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+--- Thread: breast 1 - sami2004 (/showthread.php?tid=538359)
breast 1 - sami2004 - ArchivalUser - 10-05-2010
A 54-year-old woman presents with a breast mass she discovered 2 days ago. She has been performing breast self-examinations monthly and noted a new mass in the upper outer quadrant of her left breast. She denies having any breast pain or nipple discharge. She has experienced no weight loss, headache, shortness of breath, or bony pain. On examination, she is found to have a 0.5 cm × 1 cm hard, mobile mass that is easily palpated. No skin abnormalities or other masses are detectable by palpation in either breast. There is no axillary or supraclavicular lymphadenopathy, and the remainder of a detailed physical
examination is normal. A biopsy is performed of the patient's breast mass, which is found to have infiltrating ductal carcinoma. Results of a complete blood count, liver function tests, and metabolic panel are all within normal limits.
At this point, the interventions that would provide the best survival and least morbidity for this patient include which of the following?
A. Modified radical mastectomy
B. Lumpectomy with axillary lymph node dissection
C. Radiation therapy
D. Modified radical mastectomy and radiation therapy
E. Lumpectomy with axillary lymph node dissection and radiation therapy
0 - ArchivalUser - 10-05-2010
E..
0 - ArchivalUser - 10-05-2010
smking is a another topic to know
A 44-year-old man comes to your clinic with questions about smoking cessation; he has smoked one and a half packs of cigarettes a day for the past 25 years. His father recently died of lung cancer, and your patient has decided to quit smoking. He wants to know about his risk of developing lung cancer.
Which of the following statements concerning the risk of this patient's developing lung cancer is true?
A. His risk would be no higher if he had smoked two packs a day than if
he had smoked one pack a day.
B. If he does quit smoking now, in 20 years his risk of lung cancer will be
the same as a man of the same age who never smoked.
C. With regard to his risk of lung cancer, it makes no difference whether
he stops smoking now or in 10 years.
D. Even though he may quit smoking now, his risk of lung cancer will
continue to rise with age.
E. When assessing risk of lung cancer, it does not matter at what age he
started smoking.
0 - ArchivalUser - 10-05-2010
E..
0 - ArchivalUser - 10-05-2010
E and B
0 - ArchivalUser - 10-05-2010
answer?
0 - ArchivalUser - 10-05-2010
E..
0 - ArchivalUser - 10-05-2010
E & B?
0 - ArchivalUser - 10-05-2010
The local management of early breast cancer has changed significantly in recent years, as
breast-conservation therapy (BCT) has been shown to have survival rates identical to those
of more extensive surgeries, such as radical mastectomy and modified radical mastectomy
(MRM). In multiple clinical trials, a combination of lumpectomy and radiation therapy
has yielded survival rates equivalent to those of MRM. Radiation therapy is a critical component of BCT because it reduces the recurrence rate from 40% to less than 10%. Axillary node dissection is important in diagnosis because positive nodes confer a worse prognosis and would prompt systemic chemotherapy. Sentinel node biopsy, in which the dominant axillary node is sampled and examined for tumor, is currently under investigation.
If the sampled sentinel node is negative for tumor, the patient is spared the axillary node dissection and its morbidity. In general, BCT is preferred to MRM; MRM is indicated in cases
in which radiation is contraindicated (such as in patients who have previously undergone
breast irradiation or who are pregnant), in cases in which there is multifocal disease, or in
cases in which there is strong patient preference.
(Answer: E—Lumpectomy with axillary lymph node dissection and radiation therapy)
2ND QUES
The following smoking factors have been identified as increasing lung cancer risk: aggregate
amount of smoking; early onset of smoking; deeper inhalation; use of unfiltered cigarettes;
high tar and nicotine content; and increasing age. A person who quits smoking
does see a mortality benefit compared with someone of the same age who continues to
smoke; however, the risk never returns to that of a lifelong nonsmoker. In addition, an
American Cancer Society study showed that quitting at an earlier age (30 to 49 years)
reduces risk more than quitting at a later age (50 to 64 years).
(Answer: D—Even though he may quit smoking now, his risk of lung cancer will continue to rise with age)