1. What is the preferred imaging modality for a 29 year old patient with a palpable breast mass?

a. Mammography
b. Ultrasound
c. CT Scan
d. MRI
2. What is the preferred imaging modality for a 49 year old female patient with a palpable breast
mass?
a. Mammography
b. Ultrasound
c. CT Scan
d. MRI
3. A 28 year old female with a palpable breast mass had an US result of a solid breast mass
suspicious for malignancy. What kind of biopsy is preferred in this case?
a. FNAB
b. Core Biopsy
c. Incisional Biopsy
d. Excisional Biopsy
4. A 45 year old female underwent mammogram for breast screening. Mammograms final
assessment was BIRADS category 3. What would you do?
a. Do nothing
b. Do biopsy
c. Surveillance follow up
5. A 25 year old female underwent FNA for a breast mass. Aspirate was non-bloody fluid and the
mass completely disappeared. Next step would be:
a. Cytology of aspirated fluid
b. Excision biopsy
c. Follow up after 6 weeks
6. A 30 year old female underwent FNA for a breast mass. Aspirated fluid was greenish brown in
color. After aspiration the mass did not completely resolve. Next step would be:
a. Cytology of aspirated fluid
b. Excision biopsy
c. Follow up after 6 weeks
7. A 24 year old female consulted at your clinic because of a breast mass of 2 months duration. On
PE mass was found to be 2 cms. In size, well-circumscribed, movable, and non-tender. There
were no palpable axillary masses. Needle biopsy was done and histopath result was
fibroadenoma. Management would be:
a. Surgical excision
b. Observe
c. Total mastectomy
d. Quadrantectomy
8. A 45 year old female with a 5 cms breast mass underwent core biopsy of said mass. Final
histopath showed malignant cystosarcoma phylloides. Appropriate treatment would include:
 a. Wide excision
b. Adjuvant chemotherapy
c. Adjuvant hormonal therapy
d. MRM
e. Adjuvant RT
9. A 42 year old with A 5 cms breast mass underwent FNAB and was diagnosed to have
fibroadenoma. However, after excision, final histopath turned out to be CSP. Further
management would be:
a. Immediate resection
b. Observe
c. RT to involved breast
10. A 35 year old female consulted because of breast pain and tenderness. 3 days PTC, ultrasound
was done which showed a complex mass at UIQ of the left breast. Appropriate treatment would
be:
a. I&D + antibiotics
b. Repeated aspiration + Antibiotics
c. Surgical excision
d. Core biopsy
11. Risk of subsequent breast cancer among patients with this benign breast lesion is not increased.
a. Fibroadenoma
b. Sclerosing adenosis
c. Apocrine change
d. Atypical ductal hyperplasia
12. A 32 year old female diagnosed with LCIS with negative family history of breast or ovarian
cancer. Most appropriate management would be:
a. Observation/Surveillance
b. Chemoprevention with Tamoxifen
c. Prophylactic mastectomy
d. Breast conservation surgery
13. A 39 year old female consulted with a mammogram finding of suspicious calcifications on the
right breast. Stereotactic core biopsy was done and histopath revealed LCIS. However, not all
calcifications were removed during the core biopsy procedure. You would:
a. Observation/surveillance
b. Mammography guided needle localization biopsy of remaining calcifications
c. Do RT of right breast
14. A 50 year old female consulted because of a mammographic result of BIRADS 4. Needle
localization excision biopsy was done and histopath result was DCIS 0.5cms in size with negative
margins. Possible surgical management would include:
a. Excision alone
b. Excision + RT
c. Total mastectomy
d. Total mastectomy + RT
 e. MRM
15. A 52 year old female was diagnosed with DCIS. After excision histopath result was: tumor size
1.6 cms, margins were >1cms, tumore was non-high grade with comedo necrosis. Based on the
Van-Nuys Prognostic Index, treatment of choice would be:
a. Excision alone
b. Excision + RT
c. Total mastectomy
16. A 45 year old patient consulted in your clinic because of a 4 cms. breast mass fixed to the
pectoralis muscles. There were palpable movable axillary nodes in the ipsilateral axilla. Biopsy
was dones and histopath result was IDCA. There were no clinical evidence of metastases. What
is the clinical stage?
a. Stage III B
b. Stage IV
c. Stage III A
d. Stage IIB
17. A 52 year old patient has a 2 cms. breast mass diagnosed as IDCA. Nipple retraction and skin
dimpling was noted on the ipsilateral breast. There were no palpable ipsilateral axillary nodes
and there were no clinical evidence of metastases. What is the clinical stage?
a. Stage IV
b. Stage III C
c. Stage I
d. Stage III B
18. A 61 year old patient has 1.5 cms breast amss diagnosed as IDCA. A palpable supraclavicular
node was also noted. What is the clinical stage?
a. Stage IV
b. Stage III A
c. Stage III B
d. Stage III C
19. A 55 year old female consulted in your clinic because of a 2 cms breast mass which was
subsequently diagnosed as IDCA. There were no palpable axillary lymph nodes. Possible surgical
treatment would include:
a. Lumpectomy + ALND
b. Lumpectomy alone
c. Total mastectomy
d. MRM
20. A 62 year old patient with a 2.5 cms breast mass at the UOQ of the right breast underwent
biopsy which showed IDCA. Mammography showed clustered calcifications in the IUQ and LOQ
of the right breast. Biopsy of said lesions showed DCIS. Surgical treatment of choice would be:
a. BCS
b. MRM
c. Radical mastectomy
d. Extended radical mastectomy
21. A 52 year old female underwent screening mammography which showed microcalcifications on
her left breast. It was read as BIRADS Category 5 lesion. Management would include:
a. US guided core biopsy
b. Mammography guided needle localization excision biopsy
c. Stereotactic core biopsy
d. If diagnosed as malignant – determination of hormone receptor status
e. Frozen section
22. A 52 year old female who was diagnosed with IDCA is undergoing MRM. During axillary
dissection, the surgeon was able to palpate enlarged nodes posterior to the pectoralis minor
muscle. Appropriate axillary dissection would be:
a. Axillary sampling
b. Level I dissection only
c. Level 1 & 2 dissection only
d. Total axillary lymphadenectomy [Level 1, 2, 3]
23. A 55 year old female with a 4.5 cms mass at the left breast was diagnosed by core biopsy to
have IDCA. Patient underwent MRM. Margins were >1mm and ALN were [-] for mets. Would you
give adjuvant RT?
a. Yes
b. No
24. A 70 year old female with a 9 mm right breast mass was diagnose by core biopsy to have IDCA.
Lumpectomy + ALND were done. Axilla was [-] for mets. Tumor was ER+/PR+. Adjucant therapy
must include:
a. Adjuvant RT
b. Adjuvant chemotherapy
c. Adjuvant hormonal therapy
25. A 55 year old female has an 8 mm breast mass diagnosed as IDCS. She underwent BCS. Axilla
had 2 [+] nodes t of 10. Tumor was ER-/PR-. Adjuvant treatment would include:
a. Adjuvant RT
b. Adjuvant chemotherapy
c. Adjuvant hormonal therapy
26. A 42 year old female with a 1.5 cms breast mass was diagnosed to have IDCA. She underwent
MRM. Axillary nodes were [-]. Tumor was ER-/PR-, HER 2+. Appropriate adjuvant treatment
would be:
a. Adjuvant RT
b. Adjuvant chemotherapy
c. Adjuvant hormonal therapy
d. No adjuvant therapy
e. Adjuvant chemotherapy + Trastuzumab
27. A 39 year old female, premenopausal, with a 2 cms. breast mass was diagnosed with IDCA. BCT
was done. Tumor was ER+/PR+. What is the most appropriate adjuvant hormonal treatment?
a. Ovarian ablation
b. Tamoxifen 20 mgs x 10 years
 c. Tamoxifen 20 mgs x 5 years
d. Aromatase inhibitors
e. Megestrol acetate [Megace]
28. A 46 year old premenopausal patient undergoes BCS for a 2cms tumor diagnosed as IDCA of the
left breast. The margins are clear and 5 out of 15 ALN are [+]for mets. Tumor was ER-/PR+.
Recommended adjuvant treatment should be:
a. RT + Chemotherapy
b. RT + Hormonal therapy
c. Chemotherapy + hormonal therapy
d. RT alone
e. Chemotherapy +RT + Hormonal therapy
29. What is the most appropriate sequence in giving adjuvant therapy?
a. RT then Chemotherapy then Hormonal therapy
b. Hormonal therapy then Chemotherapy then RT
c. [RT + Chemotherapy] then hormonal
d. Chemotherapy then RT then Hormonal Therapy
e. Chemotherapy the Hormonal therapy then RT
30. A 61 year old female consulted in your clinic because of a 7 cms ulcerating fixed mass of the left
breast. There were palpable movable ALN in the left axilla. Biopsy of the mass revealed IDCA.
What would be the appropriate initial management?
a. MRM
b. RT
c. Radical mastectomy
d. Extended radical mastectomy
e. Neoadjuvant chemotherapy
31. A 62 year old female underwent BCT of the left breast because of as cms mass diagnosed as
IDCA. 5 years later, a 2.5 cms mass was noted again on the left breast. Core biopsy ws done and
histopath result was IDCA. What is the preferred surgical management?
a. MRM
b. BCS
c. Total mastectomy
d. Radical mastectomy
32. A 49 year old patient underwent MRM for a 4 cms right breast mass diagnosed as IDCA. There
were no nodes [+} for mets. 2 years later, patient noted a 3 cms fixed mass on the chest wall.
Biopsy of the mass showed IDCA. Tumor was hormone receptor [+]. Appropriate management
would include:
a. Excision of chest wall mass
b. RT
c. Chemotherapy
d. Hormonal therapy
e. All of the above
33. A 33 year old patient, pregnant AOG 10 to 11 weeks, consulted because of a 1.5 cms mass on
the left breast. Core biopsy result was IDCA. Appropriate surgical treatment would be:
a. Lumpectomy + ALND
b. Lumpectomy alone
c. Total mastectomy
d. MRM
34. Recommended adjuvant treatment for the above case would be:
a. Adjuvant RT
b. Adjuvant chemotherapy
c. Adjuvant hormonal therapy
d. None of the above
e. All of the above
35. A 50 year old woman consulted because ofa 6 cms mass at the right breast. Core biopsy showed
IDCA. Mammography was done which showed a 0.8 cms mass at the left beast. Biopsy resul of
the left breast mass was DCIS. Both tumors were hormone receptor [+]. Management would
include:
a. MRM right, Lumpectomy left
b. Bilateral MRM
c. MRM right, Lumpectomy + ALND left
d. Adjuvant RT both sides
e. Adjuvant chemotherapy + Hormonal therapy
36. A 25 year old pregnant woman consulted in your clinic because of a firm 2.5 cms left breast
mass which is tender and sometimes painful. Core biopsy showed granulomatous lobular
mastitits. Management would be:
a. Excision biopsy
b. Antibiotics
c. I & D
d. Observation
e. Steroids
37. The only group of patients with benign non-proliferative breast lesions with an increased risk for
development of BCA are those patients with:
a. Papillary apocrine change
b. Mild hyperplasia with family history of BCA
c. Epithelial related calcifications
d. Cyst with family history of BCA
38. A 60 year old woman underwent MGNLB. Histopath showed DCIS with close surgical margins
(<1mm) at the fibrogladular boundary of the breast. The appropriate subsequent treatment is:
a. Surgical re-excision is a must
b. Higher boost dose radiation is indicated in the lumpectomy site
c. Chemotherapy
d. Total mastectomy
39. The following are relative contraindications to BCT except:
 a. Active connective tissue disease involving the skin
b. Tumors > 5cms
c. Diffuse suspicious or malignant appearing calcifications involving more than 1 quadrant
of the breast
d. Women 35 years and younger
e. Premenopausal women with a known BRCA ½ mutation
40. A 53 year old female was diagnosed with DCIS after core needle biopsy. She underwent
lumpectomy of the remaining lesion. Histopath of the lesion showed concomitant invasive
disease with adequate negative margins. Further surgical treatment would be:
a. Total mastectomy
b. Total mastectomy with ALND
c. Axillary staging
d. No further surgical management
41. A 48 year old underwent MRM for a 2 cms left breast mass which turned out to be ILCA. ALND
revealed 16 axillary nodes with 11 [+] for micrometastases. There were noevidence of distant
metastases. Px pathologic stage is:
a. Stage III C
b. Stage II A
c. Stage III A
d. Stage II B
42. A 57year old female with right breast mass measuring 3 cms in size. Core biopsy done showed
IDCA. MRM was done. Tumor was ER+/PR+, Her2+ with negative ALN. All of the following are
indicated adjuvant treatment except:
a. Chemotherapy
b. Radiotherapy
c. Hormonal therapy
d. Trastuzumab
43. A 42 year old female diagnosed with BCA is on adjuvant tamoxifen. She became ammenorheic
after 3 years of tamoxifen and was later shifted to Letrozole (AI). After 4 months on Letrozole
she began to menstruate again. You would:
a. Continue Letrozole
b. Shift to another AI (Anastrozole or Exesmestane)
c. Discontinue Letrozole and resume tamoxifen
d. Discontinue hormonal treatement
44. A 65 year old woman with a 5 cms left breast mass underwent core biopsy. Histopath showed
IDCA and the tumor was ER+/PR+ and HER2+. She desires BCT. All accepted treatment prior to
BCT except:
a. Neoadjuvant chemotherapy
b. Neoadjuvant hormonal therapy
c. Neoadjuvant chemotherapy + Trastuzumab
d. None of the above
45. A 60 year old female with a 6 cms ulcerating mass of the left breast with palpable axillary nodes
was diagnosed with IDCA. Neoadjuvant chemotherapy was done x 3 cycles. The ulceration and
palpable ALN disappeared and the mass decreased to 2 cms. in size. Patient underwent MRM. If
adjuvant RT still indicated in this case?
a. Yes
b. No
46. Criteria for determining menopause include:
a. Prior bilateral oophorectomy
b. Age 60 years old and above
c. Age <60 years old, but amenorrheic for 12 months or more
d. Age <60 years old, amenorrheic for 12 months and on chemotherapy
e. None of the above
47. A 45 year old woman underwent MRM for a hormone receptor + BCA. She was given adjuvant
chemotherapy for 6 cycles after which she became amenorrheic. What would you do to ensure
postmenopausal status if you want to use aromatase inhibitors.
a. Surgical oophorectomy
b. TAH-BSO
c. Serial measurement of FSH and or estradiol
d. RT oophorectomy
48. A 45 year old female consulted because of a non healing eczema of the NAC. Mammography
done showed a breast lesion which turned out to be DCIS after core biopsy. Biopsy of the NAC
showed Paget’s disease. Surgical management would include:
a. MRM
b. Mastectomy + SLNB
c. Wide excision of breast lesion and NAC
d. Wide excision of breast lesion and NAC + RT of ipsilateral breast
49. The following surgical procedures can be done during the late 2nd trimester of pregnancy except:
a. MRM- Total mastectomy + ALND
b. BCS- Lumpectomy + ALND
c. Total mastectomy + SLNB
d. Lumpectomy + SLNB
e. None of the above
50. The following adjuvant treatment can be given during the 2nd trimester of pregnancy:
a. FAC
b. Taxanes
c. Trastuzumab
d. Hormonal treatment
e. Adjuvant RT
51. A 45 year old patient consulted because of a palpable irregular mass at the UOQ of the left
breast. Mammography was requested which showed BIRADS 4 lesion at the UIQ of the same.
What would be your next step?
a. Biopsy of palpable lesion
b. Biopsy of mammographic lesion
c. Ultrasound of the breast
d. Biopsy of both lesions
52. A 45 year old female has a right breast mass which is 2 cms in size, irregular in shape, firm and
slightly movable. Mammogram showed a Birads 3 category lesion. US was requested and the
result was that of a solid lesion suspicious for malignancy. Core biopsy result was benign. Next
step would be to?
a. Observe
b. Repeat mammogram
c. Repeat ultrasound
d. Surgical excision
53. A 50 year old female with a left breast mass, 2.5 cms in size, smooth, movable and non-tender
underwent mammogram. Result wasa BIRADS 2 lesion. US was done and showed a probably
benign finding. Next step would be:
a. MRI
b. Observe (PE + US + mammogram every 6 to 12 months
c. Tissue diagnosis (Core biopsy or pen biopsy)
d. BCS
54. A 50 year old female underwent core biopsy. Histopath showed pleomorphic LCIS. What is the
proposed management?
a. Complete excision with negative margins
b. Observe
c. Lumpectomy with axillary staging
d. MRM
55. A 60 year old female underwent core biopsy for a right breast mass. Histopath showed DCIS.
Total mastectomy was done and histopath revealed concomitant invasive cancer. Subsequent
management would be:
a. SLNB
b. ALND
c. Observe
d. RT
56. A 65 year old female with left breast mass at UOQ measuring 3 cms underwent excision biopsy.
Histopath showed metaplastic carcinoma with adequate margins. Next step would be:
a. Observe/Surveillance
b. RT
c. ALND
d. SLNB
57. A 55 year old female with a 0.4 cms breast mass diagnosed as IDCA by core biopsy. She
underwent BCS. Axillary nodes were negative for mets. Tumor was ER/PR + HER2+. Adjuvant
treatment would consist of:
a. Endocrine tx
b. Chemotherapy
c. Trastuzumab
58. A 51 year old female underwent MRM for a IDCA of the left breast. Tumor was ER/PR negative
and HER2 negative. These findings are associated with what breast cancer subtype?
a. Luminal A
b. Luminal B
c. Basal
d. HER2
59. A 63 year old female diagnosed with tubular carcinoma of the right breast. Tumor is 3 cms. in
size ER/PR+ with negative axillary lymh nodes. Adjuvant treatment would include:
a. Chemotherapy
b. RT
c. Endocrine tx
d. Trstuzumab
60. A 59 year old female with a 6 cms breast mass with palpable axillary nodes underwent
neoadjuvant chemotherapy. After 4 cycles the mass decrease to 2 cms and the axillary nodes
disappeared. Adjuvant treatment includes:
a. Chemotherapy alone
b. RT alone
c. Chemotherapy and RT
d. No adjuvant tx
61. A HER2 testing of a breast cancer specimen showed a result of IHC 2+. This result means:
a. HER2 is negative
b. HER2 is positive
c. HER2 borderline needs ISH testing
d. HER2 borderline needs repeat IHC testing
62. A patient with Paget’s disease with a concomitant 3 cms IDCA. Axillary nodes were negative for
mets. What is the stage?
a. Stage 1
b. Stage 2
c. Stage 3
d. Stage 4
63. A 54year old female came into your clinic with a palpable mass about 2 cms. in her right breast.
Mammography and ultrasound showed normal results. What is the next step?
a. Needle biopsy
b. Excision biopsy
c. Observe
d. Wide excision
64. A 47 year old female came into your clinic because of persistent spontaneous serous nipple
discharge which occurs at least 2 occasions per week and had persisted for > 4 weeks. PE
showed single duct discharge and no palpable mass. Mammography and ultrasound were
normal. Management would be:
a. Observe
b. Microdochectomy with total duct excision
c. Ductoscopy
d. Ductography
65. Another patient 50 year old female with persistent spontaneous serosanguinous nipple
discharge consulted in your clinic. PE showed multiple duct discharge with no breast mass.
Mammography and ultrasound were normal. Persistent staining of clothes wasbeing
experienced by the patient. Management would be:
a. Reassurance
b. Total duct excision
c. Ductoscopy
d. Microdochectomy
66. A non-lactating 37 year old woman came into your clinic with a painful erythematous lesion at
the periphery of her left breast. Your diagnosis was peripheral nonlactational breast abscess.
Management would be:
a. Observe
b. Aspiration or I&D
c. Aspiration or I&D + antibiotics
d. Aspiration or I&D + antibiotics + mammography
67. A 40 year old female complaining of right breast pain consulted in your clinic. On PE she has a
tender palpable subcutaneous cord and linear skin dimpling. Management would be:
a. Observation and mammography
b. Biopsy of subcutaneous cord lesion
c. Antibiotics
d. Steroids