Carcinoma Breast - Risk Factors and Types MCQs

Explanation: Prophylactic cranial irradiation (PCI) is primarily used to reduce the risk of brain metastases in cancers that have a high likelihood of spreading to the central nervous system. Lung Cancer: PCI is most commonly administered in small cell lung cancer (SCLC) due to its aggressive nature and high tendency to metastasize to the brain. It has been shown to improve overall survival and decrease the incidence of brain metastases in patients who respond to initial treatment. Breast Cancer: PCI may be considered in select cases of breast cancer, particularly in patients at high risk for brain metastases. This includes aggressive subtypes such as HER2-positive and triple-negative breast cancer . Options A, B, and D are incorrect. Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC9020164/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4477380/

Skeletal metastases occurs via the bloodstream in breast carcinoma. The commonly involved sites in order of frequency include - Lumbar vertebrae - most common Femur Thoracic vertebrae Ribs Skull The deposits are generally more osteolytic than osteoblastic . Metastases may also commonly occur in the liver, lungs and brain and, occasionally, the adrenal glands and ovaries via the bloodstream. Reference : Love & Bailey short practice of surgery, chapter: 53, Edition: 27th, Pg: 873

Nipple discharge is not a feature of fibrocystic disease of the breast. Fibrocystic disease of the breast - Common during the fourth and fifth decades of life , generally lasting until menopause. There is an exaggerated response of breast stroma and epithelium to various circulating and locally produced hormones and growth factors. Characterized by the constellation of premenstrual cyclic breast pain, tenderness, and nodularity. As per Bailey it is not seen, so go with choice 3 Reference: Bailey & Love's SHORT PRACTICE of SURGERY, 28th edition, PART 8: ENDOCRINE AND BREAST, Chapter no.58

Risk factors for carcinoma of the male breast include- Gynaecomastia Excess endogenous or exogenous oestrogen. BRCA2 mutation Klinefeltor syndrome Infiltrating ductal carcinoma is the most common type of breast cancer in men. Diagnosis, grading, treatment and prognosis are the same as female breast cancer. BRCA2 mutation mostly causes a hormone receptor positive tumor. Hence tamoxifen can be used for treatment. Reference : Schwartz Principles of surgery, chapter: 17, Edition: 11 th , Pg: 551, 600

Explanation: Based on consensus pathological classification (e.g., from the American College of Pathologists), benign breast conditions carry varying risks for subsequent breast cancer: No Increased Risk: Conditions like squamous metaplasia , adenosis, cysts, and fibroadenoma. Slightly Increased Risk (1.5-2x): Florid epithelial hyperplasia and papilloma with a fibrovascular core . (Option A and B ruled out) Moderately Increased Risk (~5x): Atypical hyperplasia (a high-risk lesion). (Option C ruled out) Therefore, squamous metaplasia is a benign change with no documented increased risk of breast cancer development. Key Takeaways: Not all benign breast disease carries the same cancer risk. Atypical hyperplasia confers the highest risk among the options given.

75% of shunt infections present within 1 month, reflecting introduction at the time of insertion. Risk factors include - Very young patients Open myelomeningocoele Long operation time Staff movement in and out of theatre Treatment - Removal of shunt Antibiotic therapy Shunt reinserted at a new site after infection resolves. Reference : Bailey & Love's short practice of surgery 28th Edition, Chapter 48, Cranial neurosurgery, Pg: 705-706

Aneurysmal bleeding has an incidence of 10 - 15 per 100 000 population per year. Risk factors include age, female sex, hypertension, smoking, cocaine abuse and A family history with two first-degree relatives affected. Reference : Bailey & Love's short practice of surgery 28th Edition, Chapter 48, Cranial neurosurgery, Pg: 709

Pressure sores occur as a result of friction or persisting pressure on soft tissues. The pressure to cause the pressure sore is 30mm Hg. They particularly affect the pressure points of a recumbent patient, including the sacrum, greater trochanter and heels. Order of involvement of bed sores: ischium> greater trochanter> sacrum Risk factors are poor nutritional status, dehydration, lack of mobility and nerve block anaesthesia technique. Early mobilisation of the patient and regular inspection of pressure points by the nursing team can act to prevent pressure sores. High-risk patients may be nursed on an air mattress, which automatically relieves the pressure areas. Keep patients mobile or regularly turned if bed-bound