Reproductive Pathology Practice Questions

Q: A 51-year-old woman has noticed an area of swelling with tenderness in her right breast that has worsened over the past 2 months. On physical examination, the 7-cm area of erythematous skin is tender with a rough, firm surface resembling an orange peel. There is swelling of the right breast, nipple retraction, and right axillary non-tender lymphadenopathy. Excisional biopsy of skin and breast is most likely to show which of the following lesions?

Infiltrating ductal carcinoma. **Explanation:** The clinical presentation described is a classic case of **Inflammatory Breast Cancer (IBC)**, which is a clinical subtype of **Infiltrating Ductal Carcinoma (IDC)**. **1. Why Infiltrating Ductal Carcinoma is correct:** The patient presents with the hallmark sign of **"Peau d'orange"** (orange peel appearance). This occurs because the underlying carcinoma (IDC) invades and obstructs the **dermal lymphatics**, leading to lymphedema of the skin. The skin becomes thickened and tethered by the suspensory ligaments of Cooper, creating the pitted appearance. The presence of nipple retraction and axillary lymphadenopathy further points toward a malignant process rather than a simple infection. **2. Why the other options are incorrect:** * **Acute Mastitis:** While it causes redness and tenderness, it typically occurs in lactating women and is associated with systemic signs of infection (fever, chills). It does not cause peau d'orange or nipple retraction. * **Atypical Epithelial Hyperplasia:** This is a microscopic premalignant finding. It does not present as a large (7-cm), palpable, erythematous mass with skin changes. * **Fat Necrosis:** Usually follows trauma. While it can cause skin tethering and a firm mass, it does not typically cause diffuse erythema, peau d'orange, or significant axillary lymphadenopathy. **Clinical Pearls for NEET-PG:** * **Peau d'orange = Dermal Lymphatic Invasion.** This automatically classifies the tumor as **T4d** (Stage IIIB), regardless of the tumor size. * **Inflammatory Breast Cancer** is a clinical diagnosis; however, the underlying pathology is most commonly **Infiltrating Ductal Carcinoma (High Grade).** * **Differential Diagnosis:** Always rule out a breast abscess in a non-lactating woman presenting with "mastitis" symptoms; if it doesn't resolve with antibiotics, suspect IBC and perform a biopsy.

Q: What is true regarding male breast carcinoma?

The majority of cases are estrogen receptor positive.. **Explanation:** Male breast carcinoma is a rare malignancy, accounting for less than 1% of all breast cancers. Understanding its unique hormonal and pathological profile is crucial for NEET-PG. **1. Why Option B is Correct:** The vast majority of male breast cancers are hormone receptor-positive. Approximately **90% of cases are Estrogen Receptor (ER) positive**, and about 80% are Progesterone Receptor (PR) positive. This frequency is significantly higher than in female breast cancer, making endocrine therapy (like Tamoxifen) a cornerstone of treatment. **2. Why Other Options are Incorrect:** * **Option A:** The most common histological type in men is **Invasive Ductal Carcinoma (IDC)**, accounting for over 80% of cases. Invasive Lobular Carcinoma (ILC) is extremely rare in men because the male breast lacks well-developed terminal lobules. * **Option C:** Paget’s disease of the nipple can occur in men, but it is **much more common in women** simply due to the higher overall incidence of breast cancer in females. However, because men have less breast tissue, nipple involvement often occurs earlier in the disease course. **High-Yield Clinical Pearls for NEET-PG:** * **Risk Factors:** The strongest risk factor is **Klinefelter syndrome (47, XXY)**, which increases risk by 50-fold. Other factors include BRCA2 mutations (more common than BRCA1 in men), cirrhosis, and radiation exposure. * **Presentation:** Usually presents as a painless, firm subareolar mass. Eccentric masses are more likely to be gynecomastia. * **Staging & Treatment:** Staging is the same as in females. **Modified Radical Mastectomy (MRM)** is the standard surgical approach due to the central location and proximity to the chest wall. * **BRCA2:** Men with breast cancer should be offered genetic counseling, as BRCA2 mutations are found in approximately 10% of cases.

Question 1

A blighted ovum is characterized by which of the following?

Accepted Answer

Avascular villi

Answer

Syncytial knots

Answer

Intervillous hemorrhage

Answer

Intracerebral hemorrhage

Question 2

Which of the following is a predisposing factor for carcinoma of the breast?

Accepted Answer

Epithelial hyperplasia

Answer

Sclerosing adenosis

Answer

Fibrocystic disease of breast

Answer

Fibroadenoma

Question 3

A 51-year-old woman has noticed an area of swelling with tenderness in her right breast that has worsened over the past 2 months. On physical examination, the 7-cm area of erythematous skin is tender with a rough, firm surface resembling an orange peel. There is swelling of the right breast, nipple retraction, and right axillary non-tender lymphadenopathy. Excisional biopsy of skin and breast is most likely to show which of the following lesions?

Accepted Answer

Infiltrating ductal carcinoma

Answer

Acute mastitis

Answer

Atypical epithelial hyperplasia

Answer

Fat necrosis

Question 4

What is the most common testicular tumor in the fourth decade of life?

Accepted Answer

Seminoma

Answer

Teratoma

Answer

Dermoid cyst

Answer

All of the above

Question 5

A 20-year-old female presents with a mass in the abdomen. Examination of the removed ovary reveals the specimen shown below. What is the most probable diagnosis?

Accepted Answer

Dysgerminoma

Answer

Choriocarcinoma

Answer

Embryonal cell tumor

Answer

Malignant teratoma

Question 6

A 34-year-old woman has noticed a bloody discharge from the nipple of her left breast for the past 3 days. On physical examination, the skin of the breasts appears normal, and no masses are palpable. There is no axillary lymphadenopathy. She has regular menstrual cycles and is using oral contraceptives. Excisional biopsy is most likely to show which of the following lesions in her left breast?

Accepted Answer

Intraductal papilloma

Answer

Acute mastitis

Answer

Fibroadenoma

Answer

Phyllodes tumor

Question 7

What is true regarding male breast carcinoma?

Accepted Answer

The majority of cases are estrogen receptor positive.

Answer

Invasive lobular carcinoma is the most common histological type.

Answer

Paget's disease of the nipple is more common in men than in women.

Answer

All of the above

Question 8

Which of the following is NOT a rare histological variant of carcinoma breast with a better prognosis?

Accepted Answer

Inflammatory carcinoma

Answer

Colloid carcinoma

Answer

Medullary carcinoma

Answer

Tubular carcinoma

Question 9

A 22-year-old woman nursing her newborn develops a tender erythematous area around the nipple of her left breast. A thick, yellow fluid is observed to drain from an open fissure. Examination of this breast fluid under the light microscope will most likely reveal an abundance of which of the following inflammatory cells?

Accepted Answer

Neutrophils

Answer

B lymphocytes

Answer

Eosinophils

Answer

Mast cells

Question 10

Which of the following are germ cell tumors of the testis?

Accepted Answer

Gynandroblastoma

Answer

Seminoma

Answer

Teratoma

Answer

Leydig cell tumor

Reproductive Pathology — MCQs

Reproductive Pathology — MCQs

On this page

Practice by Chapter

Want unlimited practice?