Exam & Evaluation (Breast Duct Carcinoma in-situ: DCIS)
Questions: Please respond to following statements.
Carcinoma in situ refers to the proliferation of abnormal cells confined to the tissue of origin.
DCIS is often detected by manual breast examination.
Which set of factors are associated with an increased risk of DCIS?
Alcohol consumption, obesity, fatty breasts
Lower socio-economic status, age >70 years, long term asprin use
Alcohol consumption, fatty breasts, early menarche
Age, Urban residence, first birth after 20 years of age
How is the diagnosis of DCIS confirmed?
Response to radiation
Which of the following morphologic descriptions is most associated with progression to invasive breast cancer?
When changes are seen on mammogram, but no breast lump can be felt, which kind of biopsy is most likely to be used?
Which woman would have the lowest VNPI score?
39 years, Grade 3, 1mm margins, 41mm lesion
65 years, Grade 1, 10mm margins, 15mm lesion
72 years, Grade 2, 1 mm margins, 15mm lesion
Select the most accurate answer regarding reconstructive surgery following mastectomy.
Insurance companies will only cover reconstructive surgery after a bilateral mastectomy.
If an insurance company covers mastectomy, they are usually required to cover reconstruction.
Reconstructive surgery is cosmetic and not generally covered by insurance companies.
The overall prognosis for a woman diagnosed with DCIS is:
Excellent - with early and appropriate treatment .
Poor - invasive breast cancer occurs frequently.
Good - except for older women.
The standard treatment for ER(+) DCIS and invasive breast cancer include the following:
Selective Estrogen Receptor Modulators (SERM)
all of the above
Which statements is true of the drug Tamoxifen?
Tamoxifen blocks estrogen action on breast cell receptors
Tamoxifen decreases the risk of endometrial cancer.
Tamoxifen is an aromatase inhibitor
Which statement is true about aromatase inhibitors such as anastrozole and exemestane?
They can only be given to premenopausal women
They increase the risk of endometrial cancers
One study found a 65% decline in invasive breast cancer.
All of the above
Ms. Jones, age 37, says her doctor recommends a lumpectomy with radiation because her DCIS is localized comedo type. She wants to wait another year and have another mammogram to see if the DCIS is still there. You say.....
Most doctors now recommend waiting to see if the DCIS changes.
Comedo architecture increases the risk of developing invasive carcinoma.
Mastectomy is the current standard of care.
Chemotherapy for DCIS with comedo architecture may be an option.
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