Breast Cancer

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. According to the authors, the purpose of the book, “Breast Cancer — The Complete Guide” is to:

a) understand coping techniques
b) get the right treatment from the right doctor
c) know options and survival rates
d) learn the importance of follow-up treatment

2. When a patient asks if breast cancer is a death sentence, the answer most likely would be:

a) “it depends on the type of cancer you have”
b) “it depends if it has spread to other organs”
c) “if you don’t seek medical care, it can be”
d) “probably not, and certainly not immediately”

3. The cancer, some surrounding tissue and nearby lymph nodes are removed is the definition of a:

a) radical mastectomy
b) modified radical mastectomy
c) lumpectomy
d) partial mastectomy

4. Unless the cancer is in an extremely advanced stage, it is almost certainly to a(n) _________that you will be sent for the purpose of diagnosis.

a) surgeon
b) radiologist
c) oncologist
d) internist

5. One of the best ways to find a good cancer specialist is to talk with friends, relatives and colleagues.

a) true
b) false

6. A major source of data when evaluating physicians is:

a) the American Cancer Society
b) the Internet
c) consulting medical directories
d) consulting with women who have had breast cancer

7. Which of the following are critical when evaluating a physician:
  1. training
  2. experience
  3. hospital affiliation
  4. size of practice

a) 2 and 4
b) 2 only
c) all but 4
d) 1 and 3

8. An acinus is best defined as:

a) a sac lined with cells that produce milk
b) a specialized connective tissue that supports the breast
c) a lymph node in adjacent tissue
d) the pigmented area around the nipple

9. Cancer involves the abnormal multiplication and spread of cells in the body.

a) true
b) false

10. Which of the following would most likely be a malignant tumor, a tumor that is:

a) soft and movable
b) firm and irregular in shape
c) well-delineated and soft
d) symmetrical and firm

11. These cancer cells remain within the confines of the duct or lobule and are defined as:

a) tubular cancer
b) infiltrating cancer
c) cytosarcoma
d) in situ cancer

12. An orderly growth of cells, confined to the breast, that results in benign, movable and rounded lumps is the definition of a:

a) cystic mastitis
b) fibroadenoma
c) Mondors disease
d) mammary duct ectasia

13. The old saying, “If it hurts, it’s not cancer” is usually:

a) true
b) false

14. Postmenopausal women:

a) need not do self breast exams
b) should do self breast exams ten days after the menstrual cycle
c) may have nodular breasts
d) should exam their breasts the first day of the month

15. One main advantage of this technique is it can be easily stored and readily transmitted for review by others. This is:

a) a mammogram
b) a sonogram
c) an ultrasound
d) digital mammography

16. Breast tissue of women in their teens and early twenties is _______ sensitive to low-level radiation than it is when they get older.

a) less
b) more

17. An ultra-sound, which uses high-frequency sound waves, has detected a liquid filled cyst. The sound wave will:

a) bounce back
b) be disseminated
c) become “transilluminated"
d) go through it

18. In a core biopsy, a large-caliber needle is used to obtain a sliver of tissue from a lump.

a) true
b) false

19. During a surgical biopsy, a tumor is large and only a small piece is removed. This is called a(n):

a) excisional biopsy
b) frozen section
c) incisional biopsy
d) a two-stage procedure

20. A medical specialist who examines and analyses tissue removed during a biopsy is a:

a) radiologist
b) pathologist
c) tecnician
d) phlebotomist

21. When a permanent section is done:
  1. a specimen is cut into 1/50,000 inch slices
  2. slices are stained with dye of different shades of red and blue
  3. extra tissue is preserved
  4. a cryostat is used to cut the excised tissue

a) all but 4
b) 1 and 2
c) 1 and 4
d) 3 only

22. When the cancer is found in more than one quadrant of the breast, it is called:

a) ultifocalm
b) multicentric

23. A sensible goal is to have treatment under way within _______ to _______ weeks after diagnosis.

a) one,two
b) three,four
c) six,eight
d) eight,ten

24. Which of the following are positive characteristics of a personal advocate:
  1. they will help you remember
  2. they help you evaluate recommendations
  3. they give you advice
  4. they are a shoulder to lean on

a) 3 only
b) 1 and 4
c) all but 3
d) 1 and 2

25. A defective gene has a change in its structure and is called a mutation, which interferes with its function. The person who has a mutated gene is called a(n):

a) risk
b) advocate
c) recipient
d) carrier

26. This occurs in isolated homogenous communities whose populations tend to intermarry, increasing the probability that any who carry a genetic mutation will transmit it to their offspring. It is called:

a) tumor markers
b) mammary duct ectasia
c) founder's effect
d) a suppresor gene

27. In this type of surgery, systemic treatment may be used:

a) lumpectomy
b) mastectomy

28. Which of the following drugs may interfere with clotting:

a) Tylenol and Coumadin
b) aspirin and Plavix
c) Aleve and Lovenox
d) Nardil and Compazine

29. The informed consent should be:
  1. presented to you by your doctor or a staff resident
  2. discussed with you prior to sedation
  3. given to you in advance so you can read it carefully
  4. witnessed by a family member

a) 1 and 3
b) all but 2
c) 3 only
d) all but 4

30. A grounding pad will be placed on the thigh because:

a) electric cautery may be used
b) it prevents blood clots
c) blood pressure is measured frequently
d) blood oxygen levels may drop

31. The single most important factor in planning and treating breast cancer and in assessing prognosis is:

a) performing a frozen section
b) avoiding use of cautery
c) metastasis to the minor pectoral muscle
d) lymph node involvement

32. Sentinal nodes are located by:
  1. performing a frozen section during surgery
  2. injecting blue dye into the affected breast prior to surgery
  3. staining cells on a slide during surgery
  4. injecting an isotope into the breast before surg

a) all but 3
b) 1 and 2
c) 3 and 4
d) 2 and 4

33. The Halstead procedure is still used to describe a:

a) lumpectomy
b) radical mastectomy
c) extended radical mastectomy
d) total mastectomy

34. This term refers to a technique that uses an incision around the areola, in the center of the breast, sometimes with a small extension toward the side:

a) nipple-sparing mastectomy
b) oncoplastic surgery
c) skin-sparing mastectomy
d) quadrantectomy

35. One of the ways to prevent infection is to:

a) avoid crowds
b) avoid going to manicurists
c) change dressings frequently
d) take vitamins and eat a healthy diet

36. Treatment for a phlebitis:

a) is usually not necessary
b) requires limited use of the affected arm
c) is usually with blood thinners
d) is painful when the clot is aspirated

37. In order to maintain range of motion, arm exercises should be started:

a) as soon as the anesthesia wears off
b) after the sutures are removed
c) within a few days
d) the morning after surgery

38. When breast cancer is found in a pregnant woman, which of the following are options:
  1. radiation is not used with a pregnant woman
  2. chemotherapy can be used in the first trimester
  3. in the second trimester, a mastectomy can be performed<

a) all but 4
b) 1 only
c) all but 2
d) 2 and 3

39. Electromagnetic rays include:
  1. ordinary light
  2. x-rays
  3. gamma rays
  4. beta rays

a) 2 and 3
b) 3 only
c) all but 1
d) all but 4

40. When metastasis has occurred, _____________ is both the first line of defense against further progression and the frontline attack against the existing disease.

a) chemotherapy
b) surgery
c) radiation

41. The person who is trained in the planning and administration of radiation for medical treatment is a radiation ___________.

a) nurse
b) specialist
c) physicist
d) oncologist

42. Determining the area to be radiated requires special equipment and computer technology. This planning is called:

a) geometry
b) simulation
c) marking
d) brachytherapy

43. The additional radiation of phase two in the area of the breast that contained the tumor is called a “boost.”

a) true
b) false

44. Very occasionally, radiation can cause a hairline fracture of a rib.

a) true
b) false

45. The stage of the cancer is primarily used to evaluate the prognosis in addition to three primary factors which are:

a) size of tumor, the woman’s age, lymph node involvement
b) previous history of cancer, infiltration, general health of the woman
c) heredity, lymph node involvement, size of the tumor
d) infiltration, size of the tumor, lymph node involvement

46. The more node involved, the greater the risk, with the highest risk among patients who have ________ or ________ cancerous nodes.

a) four more
b) ten more
c) six less
d) twelve less

47. The presence of these genes is now considered an important risk factor for the recurrence of breast cancer:

a) onconogenes
b) t-cells
c) nuclear grade cells
d) aneuploid cells

48. Systemic therapy:
  1. is referred to adjuvant therapy
  2. travels through the bloodstream
  3. reduces the risk of recurrence by fifty percent
  4. can begin several months after surgery

a) 2 only
b) 1 and 2
c) all but 4
d) 1, 2 and 4

49. __________ works best in a premenopausal woman and ___________ works best in postmenopausal women whose tumors were estrogen or progesterone receptor-positive.

a) Chemotherapy, hormone therapy
b) Hormone therapy, chemotherapy

50. The medical oncologist who administers chemotherapy should:
  1. be board-certified or board-eligible in medical oncology
  2. have extensive experience and skill in the treatment of breast cancer
  3. have two years of oncology training during re

a) 2 and 4
b) all but 3
c) all but 2
d) all but 1

51. The most common route for administration of chemotherapy is:

a) orally
b) injection
c) intervenously

52. Alternate ways to administer chemotherapy is:
  1. Hickman Device
  2. Broviac Device
  3. Infuse-a-Port
  4. saline lock

a) 1 and 2
b) all but 4
c) all but 3
d) 3 only

53. Cytotoxic drugs act largely by:

a) destroying cells
b) preventing replication
c) altering the DNA
d) splitting the nucleus

54. The physician should tailor a special treatment for each patient.

a) true
b) false

55. This type of drug interferes with cell structure and cell division:

a) alkylating agent
b) antimetabolites
c) natural products
d) targeted agents
e) hormones

56. Methods of decreasing hair loss when taking Vincristine in drug combinations is to:
  1. apply a soft tourniquet around the head
  2. infuse the medication slowly
  3. apply an ice pack to the head
  4. dilute the medication prior to administra

a) all but 3
b) 1 and 3
c) all but 1
d) 2 and 4

57. ___________ corrects anemia caused by chemotherapy and ____________ stimulates growth of white blood cells.

a) Procrit, Neupogen
b) Neupogen, Procrit

58. Because of excess stomach acid:

a) antacids are recommended to neutralize the pH
b) several small meals are recommended
c) nausea and weight loss are common
d) it is mistaken for hunger and weight gain occurs

59. A diabetic woman closely monitors her blood sugar. Which of the following drugs would cause it to be elevated:

a) Prednisone
b) Adriamycin
c) Cytoxan
d) taxol

60. A woman has been diagnosed with 1-3 nodes involved. This would put her in:

a) group 2
b) group 3
c) group 4
d) group 5

61. Triple negative breast cancer:

a) requires higher doses of radiation
b) does not react well to chemotherapy
c) occurs more frequently in Caucasian women
d) requires chemotherapy to reduce the size of the tumors

62. One reason women do not want breast reconstruction is because it is a betrayal of what they have lived through to hide the fact they have had breast surgery, and conform to what society feels a woman’s body should look like.

a) true
b) false

63. Which of the following are used for reconstruction when the mastectomy is done:

a) silicone-filled implants
b) saline injections
c) TRAM flap surgery
d) implants and expanders of artificial origin

64. When tissue is moved from one part of the body to another with arteries and veins intact, it is called a:

a) pedicle flap
b) free flap
c) myocutaneous flap
d) autologous transplant

65. This type of surgery is not suitable for women who are very thin, extremely obese, have abdominal scars from previous surgeries, or who are heavy smokers.

a) latissimus dorsi reconstruction
b) TRAM flap
c) DIEP flap
d) gluteal reconstruction

66. The major complication of flap reconstruction is:

a) the breast will become hard
b) infection develops
c) leakage of the saline solution
d) the transferred tissue does not survive

67. Several years after a mastectomy, cancer recurred in the lymph nodes of the neck. This is called:

a) metastasis
b) carcinoma in situ
c) regional recurrence
d) distant recurrence

68. If a woman needs long-term hormone therapy or chemotherapy and further surgery is not planned, it may be best to select which of the following to be in charge of the case:

a) radiation oncologist
b) surgeon
c) internist
d) oncologist

69. This type of test is a tumor marker and shows abnormal results when a tumor is large enough to release detectable quantities of certain substances:

a) CEA
b) CBC
c) alkaline phosphatase
d) BUN

70. A chest x-ray may be recommended ___________ for the first _______ _______ after surgery.

a) monthly, six months
b) yearly, five years
c) quarterly, three years
d) annually, two years

71. When preparing for a bone scan, a woman should:

a) prepare to drink radioactive glucose
b) not eat or drink fluids 8 hours prior to testing
c) remove metal jewelry and prosthesis
d) expect a radioactive liquid to be injected into the blood stream

72. When picking up films of x-rays and scans to take to the consulting physician, you would:
  1. go to the film room of the hospital’s x-ray department
  2. not pay for this service
  3. obtain a request-for–records form from the consulting physicia

a) 1 and 4
b) 1 and 3
c) all but 2
d) 1 and 2

73. Breast cancer cells, because of their particular properties, often establish themselves and produce recurrence in the:

a) liver
b) brain
c) lung
d) bone

74. Prognosis is:
  1. a prediction
  2. dependent on statistics
  3. based on response to treatment
  4. not necessarily applicable to a particular patient

a) 1, 2 and 4
b) 1 and 3
c) all but 2
d) 3 only

75. To relieve or lessen without curing is the definition of palliative therapy.

a) true
b) false

76. What percent of women who develop breast cancer have no family history:

a) ten percent
b) forty percent
c) sixty percent
d) eighty-five percent

77. One method of decreasing fat intake and reduce the risk of breast cancer is to lower the consumption of animal proteins to less than 6 percent.

a) true
b) false

78. The number one cancer killer of women in the United States is:

a) breast cancer
b) lung cancer
c) ovarian cancer
d) uterine cancer

79. Never having a child _________ your risk of breast cancer.

a) increase
b) decrease

80. Prior to beginning hormone replacement therapy, which of the following should be done:

a) breast exam and Pap smear
b) mammogram and CEA
c) breast exam and mammogram
d) chest x-ray and a complete physical

81. These genes produce substances that slow abnormal cell growth:

a) viral oncogenes
b) proto-oncogenes
c) telomere genes
d) suppressor genes

82. The science relating to the regulatory pathway of genes and whether or not their messages can be expressed is the definition of epigenetics.

a) true
b) false

83. All cells including breast cells have a built-in mechanism to self destruct. This process is called:

a) interference
b) inactivation
c) apoptosis
d) methylation

84. When cancer is found a needle is placed in the lesion to be destroyed and it is subjected to heat. This is the definition of :

a) cryosurgery
b) radiofrequency ablation
c) ductoscopy
d) biopsy

85. In this phase of drug testing, an application is filed with the Food and Drug Administration to begin clinical studies using the drug on human beings. This is:

a) phase I
b) phase II
c) phase III
d) phase III

86. Which of the following organizations in the community offer practical and emotional support:

a) Be a Survivor
b) Oncolink
c) Reach to Recovery
d) Cancer Hope Network

87. A causative factor being reinvestigated is a possible link between breast cancer and:

a) drugs found in the water supply
b) fertilizers used to grow vegetables
c) hormones fed to animals
d) insecticide residues that entered the food chain

88. The need for more research, better and more affordable care, fewer insurance hassles and ____________ are among the important issues facing our society.

a) genetic testing
b) affordable drugs
c) yearly mammograms
d) decreased disparity

89. Much of what we know about breast cancer in the United States comes from the:

a) the American Cancer Society and the National Cancer Institute
b) American Society of Clinical Oncology and cancer centers
c) state cancer registries and the SEER program of the National Cancer Institute
d) oncologists and the Cancer Information Service

90. The Mammography Quality Standards Reauthorization Act of 2003 led the Food and Drug Administration to:

a) assure that facilities performing mammograms meet federal standards for quality
b) guarantee that mammograms deliver the lowest amount of x-rays to effectively meet standards
c) appoint a radiation oncologist to interpret all mammograms
d) make available to uninsured and low-income women over the age of 40, a high quality mammogram on a yearly basis