Breast

Question 1

Staging Breast: Tumor > 1mm but </= 5 mm

Answer 1

T1a

Question 2

Staging Breast: Tumor > 5 mm but </= 10 mm

Answer 2

T1b

Question 3

Staging Breast: Tumor >10mm but </=20mm

Answer 3

T1c

Question 4

Staging Breast: Tumor > 20 mm but </= 50 mm

Answer 4

T2

Question 5

Staging Breast: Tumor > 50 mm

Answer 5

T3

Question 6

Staging Breast: Extension to chest wall; (invasion/adherence to pectoralis w/o invasion of chest wall structures does not qualify)

Answer 6

T4a

Question 7

Staging Breast: Ulceration and/or ipsilateral macroscopic satellite nodules and/or edema of the skin that does not meet criteria for inflammatory carcinoma

Answer 7

T4b

Question 8

Staging Breast: Both chest wall and skin invasion

Answer 8

T4c

Question 9

Staging Breast: inflammatory carcinoma (and what are the criteria)

Answer 9

T4 d
rapid onset (< 6months) of warmth, erythema, edema of > 1/3 of breast w/w/o palpable mass AND pathologic confirmation of invasive carcinoma

Question 10

Staging Breast: Clinical: metastasis to a movable ipsilateral I/II lymph nodes

Answer 10

cN1

Question 11

Staging Breast: Clinical: Metastasis in ipsilateral level I/II axillary lymph nodes fixed to one another or to other structures

Answer 11

cN2a

Question 12

Staging Breast: Clinical: Metastasis in ipsilateral IMN w/o axillary nodal involvement

Answer 12

cN2b

Question 13

Staging Breast: Clinical: Metastasis in ipsilateral infraclavicular LN

Answer 13

cN3a

Question 14

Staging Breast: Clinical: Metastasis in ipsilateral IMN and axillary LN

Answer 14

cN3b

Question 15

Staging Breast: Clinical: Metastasis in SCV LN

Answer 15

cN3c

Question 16

Staging Breast: Pathologic: metastasis in 1-3 axillary LN

Answer 16

pN1a

Question 17

Staging Breast: Pathologic: Metastasis in IMN sentinel lymph node

Answer 17

pN1b

Question 18

Staging Breast: Pathologic: Metastasis in 1-3 axillary LN and IMN sentinel lymph node

Answer 18

pN1c

Question 19

Staging Breast: Pathologic: Metastasis in 4-9 axillary lymph nodes

Answer 19

pN2a

Question 20

Staging Breast: Pathologic: Metastasis in clinically detected IMN w/w/o microscopic confirmation with pathologically negative axillary nodes

Answer 20

pN2b

Question 21

Staging Breast: Pathologic: metastasis in 10 or more axillary LN or infraclavicular nodes

Answer 21

pN3a

Question 22

Staging Breast: Pathologic: metastasis in 1-9 axillary LN with clinically detected IMN or 4-9 axillary lymph nodes with positive IMN sentinel lymph node

Answer 22

pN3b

Question 23

Staging Breast: Pathologic: Metastasis in ipsilateral SCV LN

Answer 23

pN3c

Question 24

Breast: APBI candidates with early stage invasive disease

Answer 24

Grade 1-2
ER +
Age >/= 40
Tumor </= 2 cm
negative margins
no LVSI
no nodes
not lobular

Question 25

Breast: APBI candidate with DCIS

Answer 25

low - intermediate grade Age >/= 40 Tumor

Question 26

APBI RT dose and expansions

Answer 26

30 Gy in 5fx QOD GTV + 1 cm = CTV CTV + 1 cm = PTV

Question 27

APBI constraints: Lung

Answer 27

Ipsilateral: V10 Gy < 20% Contralateral: V5 Gy < 10%

Question 28

APBI constraints: Breast

Answer 28

Ipsilateral: V15 Gy < 50%, V28.5 < 25% Contralateral: Max point 100 cGy

Question 29

WBRT Boost recommendations

Answer 29

Young age, high mitotic count, close/positive margins

Question 30

APBI constraints: Heart

Answer 30

right side V1.5 Gy < 10%, mean < 1 Gy left side V4.5 < 10%, mean < 2 Gy

Question 31

APBI constraints: PTV max point dose

Answer 31

3150 cGy (hard 3300 cGy)

Question 32

WBRT omission criteria

Answer 32

age > 65 ER + HER2 - N0 <3cm grade < 3

Question 33

Pulmonary toxicity - pneumonitis treatment

Answer 33

5-6 weeks prednisone 60 mg, decreased by 10 per week repeat CT to show resolution