A 49-year-old woman presents to her physician with complaints of breast swelling and redness of the skin over her right breast for the past 1 month. She also mentions that the skin above her right breast appears to have thickened. She denies any pain or nipple discharge. The past medical history is significant for a total abdominal hysterectomy at 45 years of age. Her last mammogram 1 year ago was negative for any pathologic changes. On examination, the right breast was diffusely erythematous with gross edema and tenderness and appeared larger than the left breast. The right nipple was retracted and the right breast was warmer than the left breast. No localized mass was palpated. Which of the following statements best describes the patient’s most likely condition?
AIt shows predominant lymphatic spread.
BThe lesion expresses receptors for estrogen and progesterone.
CThe lesion is due to Streptococcal infection.
DIt is a benign lesion.
EThe inflammation is due to obstruction of dermal lymphatic vessels.
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
The patient undergoes a mammogram, which shows a 6.5mm sized mass with an irregular border and spiculated margins. A subsequent core needle biopsy of the mass shows infiltrating ductal carcinoma with HER2-positive, estrogen-negative, and progesterone-negative immunohistochemistry staining. Blood counts and liver function tests are normal. Laboratory studies show: Hemoglobin 12.5 g/dL Serum Na+ 140 mEq/L Cl- 103 mEq/L K+ 4.2 mEq/L HCO3- 26 mEq/L Ca2+ 8.9 mg/dL Urea Nitrogen 12 mg/dL Glucose 110 mg/dL Alkaline Phosphatase 25 U/L Alanine aminotransferase (ALT) 15 U/L Aspartate aminotransferase (AST) 13 U/L Which of the following is the most appropriate next step in management?
ABreast-conserving therapy and sentinel lymph node biopsy
BBilateral mastectomy with lymph node dissection
CTrastuzumab therapy
DBone scan
EWhole-body PET/CT
+ 7 more in the PDF
Browse all chapters