A 64-year-old woman presents to the surgical oncology clinic as a new patient for evaluation of recently diagnosed breast cancer. She has a medical history of type 2 diabetes mellitus for which she takes metformin. Her surgical history is a total knee arthroplasty 7 years ago. Her family history is insignificant. Physical examination is notable for an irregular nodule near the surface of her right breast. Her primary concern today is which surgical approach will be chosen to remove her breast cancer. Which of the following procedures involves the removal of a portion of a breast?
AArthroplasty
BLumpectomy
CVasectomy
DMastectomy
ELaminectomy
A 70-year-old man comes to the physician because of right-sided back pain, red urine, and weight loss for the last 4 months. He has smoked one pack of cigarettes daily for 40 years. A CT scan of the abdomen shows a large right-sided renal mass. Biopsy of the mass shows polygonal clear cells filled with lipids. Which of the following features is necessary to determine the tumor grade in this patient?
AInvasion of surrounding structures
BResponse to chemotherapy
CNuclear pleomorphism and nucleolar prominence
DInvolvement of regional lymph nodes
ESize of malignant proliferation
An 84-year-old woman is brought to the physician by her son after he found her trying to hang herself from the ceiling because she felt that she was a burden to her family. Her family says that for the past 2 months she has had no energy to leave her room, has been sleeping most of the day, has lost 10 kg (22 lb), and cries every day. She was diagnosed with breast cancer that has metastasized to the liver 4 months ago. She moved in with her son and daughter-in-law shortly after the diagnosis. She initially underwent chemotherapy but discontinued the treatment when the metastases spread to the spine and brain. Her life expectancy is 1–2 weeks and she is currently receiving home-hospice care. Her only current medication is a fentanyl patch. She is 160 cm (5 ft 3 in) tall and weighs 46 kg (101.4 lb); BMI is 18 kg/m2. Her vital signs are within normal limits. Examination shows slow speech, a flat affect, and depressed mood. Which of the following treatments is initially most likely to provide the greatest benefit for this patient?
AElectroconvulsive therapy
BMethylphenidate
CMegestrol
DFluoxetine
EBupropion
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