ABSITE LATEST 2026 CORE EXAM MANUAL QUESTIONS
AND ANSWERS GRADED A+
✔✔BIRADS - ✔✔1 Negative Routine screening 2 Benign finding Routine screening 3
Probably benign finding Short-interval 4 Suspicious abnormality Definite probability
malignancy; biopsy 5 Highly suggestive of malignancy High probability cancer;
appropriate action should
✔✔Nodal status - ✔✔most imp prognostic factor for breast CA - I - lateral to pectoralis
minor muscle • II - beneath pectoralis minor muscle • III - medial to pectoralis minor
muscle • Rotter's nodes - between the pectoralis major and pectoralis minor muscles
✔✔Breast CA TNM - ✔✔T1: <2 cm. T2: 2-5 cm. T3: >5 cm. T4: skin or chest wall
involvement (does not include pectoral muscles), peau d'orange, inflammatory cancer
N1: ipsilateral axillary nodes. N2: fixed ipsilateral axillary nodes. N3: ipsilateral internal
mammary nodes M1: distant metastasis (includes ipsilateral supraclavicular nodes)
Stage TNM Status I T1,N0,M0 IIa T0-1,N1,M0 or T2,N0,M0 IIb T2,N1,M0 or T3,N0,M0
IIIa T0-3,N2,M0 or T3,N1-2,M0 IIIb Any T4 or N3 tumors IV M1
✔✔Male breast cancer - ✔✔breast cancer - more likely to be hormonally active,
Klinefelter's syndrome, more likely bilateral. Tx: MRM
✔✔BRCA I - ✔✔a/w ovarian and endometrial CA; consider TAH/BSO
✔✔BRCA II - ✔✔a/w male breast CA
✔✔Inflammatory breast CA - ✔✔May need chemotherapy and XRT 1st, then
mastectomy • Considered T4 disease • Very aggressive → median survival of 36
months • Has dermal lymphatic invasion, which causes peau d'orange lymphedema
appearance; erythematous and warm
✔✔Contraindications to breast conserving therapy - ✔✔Two or more primary tumors in
separate quadrants of the breast • Persistent positive margins after reasonable surgical
attempts • Pregnancy is an absolute contraindication to the use of breast irradiation.
When cancer is diagnosed in the third trimester; it may be possible to perform breast-
conserving surgery and treat the patient with irradiation after delivery • A history of prior
therapeutic irradiation to the breast region that would result in retreatment to an
excessively high radiation dose • Diffuse malignant-appearing microcalcifications
✔✔Breast tumore >1 cm Tx - ✔✔Lumpectomy and SLNB (or ALND), postop XRT -
need 1-cm margin
✔✔XRT after mastectomy - ✔✔• >4 nodes • Skin or chest wall involvement • Positive
margins • Tumor > 5 cm (T3) • Extracapsular nodal invasion • Inflammatory CA • Fixed
axillary nodes (N2) or internal mammary nodes (N3) • Lumpectomy with XRT
, ✔✔Breast CA Chemo - ✔✔• TAC for 6-12 weeks • Positive nodes - everyone gets
chemo except postmenopausal women with positive estrogen receptors → tamoxifen •
>1 cm and negative nodes - everyone gets chemo except patients with positive
estrogen receptors → tamoxifen • <1 cm and negative nodes - no further treatment
✔✔Cystosarcoma phyllodes - ✔✔>5-10 mitoses, NO nodal mets, 10% malig, resembles
giant fibroadenoma, TX: WLE
✔✔Pregnancy with breast mass - ✔✔• 1st trimester - MRM • 2nd trimester - MRM • 3rd
trimester - MRM or if late can perform lumpectomy with ALND and postpartum XRT •
May be able to wait until delivery for treatment • No chemotherapy or XRT while
pregnant; no breast-feeding after delivery
✔✔PTH - ✔✔inc serum Ca, distal convoluted tubule
✔✔Vit D - ✔✔ince Ca and PO4 absorption, Ca Binding Protein
✔✔Primary HPT - ✔✔PRAD-1, women, age, inc Ca, dec PO4, hyperchloremic
metabolic acidosis, osteitis fibrosa cystica, bones/stones/groans
✔✔Primary HPT w/u - ✔✔elevated Ca, CXR, excretory urogram, protein
electrophoresis, 24-hr urinary ca, rule out MEN I, PTH level
✔✔PT Adeno CA - ✔✔Cal >13.5-15, radical parathyroidectomy + ipsi thyroid
✔✔Missing PT gland - ✔✔check inferiorly, sestamibi, follow PTH, ipsi thyroidectomy
✔✔post op hypoCa - ✔✔bone hunger (nml PTH, dec HCO3-), hypoMg, failure of PT
remnant or graft (dec PTH, nml HCO3-)
✔✔Secondary HPT - ✔✔renal failure, inc PTH/low Ca, most do not need surgery
✔✔Tertiary HPT - ✔✔corrected renal dz but still PTH overproduction
✔✔Familial Hypercalcemic Hypocalciuria - ✔✔Inc serum and dec urine Ca, PTH-R DCT
kidney, no Tx
✔✔PseudohypoPT - ✔✔PTH-R defect, unresponsive to PTH
✔✔PTH Ca - ✔✔50% 5-yr survival, lung mets, wide en bloc excision
✔✔MEN I - ✔✔Parathyroid, Panc islet cell, pit adenoma
AND ANSWERS GRADED A+
✔✔BIRADS - ✔✔1 Negative Routine screening 2 Benign finding Routine screening 3
Probably benign finding Short-interval 4 Suspicious abnormality Definite probability
malignancy; biopsy 5 Highly suggestive of malignancy High probability cancer;
appropriate action should
✔✔Nodal status - ✔✔most imp prognostic factor for breast CA - I - lateral to pectoralis
minor muscle • II - beneath pectoralis minor muscle • III - medial to pectoralis minor
muscle • Rotter's nodes - between the pectoralis major and pectoralis minor muscles
✔✔Breast CA TNM - ✔✔T1: <2 cm. T2: 2-5 cm. T3: >5 cm. T4: skin or chest wall
involvement (does not include pectoral muscles), peau d'orange, inflammatory cancer
N1: ipsilateral axillary nodes. N2: fixed ipsilateral axillary nodes. N3: ipsilateral internal
mammary nodes M1: distant metastasis (includes ipsilateral supraclavicular nodes)
Stage TNM Status I T1,N0,M0 IIa T0-1,N1,M0 or T2,N0,M0 IIb T2,N1,M0 or T3,N0,M0
IIIa T0-3,N2,M0 or T3,N1-2,M0 IIIb Any T4 or N3 tumors IV M1
✔✔Male breast cancer - ✔✔breast cancer - more likely to be hormonally active,
Klinefelter's syndrome, more likely bilateral. Tx: MRM
✔✔BRCA I - ✔✔a/w ovarian and endometrial CA; consider TAH/BSO
✔✔BRCA II - ✔✔a/w male breast CA
✔✔Inflammatory breast CA - ✔✔May need chemotherapy and XRT 1st, then
mastectomy • Considered T4 disease • Very aggressive → median survival of 36
months • Has dermal lymphatic invasion, which causes peau d'orange lymphedema
appearance; erythematous and warm
✔✔Contraindications to breast conserving therapy - ✔✔Two or more primary tumors in
separate quadrants of the breast • Persistent positive margins after reasonable surgical
attempts • Pregnancy is an absolute contraindication to the use of breast irradiation.
When cancer is diagnosed in the third trimester; it may be possible to perform breast-
conserving surgery and treat the patient with irradiation after delivery • A history of prior
therapeutic irradiation to the breast region that would result in retreatment to an
excessively high radiation dose • Diffuse malignant-appearing microcalcifications
✔✔Breast tumore >1 cm Tx - ✔✔Lumpectomy and SLNB (or ALND), postop XRT -
need 1-cm margin
✔✔XRT after mastectomy - ✔✔• >4 nodes • Skin or chest wall involvement • Positive
margins • Tumor > 5 cm (T3) • Extracapsular nodal invasion • Inflammatory CA • Fixed
axillary nodes (N2) or internal mammary nodes (N3) • Lumpectomy with XRT
, ✔✔Breast CA Chemo - ✔✔• TAC for 6-12 weeks • Positive nodes - everyone gets
chemo except postmenopausal women with positive estrogen receptors → tamoxifen •
>1 cm and negative nodes - everyone gets chemo except patients with positive
estrogen receptors → tamoxifen • <1 cm and negative nodes - no further treatment
✔✔Cystosarcoma phyllodes - ✔✔>5-10 mitoses, NO nodal mets, 10% malig, resembles
giant fibroadenoma, TX: WLE
✔✔Pregnancy with breast mass - ✔✔• 1st trimester - MRM • 2nd trimester - MRM • 3rd
trimester - MRM or if late can perform lumpectomy with ALND and postpartum XRT •
May be able to wait until delivery for treatment • No chemotherapy or XRT while
pregnant; no breast-feeding after delivery
✔✔PTH - ✔✔inc serum Ca, distal convoluted tubule
✔✔Vit D - ✔✔ince Ca and PO4 absorption, Ca Binding Protein
✔✔Primary HPT - ✔✔PRAD-1, women, age, inc Ca, dec PO4, hyperchloremic
metabolic acidosis, osteitis fibrosa cystica, bones/stones/groans
✔✔Primary HPT w/u - ✔✔elevated Ca, CXR, excretory urogram, protein
electrophoresis, 24-hr urinary ca, rule out MEN I, PTH level
✔✔PT Adeno CA - ✔✔Cal >13.5-15, radical parathyroidectomy + ipsi thyroid
✔✔Missing PT gland - ✔✔check inferiorly, sestamibi, follow PTH, ipsi thyroidectomy
✔✔post op hypoCa - ✔✔bone hunger (nml PTH, dec HCO3-), hypoMg, failure of PT
remnant or graft (dec PTH, nml HCO3-)
✔✔Secondary HPT - ✔✔renal failure, inc PTH/low Ca, most do not need surgery
✔✔Tertiary HPT - ✔✔corrected renal dz but still PTH overproduction
✔✔Familial Hypercalcemic Hypocalciuria - ✔✔Inc serum and dec urine Ca, PTH-R DCT
kidney, no Tx
✔✔PseudohypoPT - ✔✔PTH-R defect, unresponsive to PTH
✔✔PTH Ca - ✔✔50% 5-yr survival, lung mets, wide en bloc excision
✔✔MEN I - ✔✔Parathyroid, Panc islet cell, pit adenoma
