, Test Bank: Breast Care Certification
Review, Second Edition
Contents
Chapter 1: Coordination of Care .........................................................................................................................3
Chapter Summary ................................................................................................................................................3
Multiple Choice Questions (MCQs) ...............................................................................................................3
Chapter 2: Diagnosis and Staging.................................................................................................................... 10
Chapter Summary ............................................................................................................................................. 10
Multiple Choice Questions (MCQs) ............................................................................................................ 10
Chapter 3: Treatment Modalities: Local and Systemic........................................................................... 17
Chapter Summary ............................................................................................................................................. 17
Multiple Choice Questions (MCQs) ............................................................................................................ 17
Chapter 4: Nursing Practice .............................................................................................................................. 24
Chapter Summary ............................................................................................................................................. 24
Multiple Choice Questions (MCQs) ............................................................................................................ 24
Chapter 5: Psychosocial and Spiritual........................................................................................................... 31
Chapter Summary ............................................................................................................................................. 31
Multiple Choice Questions (MCQs) ............................................................................................................ 31
,Chapter 1: Coordination of Care
Chapter Summary
Chapter 1 focuses on the essential role of the breast care nurse in
navigating patients through the complex continuum of care. This
includes risk assessment, screening, and early detection strategies. Key
concepts involve understanding genetic risk factors (such as BRCA1/2
mutations), implementing screening guidelines (mammography, clinical
breast exams), and coordinating multidisciplinary care. The chapter
emphasizes the importance of patient education on risk reduction,
lifestyle modifications, and the significance of timely follow-up for
abnormal findings.
Multiple Choice Questions (MCQs)
1. Which of the following is considered the "gold standard" for
breast cancer screening in asymptomatic women over age 40?
A. Digital Mammography
B. Breast Ultrasound
C. Magnetic Resonance Imaging (MRI)
D. Clinical Breast Examination (CBE)
**Correct Answer: A**
**Rationale:** Mammography is the only screening tool proven to reduce
breast cancer mortality through early detection.
2. A woman with a confirmed BRCA1 mutation has an estimated
lifetime risk of developing breast cancer of approximately:
A. 10-20%
B. 30-40%
C. 55-72%
D. 90-100%
,**Correct Answer: C**
**Rationale:** BRCA1 mutations significantly increase risk, with studies
showing a lifetime risk up to 72%.
3. The primary goal of a "Patient Navigator" in breast care is to:
A. Perform diagnostic biopsies.
B. Eliminate barriers to timely care and facilitate access to resources.
C. Prescribe chemotherapy.
D. Interpret mammogram results.
**Correct Answer: B**
**Rationale:** Navigators help patients move through the healthcare
system efficiently from screening to survivorship.
4. Which lifestyle modification is most strongly associated with a
reduction in breast cancer risk?
A. Increasing caffeine intake.
B. Maintaining a healthy weight and regular physical activity.
C. Eating a high-protein diet.
D. Sleeping 10 hours a night.
**Correct Answer: B**
**Rationale:** Obesity (especially post-menopausal) and sedentary
lifestyles are known modifiable risk factors.
5. According to the American Cancer Society (ACS), women at
"average risk" should have the option to start annual
mammograms at age:
A. 30
,B. 35
C. 40
D. 50
**Correct Answer: C**
**Rationale:** ACS guidelines suggest women ages 40-44 should have the
choice to start annual screening.
6. A "high-risk" woman for whom annual screening MRI is
recommended (in addition to mammography) includes those with:
A. A history of one benign breast biopsy.
B. Dense breast tissue on a mammogram.
C. A lifetime risk of breast cancer ≥20% as calculated by risk models
(e.g., Tyrer-Cuzick).
D. Any family history of breast cancer.
**Correct Answer: C**
**Rationale:** MRI is reserved for those with significantly elevated risk
(20-25% or greater).
7. Which of the following is a non-modifiable risk factor for breast
cancer?
A. Alcohol consumption.
B. Use of hormone replacement therapy.
C. Age at menarche (early onset).
D. Physical inactivity.
**Correct Answer: C**
,**Rationale:** Biological factors like early menstruation (<12) or late
menopause (>55) cannot be changed.
8. The Gail Model is a tool used primarily to:
A. Stage a diagnosed breast cancer.
B. Estimate the 5-year and lifetime risk of developing invasive breast
cancer.
C. Predict the response to chemotherapy.
D. Determine the need for radiation.
**Correct Answer: B**
**Rationale:** The Gail Model uses personal and family history to
calculate risk.
9. Chemoprevention (e.g., Tamoxifen or Raloxifene) is typically
considered for women with:
A. A 5-year risk of breast cancer ≥1.67%.
B. Any suspicious lump.
C. Fear of cancer.
D. A history of breastfeeding.
**Correct Answer: A**
**Rationale:** 1.67% is the threshold used in major prevention trials for
high-risk women.
10. Which type of breast biopsy is preferred for a suspicious non-
palpable calcification seen on a mammogram?
A. Fine Needle Aspiration (FNA)
B. Stereotactic Core Needle Biopsy
,C. Incisional Biopsy
D. Excisional Biopsy
**Correct Answer: B**
**Rationale:** Stereotactic biopsy uses mammographic imaging to guide
the needle to the calcifications.
11. A "BI-RADS 3" assessment on a mammogram report indicates
the finding is:
A. Negative.
B. Benign.
C. Probably benign (short-interval follow-up recommended).
D. Highly suspicious.
**Correct Answer: C**
**Rationale:** BI-RADS 3 findings have a <2% risk of malignancy and
usually require a 6-month follow-up.
12. The "Continuum of Care" in breast health begins with:
A. Diagnosis.
B. Treatment.
C. Health promotion and risk assessment.
D. Survivorship.
**Correct Answer: C**
**Rationale:** Care starts with education and screening before any
disease is found.
13. Which of the following is a barrier to screening mammography
often addressed by breast care nurses?
,A. Lack of insurance or high cost.
B. Fear of pain or radiation.
C. Lack of transportation.
D. All of the above.
**Correct Answer: D**
**Rationale:** Nurses work to overcome financial, emotional, and physical
barriers to care.
14. "Informed Decision Making" regarding screening involves:
A. Telling the patient they must have a mammogram.
B. Discussing the benefits, risks, and limitations of the screening test.
C. Only providing information if the patient asks.
D. Having the doctor make the final choice.
**Correct Answer: B**
**Rationale:** Patients should understand potential for false positives and
overdiagnosis.
15. A woman with "dense breasts" (Category C or D on BI-RADS)
should be informed that:
A. She has cancer.
B. Mammography may be less sensitive in detecting small tumors.
C. She should never have another mammogram.
D. Dense tissue is a sign of youth.
**Correct Answer: B**
**Rationale:** Dense tissue and cancer both appear white on a
mammogram, making detection harder.
,16. Which of the following genes, when mutated, is associated with
Li-Fraumeni syndrome and a high risk of breast cancer?
A. PTEN
B. TP53
C. STK11
D. CDH1
**Correct Answer: B**
**Rationale:** TP53 mutations are the hallmark of Li-Fraumeni
syndrome.
17. The role of the "Multidisciplinary Team" in breast care is to:
A. Have everyone perform the same task.
B. Provide a coordinated approach to diagnosis and treatment planning.
C. Increase the cost of care.
D. Make decisions without the patient.
**Correct Answer: B**
**Rationale:** Teams include surgeons, oncologists, radiologists, and
nurses working together.
, Chapter 2: Diagnosis and Staging
Chapter Summary
Chapter 2 covers the critical steps following an abnormal screening or
the discovery of a breast symptom. It details the diagnostic workup,
including diagnostic mammography, ultrasound, and various biopsy
techniques. The chapter explains the pathology of breast cancer,
including receptor status (ER, PR, HER2) and histological types (Ductal
vs. Lobular). Staging is discussed using the TNM (Tumor, Node,
Metastasis) system, emphasizing the importance of accurate staging for
determining prognosis and selecting appropriate treatment modalities.
Multiple Choice Questions (MCQs)
1. The "T" in the TNM staging system for breast cancer refers to:
A. Time since diagnosis.
B. Tumor size and extent.
C. Type of cells.
D. Treatment plan.
**Correct Answer: B**
**Rationale:** T describes the size of the primary tumor and whether it
has spread to the skin or chest wall.
2. A tumor that is 1.5 cm in its greatest dimension with no lymph
node involvement is staged as:
A. T1c N0
B. T2 N0
C. Tis N0
D. T3 N1
**Correct Answer: A**
Review, Second Edition
Contents
Chapter 1: Coordination of Care .........................................................................................................................3
Chapter Summary ................................................................................................................................................3
Multiple Choice Questions (MCQs) ...............................................................................................................3
Chapter 2: Diagnosis and Staging.................................................................................................................... 10
Chapter Summary ............................................................................................................................................. 10
Multiple Choice Questions (MCQs) ............................................................................................................ 10
Chapter 3: Treatment Modalities: Local and Systemic........................................................................... 17
Chapter Summary ............................................................................................................................................. 17
Multiple Choice Questions (MCQs) ............................................................................................................ 17
Chapter 4: Nursing Practice .............................................................................................................................. 24
Chapter Summary ............................................................................................................................................. 24
Multiple Choice Questions (MCQs) ............................................................................................................ 24
Chapter 5: Psychosocial and Spiritual........................................................................................................... 31
Chapter Summary ............................................................................................................................................. 31
Multiple Choice Questions (MCQs) ............................................................................................................ 31
,Chapter 1: Coordination of Care
Chapter Summary
Chapter 1 focuses on the essential role of the breast care nurse in
navigating patients through the complex continuum of care. This
includes risk assessment, screening, and early detection strategies. Key
concepts involve understanding genetic risk factors (such as BRCA1/2
mutations), implementing screening guidelines (mammography, clinical
breast exams), and coordinating multidisciplinary care. The chapter
emphasizes the importance of patient education on risk reduction,
lifestyle modifications, and the significance of timely follow-up for
abnormal findings.
Multiple Choice Questions (MCQs)
1. Which of the following is considered the "gold standard" for
breast cancer screening in asymptomatic women over age 40?
A. Digital Mammography
B. Breast Ultrasound
C. Magnetic Resonance Imaging (MRI)
D. Clinical Breast Examination (CBE)
**Correct Answer: A**
**Rationale:** Mammography is the only screening tool proven to reduce
breast cancer mortality through early detection.
2. A woman with a confirmed BRCA1 mutation has an estimated
lifetime risk of developing breast cancer of approximately:
A. 10-20%
B. 30-40%
C. 55-72%
D. 90-100%
,**Correct Answer: C**
**Rationale:** BRCA1 mutations significantly increase risk, with studies
showing a lifetime risk up to 72%.
3. The primary goal of a "Patient Navigator" in breast care is to:
A. Perform diagnostic biopsies.
B. Eliminate barriers to timely care and facilitate access to resources.
C. Prescribe chemotherapy.
D. Interpret mammogram results.
**Correct Answer: B**
**Rationale:** Navigators help patients move through the healthcare
system efficiently from screening to survivorship.
4. Which lifestyle modification is most strongly associated with a
reduction in breast cancer risk?
A. Increasing caffeine intake.
B. Maintaining a healthy weight and regular physical activity.
C. Eating a high-protein diet.
D. Sleeping 10 hours a night.
**Correct Answer: B**
**Rationale:** Obesity (especially post-menopausal) and sedentary
lifestyles are known modifiable risk factors.
5. According to the American Cancer Society (ACS), women at
"average risk" should have the option to start annual
mammograms at age:
A. 30
,B. 35
C. 40
D. 50
**Correct Answer: C**
**Rationale:** ACS guidelines suggest women ages 40-44 should have the
choice to start annual screening.
6. A "high-risk" woman for whom annual screening MRI is
recommended (in addition to mammography) includes those with:
A. A history of one benign breast biopsy.
B. Dense breast tissue on a mammogram.
C. A lifetime risk of breast cancer ≥20% as calculated by risk models
(e.g., Tyrer-Cuzick).
D. Any family history of breast cancer.
**Correct Answer: C**
**Rationale:** MRI is reserved for those with significantly elevated risk
(20-25% or greater).
7. Which of the following is a non-modifiable risk factor for breast
cancer?
A. Alcohol consumption.
B. Use of hormone replacement therapy.
C. Age at menarche (early onset).
D. Physical inactivity.
**Correct Answer: C**
,**Rationale:** Biological factors like early menstruation (<12) or late
menopause (>55) cannot be changed.
8. The Gail Model is a tool used primarily to:
A. Stage a diagnosed breast cancer.
B. Estimate the 5-year and lifetime risk of developing invasive breast
cancer.
C. Predict the response to chemotherapy.
D. Determine the need for radiation.
**Correct Answer: B**
**Rationale:** The Gail Model uses personal and family history to
calculate risk.
9. Chemoprevention (e.g., Tamoxifen or Raloxifene) is typically
considered for women with:
A. A 5-year risk of breast cancer ≥1.67%.
B. Any suspicious lump.
C. Fear of cancer.
D. A history of breastfeeding.
**Correct Answer: A**
**Rationale:** 1.67% is the threshold used in major prevention trials for
high-risk women.
10. Which type of breast biopsy is preferred for a suspicious non-
palpable calcification seen on a mammogram?
A. Fine Needle Aspiration (FNA)
B. Stereotactic Core Needle Biopsy
,C. Incisional Biopsy
D. Excisional Biopsy
**Correct Answer: B**
**Rationale:** Stereotactic biopsy uses mammographic imaging to guide
the needle to the calcifications.
11. A "BI-RADS 3" assessment on a mammogram report indicates
the finding is:
A. Negative.
B. Benign.
C. Probably benign (short-interval follow-up recommended).
D. Highly suspicious.
**Correct Answer: C**
**Rationale:** BI-RADS 3 findings have a <2% risk of malignancy and
usually require a 6-month follow-up.
12. The "Continuum of Care" in breast health begins with:
A. Diagnosis.
B. Treatment.
C. Health promotion and risk assessment.
D. Survivorship.
**Correct Answer: C**
**Rationale:** Care starts with education and screening before any
disease is found.
13. Which of the following is a barrier to screening mammography
often addressed by breast care nurses?
,A. Lack of insurance or high cost.
B. Fear of pain or radiation.
C. Lack of transportation.
D. All of the above.
**Correct Answer: D**
**Rationale:** Nurses work to overcome financial, emotional, and physical
barriers to care.
14. "Informed Decision Making" regarding screening involves:
A. Telling the patient they must have a mammogram.
B. Discussing the benefits, risks, and limitations of the screening test.
C. Only providing information if the patient asks.
D. Having the doctor make the final choice.
**Correct Answer: B**
**Rationale:** Patients should understand potential for false positives and
overdiagnosis.
15. A woman with "dense breasts" (Category C or D on BI-RADS)
should be informed that:
A. She has cancer.
B. Mammography may be less sensitive in detecting small tumors.
C. She should never have another mammogram.
D. Dense tissue is a sign of youth.
**Correct Answer: B**
**Rationale:** Dense tissue and cancer both appear white on a
mammogram, making detection harder.
,16. Which of the following genes, when mutated, is associated with
Li-Fraumeni syndrome and a high risk of breast cancer?
A. PTEN
B. TP53
C. STK11
D. CDH1
**Correct Answer: B**
**Rationale:** TP53 mutations are the hallmark of Li-Fraumeni
syndrome.
17. The role of the "Multidisciplinary Team" in breast care is to:
A. Have everyone perform the same task.
B. Provide a coordinated approach to diagnosis and treatment planning.
C. Increase the cost of care.
D. Make decisions without the patient.
**Correct Answer: B**
**Rationale:** Teams include surgeons, oncologists, radiologists, and
nurses working together.
, Chapter 2: Diagnosis and Staging
Chapter Summary
Chapter 2 covers the critical steps following an abnormal screening or
the discovery of a breast symptom. It details the diagnostic workup,
including diagnostic mammography, ultrasound, and various biopsy
techniques. The chapter explains the pathology of breast cancer,
including receptor status (ER, PR, HER2) and histological types (Ductal
vs. Lobular). Staging is discussed using the TNM (Tumor, Node,
Metastasis) system, emphasizing the importance of accurate staging for
determining prognosis and selecting appropriate treatment modalities.
Multiple Choice Questions (MCQs)
1. The "T" in the TNM staging system for breast cancer refers to:
A. Time since diagnosis.
B. Tumor size and extent.
C. Type of cells.
D. Treatment plan.
**Correct Answer: B**
**Rationale:** T describes the size of the primary tumor and whether it
has spread to the skin or chest wall.
2. A tumor that is 1.5 cm in its greatest dimension with no lymph
node involvement is staged as:
A. T1c N0
B. T2 N0
C. Tis N0
D. T3 N1
**Correct Answer: A**
