Breast and endocrine surgery: Zuska disease: practice question

A General Surgery 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.

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General Surgery · Breast and endocrine surgery: Zuska disease

Sample item

A 35-year-old smoker has recurrent subareolar abscesses with a chronic fistula tracking to the edge of the areola. What is the underlying pathology?

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

The answer and the reasoning

B. Squamous metaplasia of lactiferous ducts with keratin plugging

Zuska disease (recurrent periareolar abscess with a mammary duct fistula) arises from squamous metaplasia of the lactiferous duct, with keratin plugs that block drainage and cause infection. Smoking is a risk factor, and the diseased duct system must be excised for cure.

Option by option

  • A. Intraductal papilloma with infection

    A papilloma gives nipple discharge, not recurrent fistulating abscess.

  • B. Squamous metaplasia of lactiferous ducts with keratin plugging (correct)

    Correct. Duct metaplasia and plugging cause recurrent abscesses and fistula.

  • C. Fat necrosis after trauma

    Fat necrosis gives a hard painless lump after trauma.

  • D. Granulomatous mastitis from tuberculosis

    Tuberculosis causes a chronic sinus with caseation, not this pattern.

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.

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Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Squamous metaplasia of lactiferous ducts with keratin plugging. Zuska disease (recurrent periareolar abscess with a mammary duct fistula) arises from squamous metaplasia of the lactiferous duct, with keratin plugs that block drainage and cause infection.

Why is "Intraductal papilloma with infection" not the answer?

A papilloma gives nipple discharge, not recurrent fistulating abscess.

Why is "Fat necrosis after trauma" not the answer?

Fat necrosis gives a hard painless lump after trauma.

Why is "Granulomatous mastitis from tuberculosis" not the answer?

Tuberculosis causes a chronic sinus with caseation, not this pattern.

What concept does this question test?

It tests Breast and endocrine surgery: Zuska disease in General Surgery. Smoking is a risk factor, and the diseased duct system must be excised for cure.

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 and endocrine surgery: Zuska disease?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery 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.