ABSITE – Breast UPDATED Exam
Questions and CORRECT Answers
Which of the following is correct in relation to BRCA1/2 mutations and breast cancer? -
CORRECT ANSWER - The lifetime risk (by age 70) of developing breast cancer for
BRCA1 mutation carriers can be as high as 80%.
(Correct. BRCA mutations carry a 50% to 80% lifetime risk of female breast cancer, a 6%
lifetime risk of male breast cancer (BRCA2), and a 15% to 25% lifetime risk of ovarian cancer.
BRCA1 mutation carriers are more likely to present with breast cancer at a lower age than
BRCA2 mutation carriers (peak incidence at 45-49 years and 65-69 years, respectively). It is
important to understand these statistics when considering either genetic testing or prevention
strategies in a known BRCA mutation carrier.)
Which of the following treatments has been shown to provide relief of symptoms in more than
50% of patients with cyclical breast pain? - CORRECT ANSWER - Evening primrose oil
The most common histologic type of invasive breast cancer is which of the following? -
CORRECT ANSWER - Ductal adenocarcinoma.
Hormone regulation of mammary epithelial development includes: - CORRECT
ANSWER - Initiation of ductal development by estrogen.
Which benign breast disease is associated with an increased risk of malignancy? - CORRECT
ANSWER - Atypical ductal hyperplasia
Which of the following statements regarding steroid hormones and breast cancer is correct?
- The kidney is the principle site of steroid metabolism.
- The rate-limiting step of steroid hormone biosynthesis involves the conversion of pregnenolone
to progesterone.
- In postmenopausal women, androgens are produced in the adrenal gland, and adipose tissue is
the principal site for aromatization.
, - Circulating steroid hormones are primarily lipid-bound and are thus considered "bioavailable."
- CORRECT ANSWER - In postmenopausal women, androgens are produced in the
adrenal gland, and adipose tissue is the principal site for aromatization.
(In postmenopausal women, androgens are produced in the adrenal gland, and adipose tissue is
the principal site for aromatization. Normal adipose tissue uses promoter I.4 of the CYP19 gene
to stimulate aromatase production; however, breast tumors and their surrounding adipose tissue
activate promotor II of the CYP19 gene, and the result is a greater expression of aromatase. AIs
can reduce estrogen production by more than 90% and are classified according to the specificity,
potency, and reversibility with which they inhibit the aromatase enzyme.)
Which of the following histologic breast changes is most associated with an increased risk of
breast cancer?
- Epithelial hyperplasia with atypia.
- Macro- and microcysts.
- Apocrine metaplasia.
- Fibroadenoma.
- Duct ectasia. - CORRECT ANSWER - Epithelial hyperplasia with atypia.
Paget disease of the breast - CORRECT ANSWER - Paget disease is nearly always
detectable on clinical examination as a crusting erosion of the nipple. It may be less subtle
presenting with thickening redness or roughness of the nipple, often associated with itching and
burning. It is often associated with subareolar intraductal cancer. Survival is dependent upon the
stage of the accompanying breast cancer.
A 42-year-old, otherwise healthy woman has a new, 1-cm in diameter density deep in the central
retroareolar region of her right breast on mammography. She has no palpable abnormality on
physical examination. No lesion is detected on ultrasonography. The best diagnostic option is -
CORRECT ANSWER - stereotactic core needle biopsy of the breast
A 32-year old male presents to clinic due to enlarging left breast. He states that he has noticed
this "swelling" for the past year but has only sought medical care now because it has becoming
noticeably larger than his right breast. He denies pain or nipple discharge. He denies family
history of breast cancer in either women or men in his immediate or distant family and steroid
use. On examination, the patient is very muscular with a smooth right breast, devoid of masses.
His left breast is noted to have rubbery mass extending concentrically from the nipple. His
Questions and CORRECT Answers
Which of the following is correct in relation to BRCA1/2 mutations and breast cancer? -
CORRECT ANSWER - The lifetime risk (by age 70) of developing breast cancer for
BRCA1 mutation carriers can be as high as 80%.
(Correct. BRCA mutations carry a 50% to 80% lifetime risk of female breast cancer, a 6%
lifetime risk of male breast cancer (BRCA2), and a 15% to 25% lifetime risk of ovarian cancer.
BRCA1 mutation carriers are more likely to present with breast cancer at a lower age than
BRCA2 mutation carriers (peak incidence at 45-49 years and 65-69 years, respectively). It is
important to understand these statistics when considering either genetic testing or prevention
strategies in a known BRCA mutation carrier.)
Which of the following treatments has been shown to provide relief of symptoms in more than
50% of patients with cyclical breast pain? - CORRECT ANSWER - Evening primrose oil
The most common histologic type of invasive breast cancer is which of the following? -
CORRECT ANSWER - Ductal adenocarcinoma.
Hormone regulation of mammary epithelial development includes: - CORRECT
ANSWER - Initiation of ductal development by estrogen.
Which benign breast disease is associated with an increased risk of malignancy? - CORRECT
ANSWER - Atypical ductal hyperplasia
Which of the following statements regarding steroid hormones and breast cancer is correct?
- The kidney is the principle site of steroid metabolism.
- The rate-limiting step of steroid hormone biosynthesis involves the conversion of pregnenolone
to progesterone.
- In postmenopausal women, androgens are produced in the adrenal gland, and adipose tissue is
the principal site for aromatization.
, - Circulating steroid hormones are primarily lipid-bound and are thus considered "bioavailable."
- CORRECT ANSWER - In postmenopausal women, androgens are produced in the
adrenal gland, and adipose tissue is the principal site for aromatization.
(In postmenopausal women, androgens are produced in the adrenal gland, and adipose tissue is
the principal site for aromatization. Normal adipose tissue uses promoter I.4 of the CYP19 gene
to stimulate aromatase production; however, breast tumors and their surrounding adipose tissue
activate promotor II of the CYP19 gene, and the result is a greater expression of aromatase. AIs
can reduce estrogen production by more than 90% and are classified according to the specificity,
potency, and reversibility with which they inhibit the aromatase enzyme.)
Which of the following histologic breast changes is most associated with an increased risk of
breast cancer?
- Epithelial hyperplasia with atypia.
- Macro- and microcysts.
- Apocrine metaplasia.
- Fibroadenoma.
- Duct ectasia. - CORRECT ANSWER - Epithelial hyperplasia with atypia.
Paget disease of the breast - CORRECT ANSWER - Paget disease is nearly always
detectable on clinical examination as a crusting erosion of the nipple. It may be less subtle
presenting with thickening redness or roughness of the nipple, often associated with itching and
burning. It is often associated with subareolar intraductal cancer. Survival is dependent upon the
stage of the accompanying breast cancer.
A 42-year-old, otherwise healthy woman has a new, 1-cm in diameter density deep in the central
retroareolar region of her right breast on mammography. She has no palpable abnormality on
physical examination. No lesion is detected on ultrasonography. The best diagnostic option is -
CORRECT ANSWER - stereotactic core needle biopsy of the breast
A 32-year old male presents to clinic due to enlarging left breast. He states that he has noticed
this "swelling" for the past year but has only sought medical care now because it has becoming
noticeably larger than his right breast. He denies pain or nipple discharge. He denies family
history of breast cancer in either women or men in his immediate or distant family and steroid
use. On examination, the patient is very muscular with a smooth right breast, devoid of masses.
His left breast is noted to have rubbery mass extending concentrically from the nipple. His
