Nurse Navigator Exam Question with
Actual Answers
Treatment for most women with breast cancer (at Prisma Health) ✔️✔️Lumpectomy, which is
an outpatient procedure
What kind of tumors NEED radiation? ✔️✔️Invasive ductal or lobular
The patient is not a candidate for a lumpectomy if... (3) ✔️✔️1. Tumor is too large to get good,
clear margins around the tumor and leave a decent cosmetic result
2. There are multiple cancers in the breast, especially if in more than 1 quadrant of the breast
3. If the patient has had a lumpectomy and radiation and gets a recurrence in the same breast that
would again require radiation
What patients will have a mastectomy? (3) ✔️✔️1. Patient choice
2. If the tumor is too large to get clear margins
3. If lesions are in two separate quadrants
Health insurance coverage of reconstruction ✔️✔️It is the law that insurance companies pay
for reconstruction if a woman is affected but not if they are unaffected. Often immediate breast
reconstruction is an option.
, Advantages of sentinel lymph node biopsy (2) ✔️✔️1. Decreasing a patient's risk for
developing lymphedema and infections in the affected arm
2. Decreasing pain and increasing recovery time for post-op patient
What patients need chemotherapy? ✔️✔️Depends on prognostic markers (estrogen,
progesterone, HER2, triple negative tumors require chemo unless the lesion is under
5mm/0.5cm), size of tumor, and lymph node status
Tumor grading ✔️✔️Grade 1 - well-differentiated (more often ER/PR positive)
Grade 2 - moderately differentiated
Grade 3 - poorly differentiated (more often triple negative)
Treatment for breast cancer is determined by what three factors? ✔️✔️Type, size, node status
What other factors determine cancer treatment? (3) ✔️✔️1. ER/PR testing
2. Grade
3. Oncotype DX testing (predicts likelihood of recurrence)
Why is Her2 positive therapy so well-tolerated? ✔️✔️It's targeted (i.e. only attacking cells that
are overexpressing Her2, not all cells like chemo)
Actual Answers
Treatment for most women with breast cancer (at Prisma Health) ✔️✔️Lumpectomy, which is
an outpatient procedure
What kind of tumors NEED radiation? ✔️✔️Invasive ductal or lobular
The patient is not a candidate for a lumpectomy if... (3) ✔️✔️1. Tumor is too large to get good,
clear margins around the tumor and leave a decent cosmetic result
2. There are multiple cancers in the breast, especially if in more than 1 quadrant of the breast
3. If the patient has had a lumpectomy and radiation and gets a recurrence in the same breast that
would again require radiation
What patients will have a mastectomy? (3) ✔️✔️1. Patient choice
2. If the tumor is too large to get clear margins
3. If lesions are in two separate quadrants
Health insurance coverage of reconstruction ✔️✔️It is the law that insurance companies pay
for reconstruction if a woman is affected but not if they are unaffected. Often immediate breast
reconstruction is an option.
, Advantages of sentinel lymph node biopsy (2) ✔️✔️1. Decreasing a patient's risk for
developing lymphedema and infections in the affected arm
2. Decreasing pain and increasing recovery time for post-op patient
What patients need chemotherapy? ✔️✔️Depends on prognostic markers (estrogen,
progesterone, HER2, triple negative tumors require chemo unless the lesion is under
5mm/0.5cm), size of tumor, and lymph node status
Tumor grading ✔️✔️Grade 1 - well-differentiated (more often ER/PR positive)
Grade 2 - moderately differentiated
Grade 3 - poorly differentiated (more often triple negative)
Treatment for breast cancer is determined by what three factors? ✔️✔️Type, size, node status
What other factors determine cancer treatment? (3) ✔️✔️1. ER/PR testing
2. Grade
3. Oncotype DX testing (predicts likelihood of recurrence)
Why is Her2 positive therapy so well-tolerated? ✔️✔️It's targeted (i.e. only attacking cells that
are overexpressing Her2, not all cells like chemo)
