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Test 6: Treatment of breast cancer

  1. What is the aim of breast cancer treatment?
    • To prevent the cancer spreading to the other breast
    • To save the breast at all costs
    • To prolong life and cure the cancer if possible
    • To remove the breast as this will always cure the cancer
  2. What types of local management are available?
    • Surgery
    • Chemotherapy
    • Hormone therapy
    • Targeted therapy
  3. What does neoadjuvant therapy mean?
    • A new form of therapy is used
    • Systemic therapy is given before surgery
    • Radiotherapy is given after chemotherapy
    • Hormone therapy is used on its own
  4. Adjuvant therapy is given:
    • Instead of surgery
    • Before surgery
    • During surgery
    • After surgery
  5. With a wide local excision:
    • Both breasts are removed
    • Radical mastectomy is done
    • The cancer with a margin of normal tissue around it is removed
    • Only the lump is removed
  6. What is a simple mastectomy?
    • All the breast tissue is removed but not the local lymph nodes
    • Both the breast tissue and the local lymph nodes are removed
    • Only the lump and the nipple are removed
    • Only a segment of the breast is removed
  7. When can a breast reconstruction be done?
    • It cannot be done at the same time as the surgery to remove the cancer
    • It can be immediate or delayed
    • It always needs to be delayed so that the skin can be stretched first
    • It should be delayed for 3 months so that the wound can heal first
  8. Important complications of removing the axillary lymph nodes include:
    • Weakness of the arm
    • Swelling of the arm
    • Swelling of the chest
    • Weakness of the hand
  9. What is a sentinel lymph node biopsy?
    • The lymph nodes closest to the breast are removed
    • The lymph nodes furthest from the breast are removed
    • The lymph nodes in the neck are removed
    • All the lymph nodes in the axilla are removed
  10. Chemotherapy is usually given:
    • At the same time as surgery
    • Instead of surgery for stage 1 breast cancer
    • For curative but not palliative care
    • When the cancer has been surgically removed but there is a high risk of recurrence
  11. Who should make the decision whether adjuvant chemotherapy should be given or not?
    • A multidisciplinary team
    • The surgeon alone
    • The radiotherapist alone
    • The oncologist alone
  12. Who should be offered neoadjuvant therapy?
    • Women who need palliative care only
    • Women who have a high risk of cancer in the other breast
    • Women with an inflammatory carcinoma
    • Women with ductal carcinoma in situ
  13. Hormone therapy should be given if:
    • The cancer cells are ER +ve
    • The cancer cells are ER −ve
    • The cancer cells are HER2 +ve
    • The hormonal status of the cells is unknown
  14. Which drug blocks estrogen receptors?
    • Goserelin
    • Tamoxifen
    • Cyclophosphamide
    • Progesterone
  15. Aromatase inhibitors block:
    • Progesterone production from the ovaries
    • Estrogen production from other hormones in postmenopausal women
    • Estrogen receptors on breast cancer cells in premenopausal women
    • Androgen production in the adrenal glands
  16. Hormone therapy should be given:
    • For 6 weeks
    • For 6 months
    • For a year
    • For at least 5 years
  17. What is an example of targeted therapy?
    • Surgery when the lump is identified by ultrasound
    • Choice of the most suitable chemotherapy
    • Treatment with Herceptin
    • Radiotherapy after marking the area on the skin
  18. Adjuvant radiotherapy is usually given after:
    • Six weeks of treatment with Raloxifene
    • Modified radical mastectomy
    • Palliative chemotherapy
    • Wide local excision
  19. Adjuvant radiotherapy is usually given:
    • Six weeks after surgery
    • To pregnant women with breast cancer
    • Before chemotherapy is started
    • If the woman has been treated previously with radiotherapy for a lymphoma
  20. Therapeutic radiotherapy is given:
    • To treat bone pain caused by cancer
    • To prevent local cancer recurrence on the chest wall
    • After axillary clearance to prevent cancer recurrence
    • To shrink a large tumour before surgery