breast cancer quiz (for radiation oncology residents)
TRANSCRIPT
Breast cancer Quiz
Dr Bharti Devnani
Moderator--Dr Ritesh Kumar
Rules
4 rounds
1st –Visual round
2nd – Multiple choice questions round
3rd- Clinical trial round
4th – True/False round
At any point of time Dr Ritesh’s decision is final
Round 1-Visual round
3 questions for each team
+10, -5
Lifeline- Call ur SR -Once
Questions can be passed
Last question on a piece of paper by all teams
Identify the device and its use
Identify the device & use
Spot diagnosis
Nodal staging of the disease
CLD and %Pulmonary toxicity
Which quadrant the lesion is?
Identify the radiation field and
indication
Identify the planning technique
Identify the planning technique
SCORES
A CB
D
E
F
Plz don’t shout, Raise your hands
Celebrity with breast cancer
SCORES
Round 2- MCQ
2 Q/team
Can use 50-50 lifeline once
Mandatory to attempt after using lifeline
+10,+5,-5Questions can not be passed
Which is a relative contraindication for BCS ?
1. Pregnancy
2. Diffuse suspicious or malignant appear
microcalcification
3. Prior history of RT
4. Diffusely positive pathologic margins
Criteria NOT included in Nottingham or Elston-
Ellis Bloom Richardson scoring is
1. Necrosis
2. Mitotic count
3. Tubule formation
4. Nuclear pleomorphism
• Definition of menopause- False statement is
1. FSH- 35mIU/ml,Estradiol- 5 pg/ml
2. Age>50 yrs
3. Age < 50 yrs but amenorrheic for 12 months
4. BSO
• A 50 yrs old lady with LABC underwent
NACT followed by MRM. Pathology showed
no response to chemotherapy. As per Miller-
Payne histopathological grading the tumor
response would be-
• Grade 1
• Grade 2
• Grade 3
• Grade 4
• Metastasis in a node of size >0.2 mm and >
200 cells
1. ITC
2. pN0 (i-)
3. pN1 mi
4. pN1a
Screening
Not an indication for annual MRI screening
1. BRCA mutation commence at age 25
2. First degree relative of BRCA commence at
25
3. > 20 percent lifetime risk by Gail model
4. Dense breast on mammography
Plz don’t shout, Raise your hands
Name the author
SCORES
Round 3
2 Q/team
Identify the trial
Lifeline-Double dip- 2 guesses at a question (Only by primary team once)
Can pass
+10 , +5,-5 to primary team, +5,-5 for subsequent teams
Name the trial
Name the trial
Name the trial
Mastectomy + Axillary Procedure
• T1 N1
• T2 N0 (Gr 3/ LVI)
• T2 N1
• T3 N0
Chest wall RT No Chest wall RT
Name the trial
Name the trial
Plz don’t shout, Raise your hands
World cancer day
World cancer day
Celebrated when?
What is the theme for the year ?
• Breast cancer awareness month
SCORES
Round 4-Teer na sahi tukka hi sahi
• No negative marking !!!
• True /False
• +5/0
DCIS
1. 2 mm margin is considered adequate.
2. Modified VNPI added age as a new criteria
3. Lumpectomy and lymph node surgery followed by WBRT is the std of care
4. Cribriform pattern is associated with good prognosis
5 According to EORTC 10853 Age <45 yrs is associated with significantly increased local recurrence.
Male breast cancer
1. Average age of presentation is earlier than
female counter part
2. Undescended testes is a risk factor
3. BRCA2 > BRCA1
4. Lobular histology is uncommon
5. Associated with high rates of hormone
expression receptors
Mammaprint
1. It is a 70 gene assay
2. No intermediate risk category
3. It is irrespective of ER or Her-2 Status
4. It can be performed in patients with 3 nodes
positive
5. Medullary histology is an exclusion criteria
Identify the person
What is the relation
Tie breaker
Where are these statues found ?
Tie breakers
• Tell the VNPI score
• Tell the Stage grouping
• Tell the allred score
Bone
• Name the Non-steroidal Aromatase inhibitor ?
1. Anastrozole
2. Tamoxifen
3. Exemestein
4. Fulvestrant
Danish 82c trial, all are true except
1. Patients were postmenopausal
2. Tamoxifen was given for 5 years
3. LRR were decreased in RT+ tamoxifen arm
4. Around 10% benefit in OS with addition of PMRT
Audience Q
Breast cancer in pregnancy
• ALND is mandatory
• MRM is the std of care
• Trastuzumab can be used safely
• Termination of pregnancy improves the
survival
• Breast feeding is contraindicated
• Chemotherapy should be given is last trimester
3-4 weeks prior to delivery
• In early her-2 + ca no benefit of extension of
Trastuzumab to 2 yrs in comparison to 1 yr