Breast Cancer BCOP Exam Questions with Correct Answers| Latest Update
Guaranteed Success
Incidence of HER-2 expression positivity 20-25%
Hereditary Breast Cancer makes up ___% of all breast cancer cases 5-10%
HER expression percentage on all breast cancers is_______? 20-25% amplification=poor
prognosis
IHC positivity= what value Scale 1-3 3 (2 is equivocal)
Risk Factors for BC Age >60, Primary family member, early menarche/late menopause,
nulliparity, first child after 30
HRT (WHI study demonstrated increased BC risk in Est + Prog HRT, second WHI study with
increased risk of stroke, decreased risk of breast cancer in those who got Est. only
replacement).
alcohol consuption, obesity, benign breast disease, breast density, radiation exposure at a
young age
BC chemoprevention? Tamoxifen if >60, or younger with >1.7 Gail Risk or LCIS
But...endometrial CA and VTE are increased
NCCN Summary of BC Risk Reduction Guidelines Yes if hx of LCIS,Gail 1.7 or more, RT
thoracic before 30, atypical hyperplasia, some genetic worries. Use drugs only if >35, Bilateral
mastectomies
Poor prognostic factors for BC Primary chemo resistance, ER/PR negative, poor
differentiation, high Ki-67, Lymphatic invasion, diabetes, obesity, HER-2 positive
Adjuvant Online- what is it. Decision tool for adjuvant treatment
, Est 10 yr risk
Oncotype Dx what is it screens for 21 genes for tamoxifen and anastrozole for risk
assessment in HR positive HER-2 negative, node negative cancer
when to use chemo based on Oncotype Dx score >30 treat
score 26-30 use other patient factors to determine benefits of treating
score <25 + >50 yo, endocrine tx
score 16-25 and <50 consider treatment - more benefit as seein in TAILORx study
No Biomarker test is recommended for prognosis of the following: ER/PR pos with HER2 neg
with node positive disease, Any Her-2 positive or Triple negative
Treatment for Lobular Carcinoma In Situ - a pure noninvasive BC Rule out DCIS, surgery(low
recurrence risk), maybe tamoxifen for premeno and Tamox, ralox or AI for postmeno
DCIS Treatment- a pure non invasive BC Breast conserving surgery plus /minus RT, total
mastectomy. Endocrine therapy for 5 yrs for ER+ Tamox for pre or post, AI for older less VTE
Stage IA,IB,IIA,IIB (Early Stage) Invasive BC or T3 N1 M0 Goal is cure, primary surgery +/- RT
always. Chemo discussion with risk assessment
Chemo for Early Stage InvasiveBC Chemo is gold standard, hormone maybe if
postmenopausal ER+
When do you use NeoAdjuvant chemo in early stage BC For large IIA and IIB tumors
What is the goal ofAdjuvant Chemo for Early stage BC CURE prevent recurrence regional
control for micromets
Guaranteed Success
Incidence of HER-2 expression positivity 20-25%
Hereditary Breast Cancer makes up ___% of all breast cancer cases 5-10%
HER expression percentage on all breast cancers is_______? 20-25% amplification=poor
prognosis
IHC positivity= what value Scale 1-3 3 (2 is equivocal)
Risk Factors for BC Age >60, Primary family member, early menarche/late menopause,
nulliparity, first child after 30
HRT (WHI study demonstrated increased BC risk in Est + Prog HRT, second WHI study with
increased risk of stroke, decreased risk of breast cancer in those who got Est. only
replacement).
alcohol consuption, obesity, benign breast disease, breast density, radiation exposure at a
young age
BC chemoprevention? Tamoxifen if >60, or younger with >1.7 Gail Risk or LCIS
But...endometrial CA and VTE are increased
NCCN Summary of BC Risk Reduction Guidelines Yes if hx of LCIS,Gail 1.7 or more, RT
thoracic before 30, atypical hyperplasia, some genetic worries. Use drugs only if >35, Bilateral
mastectomies
Poor prognostic factors for BC Primary chemo resistance, ER/PR negative, poor
differentiation, high Ki-67, Lymphatic invasion, diabetes, obesity, HER-2 positive
Adjuvant Online- what is it. Decision tool for adjuvant treatment
, Est 10 yr risk
Oncotype Dx what is it screens for 21 genes for tamoxifen and anastrozole for risk
assessment in HR positive HER-2 negative, node negative cancer
when to use chemo based on Oncotype Dx score >30 treat
score 26-30 use other patient factors to determine benefits of treating
score <25 + >50 yo, endocrine tx
score 16-25 and <50 consider treatment - more benefit as seein in TAILORx study
No Biomarker test is recommended for prognosis of the following: ER/PR pos with HER2 neg
with node positive disease, Any Her-2 positive or Triple negative
Treatment for Lobular Carcinoma In Situ - a pure noninvasive BC Rule out DCIS, surgery(low
recurrence risk), maybe tamoxifen for premeno and Tamox, ralox or AI for postmeno
DCIS Treatment- a pure non invasive BC Breast conserving surgery plus /minus RT, total
mastectomy. Endocrine therapy for 5 yrs for ER+ Tamox for pre or post, AI for older less VTE
Stage IA,IB,IIA,IIB (Early Stage) Invasive BC or T3 N1 M0 Goal is cure, primary surgery +/- RT
always. Chemo discussion with risk assessment
Chemo for Early Stage InvasiveBC Chemo is gold standard, hormone maybe if
postmenopausal ER+
When do you use NeoAdjuvant chemo in early stage BC For large IIA and IIB tumors
What is the goal ofAdjuvant Chemo for Early stage BC CURE prevent recurrence regional
control for micromets
