Q) Greenish breast discharge seen in
A. Fibrocystic ds
B. Duct Ectasia
C. Paget ds.
D. Duct papilloma
Q) True regarding Paget's disease of the breast
A. Seen in 5-10% Carcinoma breast
B. 50-60% associated with underlying mass
C. Treated by MRM always
d) Radiotherapy is the treatment of choice
Q) 47 year old premenopausal lady with a 3X 3cm left breast lump with IDC grade III, TNBC.
On examination, there is a single subcentimetric mobile soft mobile ipsilateral axillary LN palpable.
Usg nodes no loss of hilum. Management of axilla? Ans is free
c) Radiotherapy only
d) No treatment
Q) Optimal duration of tamoxifen in premenstrual women
a. 5 yrs
b. 10 yrs
Q) According to SENTINA trial how many minimum sentinel lymph nodes to be removed (Onco 2019)
Q. True about breast cancer is?
a) Doubling time of breast tumor is 1 month
b) Skip metastasis in level iii lymph nodes is common
c) Lungs are commonly involved by direct invasion
d) Dimpling of skin is due to shortening of cooper's ligaments
Q ) Hereditary diffuse Gastric carcinoma is associated with which breast cancer
A. Ductal carcinoma NOS subtype
B. Lobular carcinoma
D. Metaplastic carcinoma
Answer for Q 79
Majority of Gastric Cancers are sporadic,
1–3% of GCs arise as a result of inherited cancer predisposition syndromes.
Li-Fraumeni syndrome, Lynch syndrome, Peutz-Jeghers syndrome, hereditary breast and ovarian cancer,1MUTYH-associated adenomatous polyposis (MAP), familial adenomatous polyposis, juvenile polyposis syndrome and PTENhamartoma tumour syndrome (Cowden syndrome).
Q) Management of occult breast cancer with N1 lymph nodes:
a) Modified radical mastectomy (MRM) with axillary dissection
b) MRM with radiotherapy to axilla
c) Only axillary dissection with radiotherapy and chemotherapy to axilla
d) Simple mastectomy with chemotherapy
Q) IN RTOG trial for ductal carcinoma in situ (DCIS) favourable tumor was defined as
a) <3,5 cm in size and 2mm free resection margin
b) <2.5 cm and 2mm margin
c) <3 cm size and 3 mm margin
d) <2.5 cm size and 3 mm margin
Answer - Free answers to surgery mcqs
Ductal carcinoma in situ is a pre invasive state in which the cancer cells have not breached the epithelial membrane. It can develop into cancer in 20%.
Simple mastectomy is the standard of care but many centers now consider it over treatment.
Van Nuys system uses
- Age of the patient
- type of DCIS
- presence of microcalcification
- resection margin
On mammography this is seen as clustered clustered calcification
Treatment options are
- Breast conserving therapy (Lumpectomy +radiation and hormonal)
More recently, Eastern Cooperative Oncology Group investigators reported the frst result of a relatively large prospective single-arm study of surgery with negative margins of at least 3 mm without radiation therapy for patients with favorable subsets of DCIS.
Patients with low-grade or intermediate-grade DCIS measuring 2.5 cm or smaller had a 5-year rate of ipsilateral breast recurrence of only 6.1%. In contrast, patients with high-grade disease had a much higher 5-year ipsilateral breast recurrence rate of 15.3%.
REF : Sabiston 853
Q) In terms of cure best results in inflammatory carcinoma breast are seen with-
a) Surgery alone
d) All of the above
Surgery MCQ PDF - Free Answer
Inflammatory carcinoma of the breast is a rare aggressive tumor that blocks the sub dermal lymphatics as a result of which cutaneous edema is common . Differentiating it from a breast abscess is important and biopsy is diagnostic. It is also responsible to peau d orange
Treatment is multidisciplinary and involves, chemotherapy followed by surgery followed by radiotherapy.