SURG3 Flashcards by Abby David

Absence of the breast development or amastia occurs when there is an arrest in the development of mammary ridge during the

A. 6th week of fetal development
B. 12th week of fetal development
C. 24th week of fetal development
D. 36th week of fetal development

A. 6th week of fetal development

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A baby was born with multiple nipples along the anterior chest and was further assessed to have bilateral renal hypoplasia. What is the syndrome demonstrated in this patient?

A. Turner’s syndrome
B. Down’s syndrome
C. Fleischer’s syndrome
D. Poland’s syndrome

C. Fleischer’s syndrome

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A 35-year-old woman visits her physician after her initial mammogram, which was normal, and asks her lifetime chance of developing breast cancer is. She has no personal history of breast disease. Her menarche occurred at age 13 and her first child was born when she was 22. She has never taken oral contraceptives. Which of the following is not a factor in estimating the Gail risk?

A. Age
B. History of present biopsy
C. Prior history of radiation exposure
D. Age at menarche

C. Prior history of radiation exposure

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A germline mutation in BRCA1 or BRCA is associated with all of the following characteristics, EXCEPT

A. Autosomal dominant transmission
B. Higher incidence of breast and ovarian cancer in women
C. Higher than average incidence of breast cancer in men 100-fold increase
D. Late-onset breast cancer

D. Late-onset breast cancer

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With regards to breast carcinoma in men, which of the following is true?

A. Detected mostly in men aged 60-70
B. Gynecomastia is a risk factor
C. Commonly associated with a mutation in BRCA1 gene
D. The stage is worse for women

A. Detected mostly in men aged 60-70

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A 58-year-old woman has a chronic erythematous, oozing, eczematoid rash involving her left nipple and areola. There were no palpable breast masses, and the findings on a recently obtained mammogram were normal. Which of the following recommendations is appropriate?

A. Refer to a dermatologist
B. Oral vitamin E and topical aloe and lanolin
C. Punch biopsy
D. Trial of cortisone

C. Punch biopsy

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Which of the following is NOT a characteristic of medullary breast cancer?

A. Lymphocytic infiltrate
B. Benign appearance on UTZ
C. High rate of metastasis on LN
D. Statistically better than average prognosis

C. High rate of metastasis on LN

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A 44-year-old woman has a tender movable mass at 12 o’clock position on her left breast. Mammogram shows 2.5-cm well-circumscribed density on the area under palpation. Ultrasound shows a 3-cm cyst. What is recommended?

A. Excisional biopsy
B. Ultrasound-guided core needle biopsy
C. Tamoxifen
D. Fine needle aspiration

D. Fine needle aspiration

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Which of the following is not true regarding MRI for breast anomalies?

A. Useful for finding primary breast lesion
B. It is more accurate than mammography in establishing the extent of disease
C. More accurate than mammography in assessing extent in older women
D. Sensitivity in detecting cancer is 90%

C. More accurate than mammography in assessing extent in older women

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A 55-year-old was found on examination to have a 3-cm mass with palpable axillary lymph nodes.
Underwent modified radical mastectomy. A 3.2-cm infiltrating intraductal carcinoma with 5/15 lymph node
positive metastasis. Negative laboratory studies and normal imaging. What is the TNM staging?

T2N2M0

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In which patient should MRI be used as an adjunct to mammography for breast cancer screening purposes?

A. A 27-year-old woman whose mother was
diagnosed with breast cancer at the age of 52
B. A 52-year-old woman who has moderately dense breast
C. A 72-year-old woman with a history of DCIS
D. A 31-year-old woman whose sister carries the BRCA mutation but has declined genetic testing for herself

D. A 31-year-old woman whose sister carries the BRCA mutation but has declined genetic testing for herself

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Which of the following risks is not elevated with the use of Tamoxifen?

A. Stroke
B. DVT
C. Endometrial cancer
D. Ischemic heart disease

D. Ischemic heart disease

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Which of these patients would benefit total breast excision over fistulectomy?

A. 63 y/o with nipple inversion
B. 32 y/o with no history of fistulectomy
C. 55 y/o with small abscess
D. 60 y/o with recurrent abscess on the same site

A. 63 y/o with nipple inversion

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A 25-year-old female with a 3-cm heard mass on her right breast. The mass was diagnosed to be a fibroadenoma. Which of the following is not an appropriate treatment for the patient?

A. Observation
B. Excision
C. Cryoablation
D. Tamoxifen

D. Tamoxifen

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Which of the following breast disease puts a male in highest risk to develop breast cancer?

A. Sclerosing adenosis
B. Florid hyperplasia
C. Intraductal papilloma
D. Fibroadenoma

B. Florid hyperplasia

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A 35-year-old female was noted to have BRCA1 gene mutation. What is the best recommendation for her regarding her increased risk of breast cancer?

A. Observation only
B. Mammogram every 6 months until 50 years of age, then annually
C. Prophylactic bilateral mastectomy and bilateral oophorectomy
D. MRI of the breast every 6 months and intake of Tamoxifen for 5 years

C. Prophylactic bilateral mastectomy and bilateral oophorectomy

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In the ANDI classification, a 4-cm fibroadenoma is considered as

A. normal
B. a disorder
C. a disease
D. a premalignant lesion

C. a disease

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Difference between Sentinel Lymph Node Biopsy over Axillary Lymph Node Dissection

A. Accuracy in determining the N stage
B. Lesser reported lymphedema
C. Lesser cost
D. Can be done for biopsy proven malignant axillary ymph node

B. Lesser reported lymphedema

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Which factor is an advantage of core needle biopsy for breast tumor over fine needle biopsy?

A. Cytopathologist is required Fine needle
B. Allow on-site diagnosis
C. Allows ER/PR/Her2neu staining
D. Less painful

C. Allows ER/PR/Her2neu staining

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The most appropriate management for a cystosarcoma phyllodes or phyllodes tumor?

A. Chemotherapy
B. Wide excision
C. Radiotherapy

B. Wide excision

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This nerve provides sensory innervation to the breast

A. Thoracodorsal nerve
B. Long thoracic nerve branches
C. Lateral mammary nerve branches
D. Intercostal nerve branches

C. Lateral mammary nerve branches

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Anatomically, the Rotter’s nodes are classified as

A. level I ALN
B. level II ALN
C. level III ALN
D. level IV ALN

B. level II ALN

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What is the advantage of aromatase inhibitors over tamoxifen?

A. Lower risk of myalgia
B. Lower risk of osteoporosis
C. Lower cost of medication
D. Lower risk of thromboembolic events

D. Lower risk of thromboembolic events

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Which lymph node group receives the most lymph drainage from the upper extremity and breast?

A. Pectoral lymph node group
B. Lateral axillary lymph node group
C. Scapular lymph node group
D. Central lymph node group

B. Lateral axillary lymph node group

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A 50-year-old woman had her initial screening mammogram and has a result of BIRADS 0. What is the most appropriate next step? A. Observe B. Repeat mammogram in 6 months C. Ultrasound of the breasts D. Advice stereotactic biopsy

C. Ultrasound of the breasts

Which of these mammographic findings are associated with breast cancer? A. Coarse calcifications B. Pleomorphic microcalcifications C. Well-defined borders D. Central vascularity

B. Pleomorphic microcalcifications

Given the following data what stage of breast cancer is 2.5 cm in size, Nottingham score 3, (+) 4/15 axillary lymph nodes negative distant metastases ER/PR positive HER2neu positive A. IA B. IIB C. IIIA D. IIIB

B. IIB T2N2M0 = IIA

A 52-year-old female underwent screening mammography which showed microcalcifications on the left breast, BIRADS category 5 lesion, which of the following management is appropriate? A. Observation B. FNAB C. Ultrasound-guided incision biopsy D. Stereotactic core biopsy

D. Stereotactic core biopsy

What does a palpable supraclavicular lymph node in breast cancer signify? A. Stage IIB breast cancer B. Stage IIIA breast cancer C. Stage IIIB breast cancer D. Stage IIIC breast cancer

D. Stage IIIC breast cancer

The following are non-hormonal risk factors for breast cancer, except A. obesity B. radiation exposure C. alcohol D. long term consumption of food with high fat content

A. obesity

Based on NCCN, they recommend that average-risk women begin annual screening mammograms at what minimum age? A. 40 B. 45 C. 50 D. 55

A. 40

BCT with BCS is the standard treatment for women with early breast cancer. There are 3 components, EXCEPT A. Neoadjuvant chemotherapy B. Lumpectomy C. SLNB D. Adjuvant radiation therapy

A. Neoadjuvant chemotherapy

This hormone is responsible for the differentiation of the epithelium and lobular development of the breasts A. Estrogen B. Progesterone C. Prolactin D. Oxytocin

B. Progesterone

Which hormone is the primary hormonal stimulus for lactogenesis in the postpartum period? A. Estrogen B. Progesterone C. Prolactin D. Oxytocin

C. Prolactin

What is the treatment of choice for recurrent periductal mastitis? A. Observation B. Antibiotics with incision and drainage C. Wide resection area D. Mastectomy

B. Antibiotics with incision and drainage

Modern therapy for breast cancer focuses on molecular markers to have treatment strategies. Which of the following statements is correct? A. Carriers of the BRCA2 mutation are more likely to have triple negative cancer B. Human epidermal growth factor HER2 positive cancers are unlikely to respond to treatment with Trastuzumab C. ER positive, HER2neu negative patients should be treated with endocrine therapy D. All breast cancers are sensitive to endocrine therapy

C. ER positive, HER2neu negative patients should be treated with endocrine therapy

Which of the following clinical characteristics of breast masses on physical exams is more suggestive of a malignant than a benign disorder A. Indistinct border surrounding the breast tissue B. Excessive motility within the breast tissue C. Tenderness over a soft mass D. Tethering of underlying muscular structure

D. Tethering of underlying muscular structure

These structures are responsible for nipple erection? A. Montgomery’s B. Meissner’s corpuscle at the dermal papilla C. Smooth muscle bundle fibers D. Cooper’s ligament along subcutaneous tissue

C. Smooth muscle bundle fibers

Which of the following epithelium line the dilated ducts or lactiferous ducts of each major duct under the nipple-areolar complex? A. Squamous epithelium B. Stratified squamous epithelium C. Cuboidal epithelium D. Columnar epithelium

B. Stratified squamous epithelium

The average female breast extends the following borders, EXCEPT A. 2nd or 3rd rib B. 6th or 7th rib C. Anterior axillary line D. Anterior border of the sternum

D. Anterior border of the sternum

Which of the following Axillary Node Group is incorrectly paired? A. Level I: Axillary Lymph Node (Lateral Group) B. Level II: Interpectoral Group (Rotter’s Nodes) C. Level III: Central Group D. Level III: Subclavicular Group (Apical)

C. Level III: Central Group

What syndrome consists of hypoplasia or complete absence of the breasts, costal cartilage or rib defects, hypoplasia of the subcutaneous tissues of the chest wall, and brachysyndactyly? A. Fleischer’s syndrome B. Poland’s syndrome C. Turner syndrome D. Syndrome of amastia

B. Poland’s syndrome

What is the primary hormonal stimulus for lactogenesis? A. Progesterone B. Estrogen C. Melanin D. Prolactin

D. Prolactin

It is described as “string phlebitis”, a thrombosed vein presenting as a tender, cordlike structure A. Hidradenitis suppurativa B. Mondor disease C. Zuska’s disease

B. Mondor disease

Which classification of antiestrogen therapy is considered the first-line treatment of postmenopausal women? A. Tamoxifen B. Aromatase inhibitor C. Trastuzumab D. Pertuzumab

B. Aromatase inhibitor

Which of the following is an absolute contraindication in the treatment of cancer during pregnancy? A. Breast conservation surgery B. Modified radical mastectomy C. Chemotherapy D. Radiation therapy

D. Radiation therapy

Gynecomastia is high risk for breast cancer if A. bilateral breasts is affected B. associated with Klinefelter’s syndrome C. diagnosed during neonatal period D. women in younger age group

B. associated with Klinefelter’s syndrome

Which of the following mechanism initiates gynecomastia, except A. Deficient androgen state B. Renal failure C. Increased estradiol by testicles D. Increased testosterone level

D. Increased testosterone level

Risk management strategy for BRCA1 and BRCA2 mutation carrier involves the following, EXCEPT A. Chemoprevention B. Tamoxifen C. Bilateral mastectomy with reconstruction D. Bilateral salpingo-oophorectomy

B. Tamoxifen

A 25-year-old breast-feeding woman develops pain, erythema, and tenderness adjacent to her right nipple areolar complex. In what situation will an operative intervention be indicated for this condition? A. Preoperative imaging reveals solid mass B. Erythema resolves from the breast C. Thinning of overlying skin of affected area D. Patient develops low grade fever

C. Thinning of overlying skin of affected area

A 55 yo female patient had a tumor size of 1.8 cm and 2 positive lymph nodes on sentinel lymph node biopsy. Negative metastatic work up. What is the stage of this patient? A. IA B. IB C. IIA D. IIB

B. IB - ratio C. IIA - correct answer

The option of Sentinel Lymph Node Biopsy (SLNB) was presented to the patient for her management. In what condition is SLNB NOT recommended? A. Tumors less than 4cm B. Prior axillary surgery C. Clinically negative axillary lymph node status D. BRCA mutation carriers

B. Prior axillary surgery

This benign breast pathology is associated with the highest risk for development of breast cancer. A. Apocrine metaplasia B. Fibroadenoma C. Sclerosing adenosis D. Atypical lobular hyperplasia

D. Atypical lobular hyperplasia

A 32-year-old pregnant female was diagnosed to have breast cancer. Which is true regarding her management? A. Hormonal therapy is the initial management for the patient. B. Chemotherapy can be given during the 2nd and 3rd trimester of pregnancy. C. If tumor is small, a breast conservation surgery should be done in the 2nd trimester. D. Bilateral mammogram should be requested to check for contralateral breast lesion.

B. Chemotherapy can be given during the 2nd and 3rd trimester of pregnancy.

A 45-year-old female banker came in for consult because of a 2.5 cm breast mass noted for the last 2 year. She denies history of any medical co morbidities but has a history of breast cancer among her maternal aunts. Biopsy of the breast mass is advised for the patient. What biopsy method is best? A. Incisional biopsy B. Excision biopsy C. Fine needle aspiration biopsy D. Core needle biopsy

D. Core needle biopsy

Which among the following statements is descriptive of Mondor's disease? A. It is not visible on mammography. B. It is a self-limiting thrombophlebitis of the superficial veins of the breasts. C. These are painful, palpable cord-like structures of the breast best treated with excision. D. It is associated with deep venous thrombosis of the lower extremities.

B. It is a self-limiting thrombophlebitis of the superficial veins of the breasts.

A 59-year-old female patient with a 3cm breast mass for two (2) years, sought consult. She had cessation of menses at 50 years of age and denies history of any medical co morbidities as well as history of any cancer among her family members. At her age, what is the imaging modality of choice for the patient's breast? A. Ultrasound of the Breasts B. Mammography C. CT scan of the Chest D. MRI of the Breast

B. Mammography

A 30-year-old female was diagnosed to have Phyllodes Tumor of the breast. What is true regarding her condition? A. Treatment is excision of the tumor. B. Is often associated with nipple retraction and skin ulceration C. Usually metastasize to the axillary and supraclavicular lymph nodes D. Borderline tumors can potentially recur locally.

D. Borderline tumors can potentially recur locally.

A 25-year-old breast-feeding woman develops pain, erythema, and tenderness adjacent to her right nipple-areolar complex. What is the appropriate imaging modality to diagnose her condition? A. Mammography B. MRI of the Breasts C. Ultrasonography D. CT scan of the Chest with IV Contrast

C. Ultrasonography

Ms. Riza, a 45-year-old female, has a 3 x 3 cm palpable mass in her left breast which appears cystic on ultrasound. Needle aspiration revealed five (5) cc of dark brown fluid. A post aspiration follow-up ultrasound done showed a solid area on the cyst wall. What is the ideal next step to do? A. Observe and repeat aspiration when fluid reaccumulates B. Do needle biopsy C. Do mammography D. Do excision

B. Do needle biopsy

Ms. Lara is a 24-year-old banker who presents with a 4.5 x 5 cm freely movable well-defined solid mass on ultrasound in her left breast. What is your diagnosis? A. Ductal papilloma B. Gigantomastia C. Giant fibroadenoma D. Phyllodes tumor

C. Giant fibroadenoma

CG, a 45-year-old female with a 5 cm breast mass on the right, noted for the last 4 years, sought consult. After further evaluation and diagnostics, there is no evidence of distant spread. She underwent Modified Radical Mastectomy on the right breast. Intraoperatively, the breast mass is 4cm with multiple enlarged, movable axillary lymph nodes. What is the immediate post-operative clinical stage of the patient? A. Stage II-A B. Stage l-B C. Stage Il-B D. Stage III-A

C. Stage Il-B

GT, a 35-year-old male came in because of his progressively increasing breast size. What condition may contribute to the pathologic cause of gynecomastia in males? A. Cardiac failure B. Endogenous intake of testosterone C. Liver Cancer D. Systemic lupus erythematosus

C. Liver Cancer

A 59-year-old female, post-menopausal patient presents with a 3 cm breast mass that was first palpated about two years ago. She is hypertensive, controlled, and has no history of any cancer among her family members. Biopsy was done which revealed Invasive Ductal Carcinoma. The patient underwent Modified Radical Mastectomy. Post-operatively, patient complained of weakened shoulder adduction. What is the best explanation for her condition? A. Intraoperatively, the surgeon cut the thoracodorsal nerve. B. The long thoracic nerve was ligated during the surgery. C. The intercostobrachial nerves were not spared during the surgery. D. A large hematoma has developed at the axillary area.

A. Intraoperatively, the surgeon cut the thoracodorsal nerve.

GH, a 55-year-old female with a 4cm breast mass on the right, underwent Modified radical mastectomy as surgical management for her breast cancer. Post-operatively, she was ER (+) and PR (+) and negative for Her2/neu receptor. Axillary lymph nodes were all negative for tumor metastasis. What is the appropriate adjuvant treatment? A. Trastuzumab for one year B. Hormonal therapy only C. Chemotherapy and Hormonal therapy only D. Chemotherapy only

B. Hormonal therapy only

A 55-year-old female presented with a fungating breast tumor on the left. She was already diagnosed with breast cancer 6 months prior to consult and was advised surgery which she did not comply with. What is the most appropriate management for this patient? A. Surgery alone B. Neoadjuvant Chemotherapy + Surgery + Radiotherapy

B. Neoadjuvant Chemotherapy + Surgery + Radiotherapy

What is the proper treatment for lobular carcinoma in-situ (LCIS)? A. Chemotherapy B. Observation and close follow-up C. Bilateral mastectomy D. Radiotherapy

B. Observation and close follow-up

What is the most common cause of bloody nipple discharge in premenopausal females? A. Fibrocystic changes B. Breast cancer C. Ductal carcinoma in-situ D. Intraductal papilloma

D. Intraductal papilloma

What groups of axillary nodes should be included in a Modified Radical Mastectomy? A. Internal mammary and subclavicular group of nodes B. Interpectoral and supraclavicular group of nodes C. Central group and subclavicular group of nodes D. Interpectoral and subclavicular group of nodes

C. Central group and subclavicular group of nodes

A 62-year-old female underwent screening mammography which showed microcalcifications on her left breast. It was read as a BIRADS Category 5 lesion. Management would include: A. FNAB B. Stereotactic core biopsy C. Observe D. Ultrasound guided incision biopsy

B. Stereotactic core biopsy

A 48-year-old female with a 4cm breast mass on the right for 5 years, sought consult. She has given birth to 3 children, all via normal vaginal delivery with no complications. She had surgical menopause at 43 years old due to Uterine myoma. She denies history of any medical co-morbidities as well as history of any cancer among her family members. A mammogram was done which revealed a solid mass on the right breast categorized as BIRADS 4. What is the appropriate management for the patient? A. Do biopsy of the breast mass B. Observation C. Initiate chemotherapy for breast cancer D. Do ultrasound of the breasts

A. Do biopsy of the breast mass

Ms. L.M., a 42-year-old female, underwent Modified radical mastectomy for breast cancer. Final histopathologic report showed tumor size of 3 cm with metastasis to 11 axillary lymph nodes. No evidence of distant metastasis. What is the pathologic stage of this patient's breast cancer? A. Stage III-A B. Stage III-C C. Stage III-B D. Stage II-B

B. Stage III-C

Which among the following breast disorders is associated with 4-fold risk of breast cancer? A. Ductal carcinoma in situ B. Sclerosing adenosis C. Florid hyperplasia D. Atypical ductal hyperplasia

D. Atypical ductal hyperplasia

TY, a 45-year-old female with a 4cm breast mass on the right for 5 years was admitted for surgery. She is G2P2 and post total abdominal hysterectomy with bilateral oophorectomy with no complications. She denies history of any medical co-morbidities as well as history of any cancer among her family members. She opted for a Breast Conservation Surgery initially, however, her surgeon explained that she is not amenable for this option. Among the conditions listed here, which is a contraindication for Breast conservation surgery? A. Breast lesion is not multicentric or multifocal. B. Breast tumors larger than 4cm in size. C. Prior radiation therapy to the breast or chest wall D. Excision biopsy initially done for the ipsilateral breast with negative margins.

C. Prior radiation therapy to the breast or chest wall

The long thoracic nerve ___. A. Innervates the latissimus dorsi muscle B. Courses anterior to the axillary vein C. Innervates the serratus anterior muscle D. Transection results in difficulty in adduction of the shoulder.

C. Innervates the serratus anterior muscle

What are the most common sites of metastases of breast cancer in the order of frequency? A. Brain, Liver, Lung B. Lung, Brain, Liver C. Bone, Lung, Liver D. Liver, Lung, Bone

C. Bone, Lung, Liver

In Foote and Stewart classification, what is the most common histopathologic type of breast cancer? A. Medullary Carcinoma B. Ductal carcinoma in situ C. Invasive Ductal Carcinoma D. Invasive Lobular Carcinoma

C. Invasive Ductal Carcinoma

The axillary vein group of nodes are found lateral to the pectoralis minor muscle, these are classified as: A. Level III axillary lymph nodes B. Level I axillary lymph nodes C. Level IV axillary lymph nodes D. Level II axillary lymph nodes

B. Level I axillary lymph nodes

When normal regression of the mammary ridge fails, accessory nipples may occur along the milk line. This condition is called: A. Polymastia accessory breasts B. Polydactyly C. Poland’s syndrome D. Polythelia

D. Polythelia

These structures provide structural support of the breast: A. Montgomery tubercles B. Coopers suspensory ligaments C. Meissner’s corpuscles D. Rotter’s nodes

B. Coopers suspensory ligaments

These structures are found on the nipple-areolar complex which are the small elevations on the surface: A. Rotter’s nodes B. Coopers suspensory ligaments C. Meissner’s corpuscles D. Montgomery tubercles

D. Montgomery tubercles

Major blood supply of the breasts include: A. Posterior branches of the posterior intercostal arteries and perforating branches of internal mammary artery B. Perforating branches of internal mammary artery and highest thoracic artery C. Axillary artery and subscapular artery D. Pectoral branches of the thoracoacromial artery and long thoracic artery

B. Perforating branches of internal mammary artery and highest thoracic artery

What is responsible for the involution of the ducts and alveoli of the breasts? A. Decreased growth hormone B. Decreased prolactin levels C. Decreased oxytocin levels D. Decreased estrogen levels

D. Decreased estrogen levels

What are the borders of the breast on the horizontal plane? A. Latissimus dorsi muscle and the lateral border of the sternum B. Edge of the pectoralis major muscle and lateral border of the sternum C. Serratus anterior muscle and sternum D. Anterior axillary line and the lateral border of the sternum

D. Anterior axillary line and the lateral border of the sternum

A 25-year-old breast feeding woman develops pain, erythema and tenderness adjacent to her right nipple areolar complex. The most frequently cultured bacteria from nipple discharge of the affected breast in this condition is____. A. Enterobacteriaciae not mentioned B. Methycillin-resistant Staphylococcus aureus C. Streptococcus agalactiae D. Acid Fast Bacilli

B. Methycillin-resistant Staphylococcus aureus

A 62-year-old female underwent screening mammography which showed microcalcifications on her left breast. It was read as a BIRADS Category 5 lesion. Management would include: A. FNAB B. Observe C. Stereotactic core biopsy D. Ultrasound-guided incision biopsy

C. Stereotactic core biopsy

A 25-year old breast-feeding woman develops pain, erythema and tenderness adjacent to her right nipple areolar complex. In chronic or recurrent abscess formation, appropriate management involves: A. Mammography to define the infection B. Administration of Cefazolin C. Get Culture studies of abscess D.Mastectomy of affected breast

C. Get Culture studies of abscess

A 48-year old female with a 4cm breast mass on the right for 5 years, sought consult. She has given birth to 3 children, all via normal vaginal delivery with no complications. She had surgical menopause at 43 years old due to Uterine Myoma. She denies history of any cancer among her family members. A mammogram was done for this patient which revealed a solid mass on the right breast categorized as BIRADS 5. What is the appropriate management for the patient? A. Do biopsy of the breast mass B. Initiate chemotherapy for breast cancer C. Observation D. Do ultrasound of the breasts

A. Do biopsy of the breast mass

A 60-year old patient with a 2 cm breast mass for 3 years, sought consult. She had cessation of menses at 50 years of age and denies history of any medical comorbidities as well as history of any cancer among her family members. The long thoracic nerve ____. A. Innervates the serratus anterior muscle B. Transection results in difficulty in adduction of the shoulder C. Courses anterior to the axillary vein D. Innervates the latissimus dorsi muscle

A. Innervates the serratus anterior muscle