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Breast for FRCS (Plast)

Breast covers aesthetic and reconstructive surgery of the breast. Augmentation includes implant choice, pocket plane and complications, including capsular contracture and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Reduction and mastopexy cover pedicle design, skin patterns and nipple viability. Reconstruction is split between implant-based techniques, with or without acellular dermal matrix, and autologous options such as the DIEP and latissimus dorsi flaps, with the timing of reconstruction around radiotherapy a recurring theme. The category also covers oncoplastic surgery, gynaecomastia, and congenital anomalies such as tuberous breast and Poland syndrome. Questions usually present a patient with a defined oncological plan and ask which reconstructive option, or which management of a complication, is most appropriate for her.

135 questions in the bank · 6 topics Updated 3 October 2026

Practise breast questions Try a free question

Topics in this domain

Breast augmentation25
Breast reduction & mastopexy25
Breast reconstruction40
Oncoplastic surgery20
Gynaecomastia12
Congenital breast (tuberous, Poland)13

What the paper tends to test

Expect reconstruction choices driven by patient factors: radiotherapy, body habitus, smoking, available donor sites and the patient’s own priorities.
The paper tends to test recognition and work-up of BIA-ALCL in a patient with a late seroma after textured implants.
Expect DIEP flap questions on perforator selection, perfusion zones, and managing venous congestion or fat necrosis.
Reduction questions usually turn on pedicle choice and nipple viability, including when a free nipple graft is the safer option.
Gynaecomastia questions test the search for an underlying cause before surgery is considered.

Classic traps and discriminators

A late seroma, classically more than a year after textured implants, should be aspirated and sent for cytology and CD30 immunohistochemistry before any revision surgery, to exclude BIA-ALCL.
Post-mastectomy radiotherapy raises complication and capsular contracture rates in implant reconstruction; the timing of reconstruction relative to radiotherapy is a common discriminator.
In Poland syndrome the sternocostal head of pectoralis major is absent, while the clavicular head is usually preserved.
Tuberous breast has a constricted base and a herniating nipple–areola complex; augmentation without releasing the constriction gives a poor result.
Gynaecomastia work-up includes a drug history and testicular examination, and a unilateral, hard or eccentric mass needs assessment to exclude male breast cancer.

Free breast practice questions

From the free sample — original, referenced, with the full explanation. Rate your confidence first.

07Breast·Breast augmentation

medium

A 29-year-old woman requests breast augmentation. She is slim, with an upper-pole pinch thickness of 1.5 cm, a stretched nipple-to-fold distance of 8 cm and loose, mildly ptotic glandular tissue with the nipple at the level of the fold.

Which implant pocket is most appropriate?

How sure are you?

08Breast·Breast reduction & mastopexy

medium

Two years after a Wise-pattern inferior-pedicle reduction a 42-year-old woman feels her breasts have dropped. The nipples point upwards above the point of maximal projection, the nipple-to-fold distance has stretched from 7 cm to 13 cm and the fold scars have risen onto the breast. Volume is satisfactory.

What is the most appropriate correction?

How sure are you?

Interactive 3D: DIEP flap

Drag to rotate, tap the hotspots, press play.

Also in this domain: TUG flap

Breast questions, answered

How should a late seroma after breast implants be investigated?

With ultrasound-guided aspiration of the fluid for cytology and CD30 immunohistochemistry before any revision surgery, to exclude BIA-ALCL. It is a typical ‘most appropriate next step’ question.

Does radiotherapy rule out implant-based reconstruction?

No, but it raises the risk of capsular contracture, infection and reconstructive failure. Questions usually ask you to weigh that risk against the alternatives, including autologous reconstruction.

Is aesthetic breast surgery in the breast or the aesthetic category?

Augmentation, reduction and mastopexy sit in the breast category of the curriculum, alongside reconstruction. The aesthetic category covers the face, body contouring and non-surgical treatments.

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