Misc

Question 1

What are the most common sites of breast cancer metastases?

Answer 1

Bone, lung and liver

Question 2

The rate of breast cancer relapse is highest in the first X years

Answer 2

5 years - more than half of these recurrences occur in the first 3 years

Question 3

If a pt undergoes breast conservation therapy, when should the first follow-up diagnostic mammogram should be?

Answer 3

6 months

Question 4

If a pt previously received breast conservation recurrs, what should be the next surgery

Answer 4

Mastectomy

Question 5

Should one resect chest wall recurrence of breast CA?

Answer 5

If it can be completely excised -yes. Otherwise consider XRT and definitely chemotherapy

Question 6

Risk factors for male breast CA

Answer 6

Abnl estrogen and androgen balance, increase in estrogen (e.g. cirrhosis and obesity), Klinefelter syndrome, BRCA2, fx

Question 7

What testicular abnl are associated with an increased risk of breast CA in men?

Answer 7

Undescended testes, congential inguinal hernia, mumps orchitis after age 20, orchiectomy and infertility

Question 8

Klinefelter syndrome is associated with what-fold increase in male breast CA?

Answer 8

50-fold increase

Question 9

Is gynecomastia a risk factor for male breast CA?

Answer 9

No

Question 10

Is fx a risk factor for male breast CA?

Answer 10

Yes. 15-20% of pts have a positive family hx

Question 11

What is significant about BRCA2 associated male breast CA?

Answer 11

Men present at a younger age, often with bilateral disease, poorer survival

Question 12

90% of all male breast cancers are what histological sub-type?

Answer 12

Invasive ductal carcinoma. Remaining 10% is DCIS.

Question 13

Why is male lobular carcinoma rarely seen

Answer 13

Men don’t have terminal lobules in the normal male breast

Question 14

What is the work-up for male breast CA?

Answer 14

The same as women. H&P, mammogram, US if indicated, bx. Metastatic work-up for more advanced disease.

Question 15

What is the prognosis for male breast CA?

Answer 15

Same as women, although men tend to present at later stages

Question 16

What is the treatment for male breast CA?

Answer 16

Mastectomy and axillary lymph node dissection

Question 17

What is the first-line adjuvent therapy for male breast CA?

Answer 17

Hormonal therapies because most tumors are ER positive

Question 18

What is the risk of developing contralateral breast CA in men?

Answer 18

30-fold increased risk

Question 19

If studies demonstrated no difference between adjuvent and neoadjuvent therapy, what is the benefit of neoadjuvent?

Answer 19

Pts who develop a pathologic complete response at the time of surgery have demonstrated a survival benefit.

Question 20

If a SLNBx is + for MACROmetastatic dz, what % of cases will have additional positive LNs during an axillary dissection?

Answer 20

50% of cases with a positive SNLBx will have additional LN involved with metastatic disease

Question 21

If a SNLBs is + for MICROmetastatic dz, what % of cases will have additionally affected LN after an axillary dissection?

Answer 21

10-15% of cases will have additionally affected LNs found after an axillary dissection

Question 22

What are the complications following a SNLBx?

Answer 22

Wound infection, hematoma, seroma, paresthesias, lymphadema, decreased ROM.