Questions:
1) Where is the most common site to palpate a painless, immobile mass in the breast?
A) Upper outer quadrant
B) Upper lower quadrant
C) Proximal to nipple
D) Lower inner quadrant
2) A 34 year old, pre-menopausal woman has recently noticed abnormal discharge from the nipple of her right breast. She has not noticed any pain but questions if she feels a small bump behind her nipple. This individual is most likely to be experiencing which benign breast condition?
A) Radial scar
B) Solitary papilloma
C) Breast cyst
D) Fibroadenoma
3) After a woman gives birth, the breast produces milk in response to what hormone?
A) Estrogen
B) Progesterone
C) Oxytocin
D) Prolactin
4) True or False: Ductal carcinoma in situ (DCIS) is the presence of abnormal cells in the ducts of the breast that have broken through the basement membrane and begun to spread locally.
5) Remodeling or reprogramming of the breast during post-pregnancy involution is important because it involves inflammatory and “wound healing-like” tissue reactions known as:
A) Reactive stroma
B) Refractory stroma
C) D-cadherin
D) E-cadherin
Answers:
Question 1:
Correct answer: A
The upper outer quadrant consists mostly of the glandular tissue of the breast and is where the majority of carcinomas are found. The lymphatic-rich area where these tumors are found is referred to as the “tail of Spence.” Other quadrants are less common due to less breast tissue mass and not as many lymphatic vessels.
Question 2:
Correct answer: B
Solitary papillomas are a type of intraductal papilloma, a benign breast growth, that grow in the large breast ducts and often cause increased clear or bloody discharge. Solitary papillomas are usually unilateral and if palpated, they are small and located behind the nipple. Papillomas are not usually painful.
Clinical manifestations of breast cysts, radial scars, and fibroadenomas do not usually include nipple discharge. Radial scars cannot be palpated, and fibroadenomas and breast cysts are not often located near the nipple.
Question 3:
Correct Answer: D
Prolactin is secreted by alveolar epithelial cells, milk production occurs in response to its secretion, and increases by continued breast-feeding
- Estrogen promotes the increase in size of the breast
- Oxytocin controls the ejection of milk
- Progesterone stimulates development of cells lining the alveoli to produce milk.
Question 4:
Correct Answer: False.
DCIS is limited to the breast ducts and lobules without invasion of the basement membrane.
Question 5:
Correct answer: A.
The reactive stroma releases various signals and interleukins that affect nearby carcinoma cells, including these cells to activate their previously silent EMT programs.
An E-cadherin is a Ca++-dependent glycoprotein that has a unique pattern of tissue distribution and are one of the four protein families that make up the cell adhesion molecules. It is not involved in remodeling and reprogramming of the breast. Refractory stroma and D-cadherins do not exist.