Breast Disease

Management

100

A breastfeeding mother presents with a 5 cm firm, fluctuant, tender, erythematous area of her left breast at the 0300 position, 3 cm from the areola. What imaging modality is most appropriately to confirm the likely diagnosis?

Breast Ultrasound

Dx = Breast Abscess

200

A patient has this risk of underlying breast cancer with a BIRADS score of 5

>95%

300

This adjuvant hormonal therapy is used following identification/management of estrogen/progesterone positive breast cancers.

Tamoxifen (pre or post-menopausal)

400

A female with known germline-caused progesterone and estrogen receptor negative breast cancer is most likely to be affected with what specific BRCA gene mutation?

BRCA1

BRCA2 = ER (+), PR (+) = Tamoxifen!

500

Premenopausal bilateral salpingo-oophorectomy reduces breast cancer risk by this amount in patient's with hereditary breast-ovarian cancer syndrome.

37 to 72%

90% reduction in breast cancer risk with bilateral mastectomy

Nipple Discharge

100

Evaluation of nipple discharge begins with this first.

Breast examination

200

Dark green nipple discharge is related to the content of this within the discharge

Cholesterol diepoxides

300

This test should be performed following initial evaluation of bilateral, expressible only nipple discharge

Hemoccult test

If (-) = reassure

If (+) = imaging

400

Most pathologic nipple discharges are caused by this

Benign Intraductal Papilloma

500

Which 3 preliminary laboratory tests should be ordered to further investigate spontaneous, multi-duct non-bloody nipple discharge? 

Prolactin

bHCG

TSH

Miscellaneous

100

This is the most common benign breast disease in young women

Fibroadenoma

200

Paget's disease of the nipple is associated with this underlying pathology in 66% of affected individuals

DCIS (66%)

Invasive cancer (33%)

300

Infiltrating ductal carcinoma constitutes this percentage of invasive breast cancer diagnoses

80%

400

A 68 year patient with recently diagnosed and managed estrogen receptor positive invasive breast cancer should be on this adjuvant hormonal therapy category whom previously was evaluated for post-menopausal bleeding 3 years ago

Aromatase inhibitor 

Anastrozole, Letrozole, Exemestane

500

This is the strongest risk factor associated with development of breast cancer

female gender

Screening

100

Per ACOG, what ages are recommended to discuss/recommend breast cancer screening

Age 40-74

If lifetime risk >20% = MRI

200

This imaging modality is most appropriate for a patient with lifetime risk of breast cancer >20%

MRI

300

This breast cancer risk model is best suited for a 40 year old female with a family history of first degree relative with male breast cancer and multiple bilateral breast cancer diagnoses

BRCAPRO, Tyrer-Cuzick, BOADICEA

400

This modulator should be considered when 5 year risk of breast cancer in females over age 35 exceeds 1.7%

Tamoxifen

500

Breast cancer risk is reduced by this much when screening is started at the age of 50

27%

PGY-3 Fun Facts

100

This resident always wins the team spirit award

Cat

200

This individual recently confirmed their seventeenth fellowship interview

Gabi

300

This resident broke their leg, hand, and received braces within a 2 week time frame.

Kyle. 

6th grade was not fun. 

400

This resident sold their post-hole digging machine following a deck building incident in 2020. 

Baracy

500

This resident previously played in soccer tournaments around the world

Gabi.