
Question 1
What are the six anatomic layers of the breast from anterior to posterior?
A) Skin, Subcutaneous fat, Mammary layer, Retromammary space, Muscle layers, Chest wall
B) Skin, Premammary layer, Retromammary space, Muscle, Chest wall
C) Subcutaneous fat, Glandular tissue, Pectoralis major, Pectoralis minor, Ribs
D) Mammary layer, Retromammary space, Pectoralis major, Skin, Fat
Answer: A
Rationale: From anterior to posterior, the six layers are: Skin, Subcutaneous (Premammary)
Layer, Mammary Layer, Retromammary Space, Muscle Layers (Pectoralis major and minor), and
Chest Wall (Ribs and Intercostal muscles). Understanding this layered anatomy is essential for
identifying the location of lesions and understanding the spread of disease.
Question 2
What is the smallest functional unit of the breast?
A) Lobule
B) Acini
C) Lactiferous duct
D) TDLU
Answer: B
Rationale: The acini is the smallest functional unit of the breast. There are hundreds of acini in
each breast, and each acinus gives rise to a ductule or terminal duct. Acini are considered the
milk-producing glands of the breast.
Question 3
What is a TDLU and what is its clinical significance?
A) Terminal Duct Lobular Unit; nearly all breast pathology originates here
B) Terminal Duct Lobular Unit; it is the milk-producing structure
C) Total Ductal Lobular Unit; it stores milk
D) Terminal Duct Lactiferous Unit; it connects to the nipple
,Answer: A
Rationale: A TDLU (Terminal Duct Lobular Unit) is made up of a lobule (approximately 30 acini)
and its associated terminal ducts. Its clinical significance is that nearly all breast pathology
originates here. This makes the TDLU the most important functional and pathological unit in the
breast.
Question 4
Describe the anatomic location of the superficial fascia within the breast.
A) At the breast, the superficial fascia divides into the superficial and deep layers, which provide
an envelope containing all the breast tissues
B) The superficial fascia is located only in the retromammary space
C) The superficial fascia is a single layer without division
D) The superficial fascia is located anterior to the skin
Answer: A
Rationale: At the breast, the superficial fascia divides into the superficial and deep layers, which
provide an envelope containing all the breast tissues. The superficial layer is located in the
premammary layer, and the deep layer is located in the retromammary space.
Question 5
Which layer of the breast is also known as the parenchymal or glandular layer?
A) Skin
B) Subcutaneous layer
C) Mammary layer
D) Retromammary space
Answer: C
Rationale: The mammary layer is also known as the parenchymal or glandular layer. It is
composed of stroma (supportive tissue) and epithelium (functional tissue). This layer contains
the milk-producing structures of the breast.
Question 6
What are the two main arterial supplies of the breast?
A) Lateral thoracic artery and Internal mammary artery
B) Thoracoacromial artery and Intercostal artery
C) Subclavian artery and Axillary artery
D) Brachial artery and Radial artery
Answer: A
Rationale: The two main arterial supplies of the breast are the lateral thoracic artery and the
internal mammary artery (internal thoracic artery). The secondary arterial supplies include the
,thoracoacromial artery and the intercostal artery. Understanding the vascular supply is crucial
for interpreting Doppler findings and understanding the spread of disease.
Question 7
What is the axillary tail of Spence?
A) The portion of glandular tissue that extends from the upper outer quadrant of each breast
into the axillary region
B) The lymphatic drainage pathway from the breast to the axilla
C) The muscle attachment of the pectoralis major
D) The extension of the nipple into the axilla
Answer: A
Rationale: The axillary tail of Spence is the portion of glandular tissue that extends from the
upper outer quadrant of each breast into the axillary region. This is an important anatomic
consideration because breast tissue can extend into the axilla, and pathology can occur in this
region.
Question 8
Which of the following is the most common developmental anomaly of the breast?
A) Athelia
B) Polythelia
C) Amazia
D) Macromastia
Answer: B
Rationale: Polythelia (accessory nipple) is the most common developmental anomaly of the
breast. Athelia is the absence of the nipple, and amazia is the absence of breast tissue with
development of the nipple. Understanding these anomalies helps in recognizing variations in
breast anatomy.
Question 9
What is the function of epithelial tissue in the breast?
A) It is the supportive tissue of the breast
B) It is the functional tissue of the breast
C) It forms the skin of the breast
D) It provides blood supply to the breast
Answer: B
Rationale: Epithelium is the functional tissue of the breast. The epithelial tissue contains the
milk-producing acini and the ductal system. Stroma is the supportive tissue of the breast.
, Question 10
Approximately how many lobes make up each breast?
A) 5-10
B) 15-20
C) 25-30
D) 35-40
Answer: B
Rationale: Several lobules make up a lobe, and approximately 15 to 20 lobes make up each
breast. One lactiferous duct arises from each lobe and travels toward the nipple.
Question 11
What is the lactiferous sinus?
A) The milk-producing gland of the breast
B) A dilated portion of the lactiferous duct just before the nipple
C) The smallest functional unit of the breast
D) The lymphatic drainage pathway
Answer: B
Rationale: The lactiferous sinus is a dilated portion of the lactiferous duct just before the nipple.
It serves as a reservoir for milk during lactation. Understanding this anatomy is important for
recognizing ductal abnormalities and evaluating nipple discharge.
Question 12
Which of the following structures connects the breast tissue to the skin and provides structural
support?
A) Acini
B) Lactiferous ducts
C) Cooper's ligaments
D) Terminal ducts
Answer: C
Rationale: Cooper's ligaments (suspensory ligaments) are fibrous connective tissue bands that
connect the breast tissue to the skin and provide structural support. They help maintain the
shape of the breast and can be involved in the architectural distortion seen in some breast
pathologies.
Question 13
The breast tissue is completely contained between the layers of which structure?
A) Superficial fascia
B) Deep fascia
Review
SECTION 1: BREAST ANATOMY AND PHYSIOLOGY
Question 1
What are the six anatomic layers of the breast from anterior to posterior?
A) Skin, Subcutaneous fat, Mammary layer, Retromammary space, Muscle layers, Chest wall
B) Skin, Premammary layer, Retromammary space, Muscle, Chest wall
C) Subcutaneous fat, Glandular tissue, Pectoralis major, Pectoralis minor, Ribs
D) Mammary layer, Retromammary space, Pectoralis major, Skin, Fat
Answer: A
Rationale: From anterior to posterior, the six layers are: Skin, Subcutaneous (Premammary)
Layer, Mammary Layer, Retromammary Space, Muscle Layers (Pectoralis major and minor), and
Chest Wall (Ribs and Intercostal muscles). Understanding this layered anatomy is essential for
identifying the location of lesions and understanding the spread of disease.
Question 2
What is the smallest functional unit of the breast?
A) Lobule
B) Acini
C) Lactiferous duct
D) TDLU
Answer: B
Rationale: The acini is the smallest functional unit of the breast. There are hundreds of acini in
each breast, and each acinus gives rise to a ductule or terminal duct. Acini are considered the
milk-producing glands of the breast.
Question 3
What is a TDLU and what is its clinical significance?
A) Terminal Duct Lobular Unit; nearly all breast pathology originates here
B) Terminal Duct Lobular Unit; it is the milk-producing structure
C) Total Ductal Lobular Unit; it stores milk
D) Terminal Duct Lactiferous Unit; it connects to the nipple
,Answer: A
Rationale: A TDLU (Terminal Duct Lobular Unit) is made up of a lobule (approximately 30 acini)
and its associated terminal ducts. Its clinical significance is that nearly all breast pathology
originates here. This makes the TDLU the most important functional and pathological unit in the
breast.
Question 4
Describe the anatomic location of the superficial fascia within the breast.
A) At the breast, the superficial fascia divides into the superficial and deep layers, which provide
an envelope containing all the breast tissues
B) The superficial fascia is located only in the retromammary space
C) The superficial fascia is a single layer without division
D) The superficial fascia is located anterior to the skin
Answer: A
Rationale: At the breast, the superficial fascia divides into the superficial and deep layers, which
provide an envelope containing all the breast tissues. The superficial layer is located in the
premammary layer, and the deep layer is located in the retromammary space.
Question 5
Which layer of the breast is also known as the parenchymal or glandular layer?
A) Skin
B) Subcutaneous layer
C) Mammary layer
D) Retromammary space
Answer: C
Rationale: The mammary layer is also known as the parenchymal or glandular layer. It is
composed of stroma (supportive tissue) and epithelium (functional tissue). This layer contains
the milk-producing structures of the breast.
Question 6
What are the two main arterial supplies of the breast?
A) Lateral thoracic artery and Internal mammary artery
B) Thoracoacromial artery and Intercostal artery
C) Subclavian artery and Axillary artery
D) Brachial artery and Radial artery
Answer: A
Rationale: The two main arterial supplies of the breast are the lateral thoracic artery and the
internal mammary artery (internal thoracic artery). The secondary arterial supplies include the
,thoracoacromial artery and the intercostal artery. Understanding the vascular supply is crucial
for interpreting Doppler findings and understanding the spread of disease.
Question 7
What is the axillary tail of Spence?
A) The portion of glandular tissue that extends from the upper outer quadrant of each breast
into the axillary region
B) The lymphatic drainage pathway from the breast to the axilla
C) The muscle attachment of the pectoralis major
D) The extension of the nipple into the axilla
Answer: A
Rationale: The axillary tail of Spence is the portion of glandular tissue that extends from the
upper outer quadrant of each breast into the axillary region. This is an important anatomic
consideration because breast tissue can extend into the axilla, and pathology can occur in this
region.
Question 8
Which of the following is the most common developmental anomaly of the breast?
A) Athelia
B) Polythelia
C) Amazia
D) Macromastia
Answer: B
Rationale: Polythelia (accessory nipple) is the most common developmental anomaly of the
breast. Athelia is the absence of the nipple, and amazia is the absence of breast tissue with
development of the nipple. Understanding these anomalies helps in recognizing variations in
breast anatomy.
Question 9
What is the function of epithelial tissue in the breast?
A) It is the supportive tissue of the breast
B) It is the functional tissue of the breast
C) It forms the skin of the breast
D) It provides blood supply to the breast
Answer: B
Rationale: Epithelium is the functional tissue of the breast. The epithelial tissue contains the
milk-producing acini and the ductal system. Stroma is the supportive tissue of the breast.
, Question 10
Approximately how many lobes make up each breast?
A) 5-10
B) 15-20
C) 25-30
D) 35-40
Answer: B
Rationale: Several lobules make up a lobe, and approximately 15 to 20 lobes make up each
breast. One lactiferous duct arises from each lobe and travels toward the nipple.
Question 11
What is the lactiferous sinus?
A) The milk-producing gland of the breast
B) A dilated portion of the lactiferous duct just before the nipple
C) The smallest functional unit of the breast
D) The lymphatic drainage pathway
Answer: B
Rationale: The lactiferous sinus is a dilated portion of the lactiferous duct just before the nipple.
It serves as a reservoir for milk during lactation. Understanding this anatomy is important for
recognizing ductal abnormalities and evaluating nipple discharge.
Question 12
Which of the following structures connects the breast tissue to the skin and provides structural
support?
A) Acini
B) Lactiferous ducts
C) Cooper's ligaments
D) Terminal ducts
Answer: C
Rationale: Cooper's ligaments (suspensory ligaments) are fibrous connective tissue bands that
connect the breast tissue to the skin and provide structural support. They help maintain the
shape of the breast and can be involved in the architectural distortion seen in some breast
pathologies.
Question 13
The breast tissue is completely contained between the layers of which structure?
A) Superficial fascia
B) Deep fascia
