Breast Cancer

Question 1

Most common benign breast mass

Answer 1

Fibroadenoma

Question 2

Most common malignant breast mass

Answer 2

Invasive ductal carcinoma

Question 3

What imaging study is used to evaluate a palpable breast mass?

Answer 3

< 30 yo - ultrasound

> 30 yo - diagnostic mammography

Question 4

What are the breast cancer screening recommendations for BRCA carriers?

Answer 4

Alternating MRI and mammography every 6 months starting at 25-30 years

Question 5

What is the risk of a second breast cancer in BRCA carriers?

Answer 5

35% in the 10 years following initial diagnosis

Question 6

What is the percent reduction of mortality for bilateral prophylactic mastectomy in BRCA carriers?

Answer 6

> 90%

Question 7

What is the treatment for proliferative breast lesions without atypia?

Answer 7

Observation

Question 8

What is the treatment for proliferative breast lesions with atypia?

Answer 8

Increased surveillance with yearly mammograms.

Consider chemoprevention with SERM or AI.

Question 9

What are the effects of tamoxifen?

Answer 9

Antiestrogen on breast
Proestrogen on bone and endometrium
Worsening of menopausal symptoms
Increased risk of VTE and endometrial neoplasia

Question 10

What are the effects of aromatase inhibitors?

Answer 10

Menopausal symptoms
Joint and muscle pain, fractures
Mood swings, depression

Question 11

What are the risk factors for developing breast cancer?

Answer 11

Age
BRCA gene
Dense breasts
Proliferative breast lesions
Early menarche, late birth, late menopause
High BMI
OCP or hormone use