Module #3: Making the diagnosis – how we find and stage breast cancers
Module #3: Making the diagnosis – how we find and stage breast cancers >> Introduction to Breast Cancer
TOTAL POINTS 10
1.The most common lymph nodes involved in breast cancer are:
1 point
Cervical
Supraclavicular
Infraclavicular
2.Do mammograms save lives?
1 point
YES, but the risk reduction for mortality is greatest in women between the ages of 60-69
YES, but only in women with breasts that are not dense
YES, mammography is associated with a lower risk of death in all women over the age of 40
NO, there have been no objective data to show a survival benefit
3.Which of the following descriptions of a mass on ultrasound is the most worrisome for a breast cancer?
1 point
Irregular, taller-than-wide, hypoechoic (grey) mass
Smooth, hyperechoic (white) mass
Lobulated, smooth, wider-than-tall hypoechoic (grey) mass
Smooth, well marginated, oval, anechoic (black) mass
4.Which of the following is NOT an indication for breast MRI?
1 point
When cancer is close to the chest wall, and you want to see if it has grown through the muscle
When cancer is found in the axillary nodes, but mammogram and ultrasound are negative (undiagnosed primary)
When patients have implants to look for a leak or rupture
When patients have distant metastatic breast cancer
5.A patient is given a BIRADS 3 on her mammogram. What does this mean?
1 point
It is indeterminate (the risk of cancer is <0.05%), and follow up with yearly mammogram is recommended
It is probably benign (the risk of cancer is about 10%), but should be biopsied just in case
It is probably malignant (the risk of cancer is 25-50%), and should be removed surgically
It is probably benign (the risk of cancer is <2%), but should be followed up with a repeat mammogram in 6 months
6.Core needle biopsies are the main biopsy technique used in the diagnosis of breast cancer. Which of the following is the main disadvantage of this technique?
1 point
It doesn’t provide architecture
Cancer cells can spread along the needle track, causing more cancers
It can’t be done in the office
It’s a bigger needle than an FNA
7.In the new AJCC 8th edition staging system, all of the following are considered EXCEPT:
1 point
Grade
Hormone receptor status
Histologic subtype
Oncotype score
8.A patient has a pathology report that finds isolated tumor cells (< 0.2 mm) in two lymph nodes. What is her N stage?
1 point
N0; node negative
N1; node positive
N2; node positive
N3; node positive
9.A patient presents to you with a 1.9 cm invasive cancer found on her mammogram. You can’t feel any abnormal lymph nodes in her armpit. She is worried about distant spread. What do you tell her?
1 point
You have Stage 2 disease clinically. The chances of you having breast cancer in a distant organ like your bones, lungs, or liver is about 20%. We can do a bone scan and CT scan of your chest and abdomen to see if you have distant disease.
You have Stage 1 disease clinically. The chances of you having breast cancer in a distant organ like your bones, lungs, or liver is about 10%. We can do a bone scan and CT scan of your chest and abdomen to see if you have distant disease.
You have Stage 1 disease clinically. The chances of you having breast cancer in a distant organ like your bones, lungs, or liver is less than 2%. There is no need to do a bone scan and CT scan of your chest and abdomen to see if you have distant disease.
You have Stage 2 disease clinically. The chances of you having breast cancer in a distant organ like your bones, lungs, or liver is less than 5%. We could do a bone scan and CT scan of your chest and abdomen to see if you have distant disease, but I’m not sure your insurance will cover it.
10.A patient has 14 cm of DCIS (ductal carcinoma in situ); her lymph nodes were negative. What is her stage?
1 point
Stage 0
Stage 1
Stage 2
Stage 3
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