Breast Ultrasonography Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Breast Ultrasonography. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Breast Ultrasonography Indian Medical PG Question 1: 20 years old female came with complaint of a palpable painless mass in right breast. On examination, mass was mobile and hard in consistency. Ultrasound of right breast was performed . Most likely diagnosis is?
- A. Breast cyst
- B. Fibroadenoma (Correct Answer)
- C. Phylloid's tumour
- D. Ductal papilloma
Breast Ultrasonography Explanation: ***Fibroadenoma***
- A **painless**, **mobile**, and **hard mass** in a 20-year-old female is highly characteristic of a fibroadenoma, which is a common **benign breast tumor**.
- Its **mobility** (often described as "breast mouse") is a key distinguishing feature from malignant masses.
*Breast cyst*
- While breast cysts can be **palpable** and **painless**, they are typically **soft or fluctuant** on palpation, not hard.
- Cysts are fluid-filled sacs, and their mobile nature is less pronounced than the discrete, solid feel of a fibroadenoma.
*Phyllodes tumor*
- Phyllodes tumors can present as a **palpable mass**, but they usually grow **rapidly** and tend to be larger, often feeling lobulated.
- While they can be benign, they have a potential for **malignant transformation** and are less common than fibroadenomas, especially in a 20-year-old.
*Ductal papilloma*
- Ductal papillomas are typically very small, located within milk ducts, and often present with **nipple discharge**, particularly bloody discharge, rather than a palpable mass.
- They are rarely felt as a discrete, mobile, hard mass on routine physical examination.
Breast Ultrasonography Indian Medical PG Question 2: What is not an advantage of USG over mammography?
- A. Can be used for guided biopsy
- B. Superior detection of microcalcifications (Correct Answer)
- C. In young females with dense breasts
- D. Can be used to differentiate solid VS cystic
Breast Ultrasonography Explanation: ***Superior detection of microcalcifications***
- **Mammography** is the gold standard for detecting **microcalcifications**, which can be a key indicator of **ductal carcinoma in situ (DCIS)** or early invasive breast cancer.
- **Ultrasound (USG)** has limited sensitivity for detecting and characterizing microcalcifications.
*Can be used for guided biopsy*
- **USG-guided biopsy** is a common and advantageous technique for obtaining tissue samples from suspicious lesions in the breast or other organs.
- This allows for **real-time visualization** of the needle, improving accuracy and reducing complications.
*Can be used to differentiate solid VS cystic*
- **USG** excels at distinguishing between **solid masses and fluid-filled cysts** due to differences in sound wave reflection.
- This capability is crucial in characterizing breast lesions and often eliminates the need for further invasive procedures for benign cysts.
*In young females with dense breasts*
- **Dense breast tissue** in young females can obscure lesions on mammography, making interpretation difficult.
- **USG** is particularly valuable in this population because it is not hindered by breast density and can provide a clearer view of underlying pathology.
Breast Ultrasonography Indian Medical PG Question 3: Which of the following features on mammogram would suggest malignancy?
- A. Smooth borders
- B. Well defined lesion
- C. A mass of decreased density
- D. Areas of spiculated microcalcifications (Correct Answer)
Breast Ultrasonography Explanation: ***Areas of spiculated microcalcifications***
- **Spiculated microcalcifications** are highly suspicious for malignancy due to their irregular shape, distribution, and association with rapid, uncontrolled cell growth.
- These calcifications often represent **necrotic cells** within rapidly growing tumors, which can deposit calcium.
*Smooth borders*
- **Smooth borders** typically indicate a benign lesion, such as a cyst or fibroadenoma, as they suggest gradual, uniform growth rather than invasive spread.
- Malignant lesions tend to have **irregular** or ill-defined borders due to their infiltrative nature.
*Well defined lesion*
- A **well-defined lesion** usually suggests a benign process, as it indicates a mass that is clearly demarcated from surrounding tissue and is likely encapsulated.
- Malignancies, conversely, often exhibit **indistinct or irregular margins** as they invade adjacent structures.
*A mass of decreased density*
- A mass of **decreased density** is generally considered a benign finding, often representing a **cyst** or an area of normal fatty tissue.
- Malignant tumors typically present as a **mass of increased density** due to their cellular proliferation and desmoplastic reaction.
Breast Ultrasonography Indian Medical PG Question 4: Fat-containing breast lesions are seen in:
- A. Galactocele
- B. Fat necrosis
- C. Hamartoma
- D. All of the options (Correct Answer)
Breast Ultrasonography Explanation: ***All of the options***
- **Galactocele**, **fat necrosis**, and **hamartoma** are all types of breast lesions that can contain fat, making this the correct comprehensive answer.
- Understanding that various benign breast conditions can present with a fat component is important for differential diagnosis.
*Galactocele*
- A **galactocele** is a benign **milk-filled cyst** that can develop in lactating or recently lactating women.
- While primarily fluid-filled, it can sometimes contain areas of fat due to the milk's content (fat globules).
*Fat necrosis*
- **Fat necrosis** is a benign condition that occurs due to **trauma** or **ischemia** to breast tissue, leading to the breakdown of fat cells.
- Imaging often reveals **oil cysts** or **calcifications** within areas of necrotic fat.
*Hamartoma*
- A **hamartoma** (also known as a fibroadenolipoma) is a benign mixed tumor composed of varying amounts of **glandular tissue**, **fibrous stroma**, and **fat**.
- The fat component is typically well-defined and can give it a characteristic appearance on imaging.
Breast Ultrasonography Indian Medical PG Question 5: Gold standard investigation for breast carcinoma screening in a patient with silicone breast implants
- A. Mammography
- B. CT scan
- C. USG
- D. MRI (Correct Answer)
Breast Ultrasonography Explanation: ***MRI***
- **MRI** is considered the **gold standard** for breast cancer screening in patients with silicone breast implants due to its superior ability to visualize breast tissue through the implant and detect subtle lesions.
- It offers **high sensitivity** in detecting both implant rupture and early malignancies, often providing better clarity than mammography in augmented breasts where implants can obscure tissue.
*Mammography*
- While a standard screening tool, **mammography** can be limited in patients with silicone implants because the implants can **obscure adjacent breast tissue**, making detection of small masses challenging.
- Special views (e.g., **Eklund views**) can be used, but sensitivity is still reduced compared to MRI in augmented breasts.
*CT scan*
- **CT scans** are not routinely used for primary breast cancer screening due to their use of **ionizing radiation** and lower sensitivity for detecting early breast lesions compared to MRI.
- CT is more commonly used for **staging** advanced cancers or evaluating complex masses detected by other modalities.
*USG*
- **Ultrasound (USG)** is a valuable complementary tool, especially for evaluating palpable lumps or clarifying findings from mammography, but it is **operator-dependent** and has a lower overall sensitivity for general screening compared to MRI.
- It is particularly useful for differentiating between **cystic and solid masses** and detecting implant ruptures but is not the gold standard for comprehensive screening in augmented breasts.
Breast Ultrasonography Indian Medical PG Question 6: Mammography can be best used in?
- A. Early breast carcinoma (Correct Answer)
- B. Mastitis
- C. Fibroadenoma
- D. Phylloides tumor
Breast Ultrasonography Explanation: ***Early breast carcinoma***
- **Mammography** is the gold standard for **early detection of breast carcinoma**, particularly for identifying **microcalcifications** and small masses before they are palpable.
- It plays a crucial role in **screening asymptomatic women** to reduce breast cancer mortality.
*Mastitis*
- **Mastitis** is an **inflammatory condition** of the breast, often associated with infection, which is usually diagnosed clinically.
- While mammography might show diffuse **increased density**, it is not the primary diagnostic tool and often has limited value due to inflammatory changes masking pathology.
*Fibroadenoma*
- **Fibroadenomas** are **benign breast tumors** common in younger women, typically appearing as well-circumscribed masses on mammography.
- While mammography can detect them, their characterization often requires **ultrasound** and **biopsy** for definitive diagnosis, as differentiation from malignant lesions can be challenging.
*Phylloides tumor*
- A **Phylloides tumor** is a rare tumor that can be benign, borderline, or malignant, and it typically presents as a rapidly growing, palpable mass.
- Mammography may show a well-defined mass, but **ultrasound** and **core needle biopsy** are essential for accurate diagnosis and distinction from fibroadenomas or malignancy.
Breast Ultrasonography Indian Medical PG Question 7: On mammogram, all of the following are the features of a malignant tumor except:
- A. Microcalcification
- B. Irregular mass
- C. Macrocalcification (Correct Answer)
- D. Spiculation
Breast Ultrasonography Explanation: ***Macrocalcification***
- **Macrocalcifications** are typically **benign** and are often associated with involutional changes in the breast, such as aging or fibroadenomas.
- These are usually larger, coarser calcifications that are easily seen and rarely indicate malignancy.
*Microcalcification*
- **Microcalcifications**, especially when **pleomorphic**, **linear**, or grouped, are a significant indicator of potential malignancy, such as **ductal carcinoma in situ (DCIS)**.
- They represent calcium deposits within the ducts or stromal tissue, which can be associated with rapidly proliferating cells.
*Irregular mass*
- An **irregularly shaped mass** with ill-defined margins is highly suspicious for malignancy because it suggests invasive growth into surrounding tissues.
- Unlike benign lesions which tend to be round or oval with smooth borders, malignant tumors often grow in an uncontrolled, infiltrative manner.
*Spiculation*
- **Spiculation** refers to **radiating lines or projections** extending from the borders of a mass, indicating an infiltrative process highly suggestive of malignancy.
- These spicules represent fibrous tissue reaction to an invading tumor and are a strong predictor of breast cancer.
Breast Ultrasonography Indian Medical PG Question 8: In a child, non-functioning kidney is best diagnosed by
- A. Creatinine clearance
- B. Ultrasonography
- C. IVU
- D. DTPA renogram (Correct Answer)
Breast Ultrasonography Explanation: ***DTPA renogram***
- A **DTPA renogram** (diethylene triamine pentaacetic acid scan) is a nuclear medicine study that assesses **renal blood flow** and **glomerular filtration rate (GFR)**.
- It is highly effective in determining if a kidney is non-functioning because it directly measures the **uptake and excretion of a radiotracer** by the kidney, providing quantitative data on its functional capacity.
*Creatinine clearance*
- **Creatinine clearance** is a measure of overall kidney function, reflecting the GFR of **both kidneys combined**.
- It cannot specifically identify a non-functioning individual kidney, as the other kidney might compensate for the non-functioning one, leading to a near-normal overall creatinine clearance.
*Ultrasonography*
- **Ultrasonography** is excellent for evaluating **renal anatomy**, such as size, shape, and presence of cysts, hydronephrosis, or stones.
- While it can show structural abnormalities, it provides limited direct information about the **functional status** of the kidney, and a structurally normal kidney can still be non-functional.
*IVU (Intravenous Urography)*
- **Intravenous Urography (IVU)** uses contrast dye injected intravenously to visualize the kidneys, ureters, and bladder, assessing both anatomy and some aspects of function.
- If a kidney is non-functioning, it would show **no uptake or excretion of the contrast dye**, but IVU involves radiation exposure and nephrotoxic contrast, making DTPA renogram often preferred in children for functional assessment.
Breast Ultrasonography Indian Medical PG Question 9: Which is not echogenic while doing ultrasonography:
- A. Bile (Correct Answer)
- B. Bone
- C. Gas
- D. Gall stones
Breast Ultrasonography Explanation: ***Bile***
- Bile is largely composed of **water**, which allows ultrasound waves to pass through it with minimal reflection, appearing **anechoic** (black) on ultrasound.
- This property makes the gallbladder lumen, when filled with bile, appear anechoic, which is crucial for identifying structures like gallstones.
*Bone*
- **Bone** is highly dense and reflects a significant portion of ultrasound waves, making it appear very **echogenic** (bright) on ultrasonography.
- Due to its high reflectivity, bone often produces a strong **acoustic shadow** behind it, obscuring deeper structures.
*Gas*
- **Gas** (air) is a strong reflector of ultrasound waves and appears brightly echogenic, often with a characteristic **dirty shadowing** or **reverberation artifact**.
- The presence of gas can significantly hinder visualization of underlying tissues due to its strong reflection and scatter of the ultrasound beam.
*Gall stones*
- **Gallstones** are solid concretions that are highly reflective of ultrasound waves, appearing as bright, **echogenic foci** within the gallbladder lumen.
- A classic ultrasound sign of gallstones is an echogenic structure with strong **posterior acoustic shadowing**.
Breast Ultrasonography Indian Medical PG Question 10: Which of the following ultrasound features of a thyroid nodule is not suggestive of malignancy?
- A. Hypoechogenicity
- B. Hyperechogenicity (Correct Answer)
- C. Microcalcification
- D. Nonhomogeneous
Breast Ultrasonography Explanation: ***Hyperechogenicity***
- A **hyperechoic** thyroid nodule appears brighter than the surrounding parenchyma on ultrasound, typically indicating a benign lesion, such as a **colloid nodule**.
- This feature suggests a higher reflection of sound waves, characteristic of tissues rich in **fluid or colloid material**.
*Hypoechogenicity*
- **Hypoechoic** nodules appear darker than the surrounding thyroid tissue, which is a strong indicator of malignancy due to their often dense cellular structure.
- This feature is associated with a higher risk of thyroid cancer and often prompts further investigation with **fine-needle aspiration (FNA)**.
*Microcalcification*
- The presence of **microcalcifications** (tiny, bright spots) within a thyroid nodule is one of the most specific ultrasound signs of **papillary thyroid carcinoma**.
- These calcifications, often punctate, represent psammoma bodies, which are a histopathological hallmark of this common thyroid cancer.
*Nonhomogeneous*
- A **nonhomogeneous** (heterogeneous) echotexture within a thyroid nodule, characterized by irregular internal architecture, can be suggestive of malignancy.
- This often indicates disorganized cellular growth, fibrosis, or cystic degeneration with solid components, which are features seen in various thyroid cancers.
More Breast Ultrasonography Indian Medical PG questions available in the OnCourse app. Practice MCQs, flashcards, and get detailed explanations.
