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BREAST DISEASE
Case #5 -
A 48 year old woman with a L breast lump

DISCUSSION QUESTIONS:
1.) What additional history do you need in this patient?  Answer 
2.) What are risk factors for breast cancer?  Answer 
3.) What are other important things to note in the physical exam?  Answer 
4.) What must then be done to diagnose this lesion?  Answer 
5.) What is the significance of the family history? What is the most common known gene mutation resulting in a high incidence of breast cancer? How is it inherited? What are the features of an inherited cancer syndrome?  Answer 
6.) What are currently recommended screening schedules for breast cancer?  Answer 
7.) What is the TNM staging classification for breast cancer?  Answer 
8.) What are factors that increase risk of recurrence? What are the two most important prognostic factors?  Answer 
9.) What is the sentinel node biopsy and why is it important and useful?  Answer 
10.) What are the surgical options for Stages I and II breast cancer?  Answer 
11.) Who gets adjuvant chemotherapy in Stages I and II?  Answer 
12.) Who gets adjuvant antiestrogen therapy?  Answer 
13.) What treatment approach do we take in Stage III breast cancer?  Answer 
14.) How do we follow breast cancer patients after treatment?  Answer 
 
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