Answer: Recent studies have shown that for women at high risk for breast cancer due to a previous personal history of breast cancer, first-degree family members with breast cancer, and other factors, the use of tamoxifen can reduce the occurrence of new breast cancers by about half. Some women who are known to carry the [...]

Answer: The two basic options are lumpectomy with axillary dissection and radiation or modified radical mastectomy. Lumpectomy/radiotherapy is used if cosmesis is important, complete excision is possible, and > 6000 rads can be delivered to the tumor bed. Modified radical mastectomy is used if cosmesis is unimportant, lesion size is large relative to breast size, [...]

Answer: Estrogen or progesterone receptors negative Positive HER-2/neu status Premenopausal patient Large tumor size Positive axillary nodes Local skin involvement Fixed axillary nodes Distant metastasis Aneuploidy and high cathepsin D Nuclear grade 3 (poor) High S-phase fraction Reference: Casciato DA, Lowitz BB (eds): Manual of Clinical Oncology, 5th ed. Boston, Little, Brown, 2000.

Answer: Factors associated with a 1.2- to 1.5-fold increase in risk include the following: Early menarche or late menopause Oral estrogens History of cancer of the ovary, uterus, or colon Alcoholic beverages (?) Obesity Reference: Tannock IF, Hill RP (eds): The Basic Science of Oncology, 3rd ed. New York, McGraw-Hill, 1998.

Answer: The primary care physician must identify high-risk patients who may have a mutation in a dominant breast cancer susceptibility gene. Such families have a history of breast or ovarian cancer in as many as half of all female relatives, with early age of onset and/or bilateral or multifocal disease. These patients have been shown [...]

Answer: There are currently several sets of recommendations from the various specialty organizations whose members are engaged in breast cancer screening RECOMMENDED FREQUENCY OF SCREENING FOR BREAST CANCER AGE > 50 AGE < 50 Organization Mammogram Breast Exam Mammogram Breast Exam ACS Annual Annual Age 40-49, annual Age 20-39, every 3 yr Age 40-49, annual [...]

Answer: Factors associated with a threefold or more increase in risk include the following: Age > 40 yr Previous cancer in one breast Breast cancer in a first- or second-degree family member History of multiple breast biopsies Parity: nulliparous, or first pregnancy after age 31 years Lobular carcinoma in situ Gene mutations: BRCA1, BRCA2, hMSH2, [...]