Breast: clinical anatomy: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Anatomy · Breast: clinical anatomy

Sample item

A 50-year-old woman has a firm breast lump with skin dimpling over it. A second woman has diffuse skin thickening with pitting like an orange peel. Which anatomical changes explain the two signs respectively?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Tumour traction on the suspensory ligaments of Cooper; obstruction of dermal lymphatic channels

The suspensory ligaments of Cooper run from the deep fascia to the skin through the breast, so a tumour that shortens them tethers the skin and causes dimpling. Peau d'orange results from carcinomatous blockage of dermal lymphatics, producing oedema with skin held down at the hair follicles. Nipple retraction is due to involvement of the lactiferous ducts.

Option by option

  • A. Tumour traction on the suspensory ligaments of Cooper; obstruction of dermal lymphatic channels (correct)

    Correct. Ligament traction causes dimpling and lymphatic obstruction causes peau d'orange.

  • B. Contraction of the pectoral fascia; blockage of the axillary vein

    Pectoral fascia fixation limits mobility on muscle contraction, and axillary vein blockage causes arm swelling.

  • C. Obstruction of dermal lymphatic channels; tumour traction on the suspensory ligaments of Cooper

    This reverses the mechanisms, and lymphatic obstruction does not produce a localised dimple.

  • D. Infiltration of the lactiferous ducts; venous congestion of the subareolar plexus

    Duct infiltration causes nipple retraction, and venous congestion does not cause peau d'orange.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anatomy questions

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is A, Tumour traction on the suspensory ligaments of Cooper; obstruction of dermal lymphatic channels. The suspensory ligaments of Cooper run from the deep fascia to the skin through the breast, so a tumour that shortens them tethers the skin and causes dimpling.

Why is "Contraction of the pectoral fascia; blockage of the axillary vein" not the answer?

Pectoral fascia fixation limits mobility on muscle contraction, and axillary vein blockage causes arm swelling.

Why is "Obstruction of dermal lymphatic channels; tumour traction on the susp…" not the answer?

This reverses the mechanisms, and lymphatic obstruction does not produce a localised dimple.

Why is "Infiltration of the lactiferous ducts; venous congestion of the subar…" not the answer?

Duct infiltration causes nipple retraction, and venous congestion does not cause peau d'orange.

What concept does this question test?

It tests Breast: clinical anatomy in Anatomy. Peau d'orange results from carcinomatous blockage of dermal lymphatics, producing oedema with skin held down at the hair follicles. Nipple retraction is due to involvement of the lactiferous ducts.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Breast: clinical anatomy?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.