Family Medicine EOR: Obstetrics and Gynecology (Smarty PANCE) Exam Questions and Answers 100% Correct | Latest Version

Family Medicine EOR: Obstetrics and Gynecology (Smarty PANCE) Exam Questions and Answers 100% Correct | Latest Version What is the incidence of breast cancer? 12% Lifetime Risk Percentage of women with breast cancer who have zero known risk factors? 75% Percentage of all breast cancers in women 30 years? ~2% Percentage of all breast cancers in women 70 years? 33% Percentage of breast cancers due to inherited mutations? 10% Approximate percentage of inherited breast cancers due to BRCA 1/2? ~50% (5% of all breast cancers) What is the expected ER status of BRCA 1 vs BRCA 2 breast cancers? BRCA 1 ER negative (~70%) BRCA 2 ER positive (~70%) Name some breast cancer susceptibility genes BRCA 1/2 Tp53 (Li Fraumeni) PTEN STK11 (Peutz-Jeghers) PTALB CDH1 How do you decrease breast cancer risk in women with BRCA mutations? Prophylactic bilateral mastectomy (90% risk reduction) +prophylactic BSO - 95% risk reduction Rule o' Thumb: 5 years before the earliest onset of cancer in mom What is the preferred screening for mutation carriers? MRI annually Most common motivation for medicological cases of the breast Failure to diagnose a breast carcinoma Triad of Error for misdiagnosis of breast cancer 1) Age 45 years 2) Self-diagnosed mass 3) Negative mammogram Hx breast cancer risk factors? NAACP Nulliparity Age at menarche (13 yrs) Age at menopause (55 yrs) Breast cancer (self, family) Pregnancy of 1st child 30yrs Physical breast cancer risk factors? CHAFED LIPS Cancer in breast (3% synchronous contralat) Hyperplasia (2x) Atypical hyperplasia (4x) Female (100x) Elderly DCIS LCIS Inherited genes Papilloma (1.5x) Sclerosing adenosis (1.5x) Relative risk of hormone replacement therapy? 1 - 1.5 Is normal fibrocystic disease a risk factor for breast cancer? No What are the possible symptoms of breast cancer? No symptoms Mass in the breast Pain (most are painless) Nipple discharge Local edema Nipple retraction Dimple Nipple rash What causes skin retraction? Tumor involvement of Cooper's ligaments causing subsequent inward traction on skin What are the signs of breast cancer? Mass (1 cm minimum palpable) Dimple Nipple rash Edema Axillary / supraclavicular nodes What is the most common site of breast cancer? Approximately one half of cancers develop in the upper outer quadrants What are the different types of invasive breast cancer? Infiltrating ductal carcinoma (~75%) Medullary carcinoma (~15%) Infiltrating lobular carcinoma (~5%) Tubular carcinoma (~2%) Mucinous colloid carcinoma (~1%) Inflammatory breast cancer (~1%) What is the most common type of invasive breast cancer? Infiltrating ductal carcinoma What is the differential diagnosis?