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1. What BIRADS category is appropriate for a mammogram with no evidence of malignancy, but with a benign finding such as cysts?

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2. What BIRADS score is associated with a 95% chance of breast cancer?

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3. What is appropriate follow up of a BIRADS III mammogram?

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4. A 35yo F presents to her PCP inquiring about breast screening. What is the appropriate recommendation?

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5. A 30yo F with a family history of breast cancer presents to your clinic to discuss screening. Her mother had breast cancer at age 45 and her maternal grandmother was diagnosed at age 50. She underwent genetic testing, which was negative. Her lifetime risk of breast cancer is estimated at 16%. What do you recommend for screening?

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6. A 51yo F undergoes routine screening mammography, which shows a BIRADS 5 lesion in the upper outer quadrant of her left breast. Ultrasound confirms the presence of a spiculated mass and US-guided core needle biopsy is performed. Pathology demonstrates atypical ductal hyperplasia. Is this pathology concordant with the imaging findings?

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7. A 51yo F undergoes routine screening mammography, which shows a BIRADS 5 lesion in the upper outer quadrant of her left breast. Ultrasound confirms the presence of a spiculated mass and US-guided core needle biopsy is performed. Pathology demonstrates atypical ductal hyperplasia. What is the next best step in management?

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8. What is the difference between a screening mammogram and a diagnostic mammogram?

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9. Name a tool that can be used to determine the risk cutoff for chemoprevention:

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10. Name a tool that can be used to estimate lifetime risk of breast cancer for a woman with a strong family history of breast cancer:

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11. Describe the appropriate first line treatment for a typical breast abscess.

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12. What patient populations are at high risk for developing a breast abscess?

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13. What are some reasons to consider excision of a fibroadenoma?

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14. Which of the following are true regarding gynecomastia?

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15. Which of the following presentations is suspicious for Mondor’s disease?

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16. A woman presents complaining of intermittent bilateral breast pain. Clinical breast exam and screening mammography are reassuring. In addition to counseling her that mastodynia is generally benign, you also suggest that she consider:

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17. A 52yo woman presents complaining of unilateral, bloody, nipple discharge. On exam you identify bloody discharge from a single duct in her left breast. The remainder of your exam is unremarkable. What do you recommend next?

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18. A 40 year old female undergoes a core biopsy of a 5mm span of calcifications. Pathology demonstrates atypical ductal hyperplasia (ADH). What are the next best steps in management?

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19. You are seeing a patient for post-op follow up after a lumpectomy for a 1.2cm span of DCIS. On final surgical pathology, there is 1cm area of pleomorphic LCIS extending to the surgical margin. You recall reading that there is an important difference between classic LCIS and pleomorphic LCIS. What do you recommend for this patient?

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20. A patient is diagnosed with an intraductal papilloma on core needle biopsy. There is no evidence of any atypia or carcinoma in the pathology from the cores. You proceed with an excisional biopsy. What is the approximate risk of finding malignancy on final surgical pathology?

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21. What should you do if a palpable breast mass in a woman > 35 has no imaging correlate on mammogram, US or MRI?

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22. Describe the appropriate imaging work up for a palpable breast mass in a 40 year old man.

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23. You are seeing a new cancer consult. She is a 45yo African American woman with a 2.5cm triple negative invasive ductal carcinoma with clinically negative lymph nodes. She desires breast conservation. What is the appropriate order for her treatment?

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24. Which breast cancers typically warrant neoadjuvant chemotherapy? Select all that apply.

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25. The American Joint Committee on Cancer (AJCC) has defined diagnostic criteria for inflammatory breast cancer. Which of the following is one of the correct criteria that is REQUIRED to make a diagnosis of inflammatory breast cancer?

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26. A 55yo F has undergone neoadjuvant chemotherapy for inflammatory breast cancer. She appears to have had an excellent response. Prior to chemo, an ultrasound showed a normal appearance to her axillary lymph nodes. What is the appropriate surgical management?

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27. Which of the following describes the standard surgical treatment of a phyllodes tumor?

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