ABSITE – Breast questions and answers with solutions 2025

What is the histology of infiltrating lobular carcinoma? -
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ANSWER Classic histologic appearance of invasive lobular carcinoma of breast origin with small
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ovoid cells with little cytoplasm in an infiltrating single-file pattern
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How to treat breast abscesses that are large OR have overlying skin necrosis OR have loculations
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? - ANSWER Incision and drainage
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serial needle aspiration is preferred for simple abscesses
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*continue breastfeeding if feasible O O O




What is the management for fibroadenomas? -
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ANSWER Fibroadenomas are benign lesions that can be followed with clinical exam or ultrasoun
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d

If there is any concern for cancer on biopsy, the mass is enlarging (>2 or 3cm), or it causes pain, i
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t should be excised
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Fibroadenomas that are degenerating are coarse and popcorn calcification on mammography
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Fibroadenomas can fluctuate with menses and grow with the hormonal stimulation of oral contr
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aceptives and pregnancy O O O




Fibroadenoma identities can be confirmed by ultrasound- O O O O O O



guided core biopsy, after which most can be left in place and observed over time with serial exa
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ms or ultrasound if a mass is not palpable
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What is the reconstruction option for a patient with history of mastectomy and irradiation and d
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o not want to perform a procedure on the contralateral breast? -
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OANSWER Deep inferior epigastric flap (DIEP) reconstruction b/c no muscle is taken and it is the p
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referable option in cases that the arterial perforators are viable (it will provide both soft tissue a
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, nd volume and offer abdominal wall preservation...but slight increase in rate of partial flap loss a
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nd necrosis)
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**breast reconstruction is a combination of both soft tissue and volume
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After mastectomy when the breast is irradiated, the tissue can change resulting to a decrease vo
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lume and increased risk of contracture
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For breast reconstruction there are multiple options such as:
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tissue expanders with later exchange for an implant
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immediate implant placement (increased risk of capsule contracture due to damaged skin)
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latissimus dorsi flap with an implant or thoracodorsal arteyr perforator flap (TDAP) (both do not
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give volume for symmetry)
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and autologous tissue (pedicled or free)
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How do you treat true gynecomastia in a young male? -
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ANSWER Direct surgical excision of the glandular tissue and liposuction of the surrounding adip
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ose tissue may be adequate to treat true gynecomastia
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*If the breast tissue has grown in size, more extensive excision of the breast tissue involving the
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skin excision may be necessary to achieve a satisfactory cosmetic outcome
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Less likely to regress with observation alone or with aromatase inhibitors due to fibrosis that has
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Olikely set in O O




What are the risk factors for male breast cancer? - ANSWER estrogen exposure
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significant family history O O




BRCA mutation (BRCA 1 = 1% lifetime risk; BRCA 2 = 10% lifetime risk)
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Prior chest radiation
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Androgen insufficiency, testicular atrophy
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Obesity, cirrhosis O O