Breast Imaging (Mammography, BI-RADS, Ultrasound, MRI) MCQs

Radiology · 18 free questions with answers & explanations.

1. A 52-year-old woman undergoes screening mammography showing a 1.2 cm irregular mass with spiculate margins in the left upper outer quadrant and ipsilateral axillary lymphadenopathy. The ACR BI-RADS category assigned should be:
2. On breast ultrasound, a lesion is described as wider-than-tall, with a circumscribed margin, uniform low-level internal echoes, and posterior acoustic enhancement. The BI-RADS category most appropriate and the likely diagnosis are:
3. Which mammographic finding is MOST strongly associated with ductal carcinoma in situ (DCIS)?
4. Breast MRI is performed for pre-operative staging. A 1.5 cm lesion shows rapid initial enhancement (>100% signal increase in the first 2 minutes) followed by wash-out kinetics on the delayed phase. According to ACR BI-RADS MRI lexicon, this kinetic curve is classified as:
5. A 35-year-old BRCA1 carrier undergoing screening has dense breasts on mammography (ACR density category D). Guidelines recommend supplemental screening with:
6. A 52-year-old woman's screening mammogram shows a 12 mm irregular mass with spiculated margins and associated pleomorphic microcalcifications in the upper outer quadrant. According to ACR BI-RADS, what is the correct assessment category?
7. On breast MRI, a 15 mm lesion in the left breast shows rapid initial enhancement followed by washout kinetics (type III curve). Which characteristic best indicates malignancy on dynamic contrast-enhanced MRI (DCE-MRI)?
8. A 45-year-old woman's mammogram shows grouped fine linear branching microcalcifications in a segmental distribution. Which BI-RADS descriptor best characterizes these calcifications, and what is the clinical implication?
9. On breast ultrasound, a hypoechoic mass with an irregular shape, angular margins, and posterior acoustic shadowing is observed. According to BI-RADS ultrasound lexicon, this lesion would most appropriately be categorized as:
10. A 52-year-old woman's screening mammogram shows a 1.2 cm irregular mass with spiculated margins at 2 o'clock in the right breast. No prior imaging is available. According to ACR BI-RADS lexicon, what category should this be assigned?
11. On breast MRI for high-risk screening, a 0.8 cm focus shows a type III kinetic curve (rapid initial enhancement followed by washout) and irregular morphology. What does the type III kinetic pattern indicate?
12. A 45-year-old woman presents with a palpable lump. Ultrasound shows a 2 cm oval hypoechoic mass with parallel orientation, circumscribed margins, and posterior acoustic enhancement. Which BI-RADS category and recommendation are most appropriate?
13. Which of the following patterns of calcification on mammography is most suspicious for ductal carcinoma in situ (DCIS)?
14. A 39-year-old woman with BRCA1 mutation undergoes annual surveillance. Her heterogeneous fibroglandular breasts are classified as ACR density category C. Which supplemental screening modality has the highest sensitivity for cancer detection in this context?
15. A 50-year-old woman undergoes screening mammography. A 12 mm spiculated mass with associated fine pleomorphic calcifications is identified in the upper outer quadrant of the right breast. According to ACR BI-RADS (5th edition), what is the appropriate BI-RADS category and recommended action?
16. On breast ultrasound, a lesion is described as oval, circumscribed, parallel orientation (wider than tall), homogeneous, mildly hypoechoic with posterior acoustic enhancement. These features are MOST consistent with:
17. A 45-year-old woman with BRCA1 mutation undergoes screening breast MRI. The most important indicator of malignancy on dynamic contrast-enhanced breast MRI is the type of kinetic curve pattern. Which pattern is MOST associated with malignancy?
18. Routine mammography in a 55-year-old woman shows diffuse bilateral skin thickening, trabecular thickening, and axillary lymphadenopathy WITHOUT a discrete mass. The most common cause of bilateral diffuse mammographic skin thickening is: