
M2 Breast Preformative Review Quiz
Quiz by Jenny Ousley
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A 45-year-old woman comes to the physician for a cosmetic breast surgery consultation. Physical examination shows that the areola falls below the inframammary fold at the level of the T8 dermatome. There is no erythema, fluctuance, swelling, dimpling, or lumps on either breast. The integrity of which of the following structure(s) is compromised?
A 42-year-old woman comes to the physician because of 10-day history of dysesthesia in the inner aspect of the arm and axilla. She had a total mastectomy including excision of the axillary tail (of Spence) after being diagnosed with carcinoma of the breast two weeks ago. Vital signs are within normal limits. Which of the following nerves was most likely injured during the procedure?
A 22-year-old woman comes to the physician because of a 2-month history of loss of sensation bilaterally in the nipples and areola following elective breast enhancement. Physical examination shows reduction of sensation of the skin from the areolae laterally to the midaxillary lines. There is no erythema and incisions are dry and healing. Which of the following nerves were most likely subject to iatrogenic injury?
A 55-year-old woman comes to the physician because of a painful lump in her right breast and a bloody discharge from her right nipple. Physical examination shows unilateral inversion of the nipple with an orange-peel appearance of the skin (peau d’orange) in the vicinity of the areola. Mammogram shows a tumor in the right upper quadrant of the breast. Which of the following best explains the inversion of her nipple?
A 56-year-old woman presents to the physician with pain and weakness in the right shoulder. Two weeks ago, the patient underwent a radical mastectomy with extensive axillary dissection after being diagnosed with carcinoma of the right breast. Physical examination shows winging of the scapula when she pushes against the wall. Injury to which of the following nerves would result in this condition?

A 42-year-old man comes to the physician for abdominal pain. He is diagnosed with liver and pancreatic disease as a result of alcoholism. Physical examination shows an enlargement of his mammary glands, as a secondary result of his disease process. Which of the following clinical conditions will most likely describe this case?
A 47-year-old woman comes to the physician for an abnormal change in her right breast. The patient does not have a family history of cancer but has drunk a bottle of wine every day for 10 years. Physical examination shows peau d’orange characteristics in her right breast. This condition is primarily a result of which of the following occurrences?Â
A 35-year-old woman comes to the physician after finding a small mass in her right breast when performing a self-examination while taking a shower. Mammogram shows mass about 1 cm in diameter slightly above, and lateral, to her right areola. She underwent lymph node biopsy and a specific dye was injected into the tissue around the tumor, which was taken up by the lymph vessels, draining the area. The vessels were traced to surgically expose the lymph nodes receiving the lymph from the tumor. Which nodes will most likely first receive lymph from the tumor?Â
A 32-year-old woman comes to the physician for a follow-up examination. One month ago, she underwent surgical dissection of her right axilla for the removal of lymph nodes for staging and treatment of her breast cancer. She has weakness and pain of her right shoulder and has difficulty raising her left arm above her head when combing her hair. Physical examination shows medial scapular winging accentuated when the patient is asked to push against a wall. In a subsequent consult visit with her surgeon, she was told that a nerve was injured during the surgical procedure. What is the origin of the injured nerve?