Breast & Endocrine Surgery MCQs

Surgery · 5 free questions with answers & explanations.

1. A 52-year-old postmenopausal woman presents with a 2 cm hard, irregular, non-tender lump in the upper outer quadrant of the right breast with skin tethering. Axillary lymph nodes are clinically enlarged. Triple assessment (clinical, mammography, and core biopsy) confirms invasive ductal carcinoma, ER-positive, HER2-negative. Sentinel lymph node biopsy shows 2 of 3 nodes positive for micrometastases. Which of the following best represents the standard surgical approach for the axilla in this patient?
2. A 35-year-old woman presents with a smooth, mobile, rubbery 1.5 cm lump in the left breast. Fine-needle aspiration cytology (FNAC) shows a benign epithelial lesion with biphasic pattern. USS shows a well-defined homogeneous hypoechoic lesion. She is anxious about malignancy. What is the most likely diagnosis and what is the appropriate management?
3. A 48-year-old woman presents with a 3-month history of bloody nipple discharge from the left breast. On examination no discrete lump is palpable. Mammography is normal. Ductoscopy and cytology of the discharge confirms the presence of atypical ductal cells. What is the most likely diagnosis and the definitive management?
4. A 42-year-old woman is found to have a 3 cm right thyroid nodule on routine examination. Thyroid function tests are normal. Ultrasound shows a hypoechoic nodule with irregular margins and microcalcifications. Fine-needle aspiration cytology reports a Bethesda category V (suspicious for malignancy) result. What is the most appropriate next step?
5. A 28-year-old man presents to the endocrine surgery clinic. He has a history of recurrent renal calculi and a recent fracture after minor trauma. Investigations reveal: serum calcium 3.1 mmol/L, phosphate 0.6 mmol/L, albumin 40 g/L, and serum intact PTH 145 pg/mL (reference 10–65 pg/mL). A Tc-99m sestamibi scan shows a focus of increased uptake inferior to the right lower thyroid pole. What is the diagnosis and appropriate treatment?