Benign Breast Disease and Breast Cancer

Question 1

True or false: Breast cancer is the most common cause of female cancer in the US?

Answer 1

True

Question 2

Breast cancer is the ____ most common cause of cancer related death in women?

Answer 2

second

Question 3

True or false: Breast cancer is the main cause of death among women age 45 - 59

Answer 3

True

Question 4

What is the most common breast tumor?

Answer 4

Fibroadenoma

Question 5

At what age does ACOG recommend starting screening mammographies and at what frequency?

Answer 5

40 yrs, q 1 - 2 years

Question 6

At what age does ACOG recommend ending screening mammographies?

Answer 6

75 yrs

Question 7

What is the biggest risk factor in terms of relative risk for developing breast cancer?

Answer 7

Age

Question 8

When do you start screening high risk patients

Answer 8

25 years with yearly mammogram and MRI

*BRCA and previous chest radiation

Question 9

What does BIRADS 0 mean?

Answer 9

Need for additional imaging

Question 10

What does BIRADS 1 mean?

Answer 10

negative, routine screening recommended

Question 11

What does BIRADS 2 mean?

Answer 11

benign, routine screening recommended

Question 12

What does BIRADS 3 mean?

Answer 12

probably benign, repeat mammogram in 6 months

Question 13

What does BIRADS 4 mean?

Answer 13

Suspicious, get a biopsy

Question 14

What does BIRADS 5 mean?

Answer 14

Highly suspicious, get a biopsy

Question 15

What does BIRADS 6 mean?

Answer 15

Known proven biopsy, surgical excision

Question 16

What are the most specific mammographic feature of breast cancer?

Answer 16

Spiculated mass, clustered microcalcifications

Question 17

What is the first step in management in a patient < 30 yrs with a palpable mass?

Answer 17

Ultrasound

Question 18

When should you biopsy a mass in a patient < 30 yrs following ultrasound?

Answer 18

If mass is solid, complex or cystic with symptoms

Question 19

What is the next step in management if you do a FNA on a cystic mass in a patient < 30 and the fluid is bloody?

Answer 19

Core biopsy or excision

Question 20

What is the first step in management in a patient > 30 yrs with a palpable mass?

Answer 20

Diagnostic mammogram

Question 21

What is the first step in management of a patient < 30 yrs with spontaneous nipple discharge?

Answer 21

Ultrasound

Question 22

What is the first step in management of a patient > 30 yrs with spontaneous nipple discharge?

Answer 22

Mammogram

Question 23

If a patient has spontaneous nipple discharge from one duct or it is bloody what is the next step in management?

Answer 23

biopsy

Question 24

Management of Lobular in situ?

Answer 24

close surveillance

Question 25

Management of ductal in situ?

Answer 25

Lumpectomy

Question 26

True or False: Lumpectomy + radiation therapy has equivalent survival rates to mastectomy

Answer 26

True

Question 27

Definition of stage I breast cancer

Answer 27

Tumor < 2 cm, negative nodes

Question 28

Definition of stage II breast cancer

Answer 28

Tumor > 2 cm but < 5 cm, positive Ipsilateral and mobile nodes

Question 29

Definition of stage III breast cancer

Answer 29

Tumor > 5 cm in greatest dimension

Question 30

Definition of stage IV breast cancer

Answer 30

Tumor of any size with direct extension to the chest wall and/or skin ulcerations with skin nodules

Question 31

When should you do adjuvant chemotherapy in a breast cancer patient?

Answer 31

Premenopausal, young, ER/PR negative, positive lymph nodes, tumor size > 1 cm

Question 32

When should you consider neoadjuvant chemotherapy

Answer 32

Large tumor size

Question 33

What is the most common type of invasive breast cancer?

Answer 33

invasive ductal carcinoma

Question 34

True or false: Ductal carcinoma occurs in younger patiensts

Answer 34

True

Question 35

What are the treatment options for ER PR positive breast cancers?

Answer 35

Tamoxifen, Aromatase inhibitors or ovarian ablation/suppression

Question 36

What are the treatment options for Her 2 receptor positive?

Answer 36

Herceptin/Trastuzamab

Question 37

What is the most common chemotherapy used to treat breastcancer?

Answer 37

Doxorubicin with Taxane

Question 38

What is a main side effect of AIs?

Answer 38

bone and joint pain, increased risk osteoporosis

Question 39

Ideal treatement regimen for SERMS and AIs?

Answer 39

5 years of SERMS then switch to AI

Question 40

What are the two main risk factors for recurrence?

Answer 40

Number of positive lymphnodes and size of tumor

Question 41

What is the most predictive factor for recurrence?

Answer 41

number of positive lymph nodes

Question 42

What is the most common location for recurrence?

Answer 42

chest wall post mastectomy

Question 43

What is the most common nodal location for recurrence?

Answer 43

Supraclavicular

Question 44

What is the median time to recurrence?

Answer 44

2-3 years