breast cancer quiz (for radiation oncology residents)

55
Breast cancer Quiz Dr Bharti Devnani Moderator--Dr Ritesh Kumar

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Page 1: Breast cancer quiz (For Radiation Oncology residents)

Breast cancer Quiz

Dr Bharti Devnani

Moderator--Dr Ritesh Kumar

Page 2: Breast cancer quiz (For Radiation Oncology residents)

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

Page 3: Breast cancer quiz (For Radiation Oncology residents)

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

Page 4: Breast cancer quiz (For Radiation Oncology residents)

Identify the device and its use

Page 5: Breast cancer quiz (For Radiation Oncology residents)

Identify the device & use

Page 6: Breast cancer quiz (For Radiation Oncology residents)

Spot diagnosis

Page 7: Breast cancer quiz (For Radiation Oncology residents)

Nodal staging of the disease

Page 8: Breast cancer quiz (For Radiation Oncology residents)

CLD and %Pulmonary toxicity

Page 9: Breast cancer quiz (For Radiation Oncology residents)

Which quadrant the lesion is?

Page 10: Breast cancer quiz (For Radiation Oncology residents)

Identify the radiation field and

indication

Page 11: Breast cancer quiz (For Radiation Oncology residents)

Identify the planning technique

Page 12: Breast cancer quiz (For Radiation Oncology residents)

Identify the planning technique

Page 13: Breast cancer quiz (For Radiation Oncology residents)

SCORES

Page 14: Breast cancer quiz (For Radiation Oncology residents)

A CB

D

E

F

Page 15: Breast cancer quiz (For Radiation Oncology residents)

Plz don’t shout, Raise your hands

Page 16: Breast cancer quiz (For Radiation Oncology residents)

Celebrity with breast cancer

Page 17: Breast cancer quiz (For Radiation Oncology residents)

SCORES

Page 18: Breast cancer quiz (For Radiation Oncology residents)

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

Page 19: Breast cancer quiz (For Radiation Oncology residents)

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

Page 20: Breast cancer quiz (For Radiation Oncology residents)

Criteria NOT included in Nottingham or Elston-

Ellis Bloom Richardson scoring is

1. Necrosis

2. Mitotic count

3. Tubule formation

4. Nuclear pleomorphism

Page 21: Breast cancer quiz (For Radiation Oncology residents)

• 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

Page 22: Breast cancer quiz (For Radiation Oncology residents)

• 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

Page 23: Breast cancer quiz (For Radiation Oncology residents)

• Metastasis in a node of size >0.2 mm and >

200 cells

1. ITC

2. pN0 (i-)

3. pN1 mi

4. pN1a

Page 24: Breast cancer quiz (For Radiation Oncology residents)

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

Page 25: Breast cancer quiz (For Radiation Oncology residents)

Plz don’t shout, Raise your hands

Page 26: Breast cancer quiz (For Radiation Oncology residents)

Name the author

Page 27: Breast cancer quiz (For Radiation Oncology residents)

SCORES

Page 28: Breast cancer quiz (For Radiation Oncology residents)

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

Page 29: Breast cancer quiz (For Radiation Oncology residents)

Name the trial

Page 30: Breast cancer quiz (For Radiation Oncology residents)

Name the trial

Page 31: Breast cancer quiz (For Radiation Oncology residents)

Name the trial

Page 32: Breast cancer quiz (For Radiation Oncology residents)

Mastectomy + Axillary Procedure

• T1 N1

• T2 N0 (Gr 3/ LVI)

• T2 N1

• T3 N0

Chest wall RT No Chest wall RT

Page 33: Breast cancer quiz (For Radiation Oncology residents)

Name the trial

Page 34: Breast cancer quiz (For Radiation Oncology residents)

Name the trial

Page 35: Breast cancer quiz (For Radiation Oncology residents)

Plz don’t shout, Raise your hands

Page 36: Breast cancer quiz (For Radiation Oncology residents)

World cancer day

World cancer day

Celebrated when?

What is the theme for the year ?

• Breast cancer awareness month

Page 37: Breast cancer quiz (For Radiation Oncology residents)

SCORES

Page 38: Breast cancer quiz (For Radiation Oncology residents)

Round 4-Teer na sahi tukka hi sahi

• No negative marking !!!

• True /False

• +5/0

Page 39: Breast cancer quiz (For Radiation Oncology residents)

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.

Page 40: Breast cancer quiz (For Radiation Oncology residents)

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

Page 41: Breast cancer quiz (For Radiation Oncology residents)

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

Page 42: Breast cancer quiz (For Radiation Oncology residents)

Identify the person

Page 43: Breast cancer quiz (For Radiation Oncology residents)

What is the relation

Page 44: Breast cancer quiz (For Radiation Oncology residents)

Tie breaker

Page 45: Breast cancer quiz (For Radiation Oncology residents)
Page 46: Breast cancer quiz (For Radiation Oncology residents)

Where are these statues found ?

Page 47: Breast cancer quiz (For Radiation Oncology residents)
Page 48: Breast cancer quiz (For Radiation Oncology residents)
Page 49: Breast cancer quiz (For Radiation Oncology residents)

Tie breakers

• Tell the VNPI score

• Tell the Stage grouping

• Tell the allred score

Page 50: Breast cancer quiz (For Radiation Oncology residents)

Bone

Page 51: Breast cancer quiz (For Radiation Oncology residents)

• Name the Non-steroidal Aromatase inhibitor ?

1. Anastrozole

2. Tamoxifen

3. Exemestein

4. Fulvestrant

Page 52: Breast cancer quiz (For Radiation Oncology residents)

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

Page 53: Breast cancer quiz (For Radiation Oncology residents)

Audience Q

Page 54: Breast cancer quiz (For Radiation Oncology residents)

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

Page 55: Breast cancer quiz (For Radiation Oncology residents)

• In early her-2 + ca no benefit of extension of

Trastuzumab to 2 yrs in comparison to 1 yr