NPSA 2018 3rd Session

1. A 46 year old woman presents with a digital breast mammography finding of architectural distortion which does not correspond to a lesion on ultrasound. What is an appropriate next step in management?

Ultrasound-guided biopsy

Repeat mammogram in one year

Mastectomy

Digital breast tomosynthesis-guided biopsy

2. What is the approximate rate of pathologic upgrading of atypical ductal hyperplasia found on core needle biopsy to ductal carcinoma in situ or invasive ductal carcinoma?

5%

15%

30%

45%

3. According to the SSO-ASTRO invasive margins guidelines, what would be the suggested management for a woman with a 3 cm, intermediate grade, unifocal breast cancer with close but negative margins following lumpectomy?

Re-excise margins

Proceed to mastectomy

Proceed to adjuvant radiation

Monitor on imaging for 6 months before proceeding

4. With regards to patient reported outcomes, which of the following surgical options are least optimal, according to the current literature and preliminary results from this study?

Breast Conserving Therapy (BCT)

Mastectomy

Mastectomy with Reconstruction (autologous)

Mastectomy with Reconstruction (implant)

5. In this study of an equal-access, no cost healthcare system, what was the overall compliance with screening breast MRI among women with a ≥20% risk of developing breast cancer?

12%

24%

48%

72%

6. Which of the following factors was the strongest predictor of complications after open AAA surgery?

Postoperative hypotension

Postoperative hypothermia

Postoperative hypoglycemia

Postoperative bradycardia

7. A 66 year old man undergoes elective AAA repair with suprarenal clamp. Intraoperatively he is noted to be hypotensive and hypothermic. His operative time is 5 hours. Which factor is the strongest predictor of postoperative mortality?

Age

Operative time

Intraoperative hypotension

Intraoperative hypothermia

8. A 65 year old female is found to have atypical ductal hyperplasia in 5 of 5 cores after biopsy of a palpable breast mass, with residual microcalcifications post-biopsy. Which of the following is the strongest risk factor for occult underlying malignancy?

Presence of microcalcifications post-biopsy

Patient age

Presence of atypical ductal hyperplasia on biopsy

High proportion of biopsy cores positive for atypical ductal hyperplasia

Npsa 2018 3rd Session