CBC Breast Cancer Treatment & Survivorship Support 2 — Questions and Answers
Question 1: Which of the following is a common long-term side effect of axillary lymph node dissection that breast counselors must educate patients about?
- Lymphedema (Correct answer)
- Cardiac arrhythmia
- Pulmonary embolism
- Alopecia
Correct answer: Lymphedema
Lymphedema, a chronic swelling caused by damage to the lymphatic system, is a significant long-term risk following axillary lymph node dissection.
Question 2: Tamoxifen as endocrine therapy is most commonly prescribed for which patient population?
- HER2-positive postmenopausal women
- Triple-negative premenopausal women
- ER-positive premenopausal women (Correct answer)
- BRCA2-positive women of any menopausal status
Correct answer: ER-positive premenopausal women
Tamoxifen is a selective estrogen receptor modulator (SERM) used for ER-positive breast cancer particularly in premenopausal women, blocking estrogen's effect on cancer cells.
Question 3: Which class of endocrine therapy is preferred for postmenopausal women with hormone receptor-positive breast cancer?
- Selective estrogen receptor modulators (SERMs)
- Aromatase inhibitors (Correct answer)
- GnRH agonists
- Progestin-based therapies
Correct answer: Aromatase inhibitors
Aromatase inhibitors (anastrozole, letrozole, exemestane) are preferred for postmenopausal women because they block peripheral estrogen synthesis, the primary estrogen source after menopause.
Question 4: Which components should be included in a comprehensive survivorship care plan (SCP)?
- Only the patient's surgical history
- Summary of treatment received, follow-up schedule, and long-term side effect information (Correct answer)
- Insurance billing codes for treatments received
- The oncologist's personal dietary recommendations only
Correct answer: Summary of treatment received, follow-up schedule, and long-term side effect information
A comprehensive survivorship care plan includes a treatment summary, recommended follow-up schedule, potential late effects, and guidance on healthy lifestyle behaviors.
Question 5: Chemotherapy-related cognitive impairment ('chemo brain') most commonly affects which cognitive domains?
- Long-term memory for past events
- Language comprehension and speech production
- Attention, concentration, and short-term memory (Correct answer)
- Motor coordination and balance
Correct answer: Attention, concentration, and short-term memory
Chemo brain primarily affects attention, concentration, and short-term memory, making it difficult for survivors to focus or recall recent information.
Question 6: Which recommendation is most appropriate for breast cancer survivors at risk for bone loss during aromatase inhibitor therapy?
- Avoid all weight-bearing exercise to protect bones
- Take calcium and vitamin D supplements and engage in weight-bearing exercise (Correct answer)
- Discontinue aromatase inhibitor therapy immediately if bone density decreases slightly
- Use high-dose estrogen therapy to counteract bone loss
Correct answer: Take calcium and vitamin D supplements and engage in weight-bearing exercise
Aromatase inhibitors can reduce bone density; calcium and vitamin D supplementation combined with weight-bearing exercise are recommended to mitigate this risk.
Question 7: How frequently are mammograms typically recommended for breast cancer survivors who have completed treatment?
- Every 5 years
- Only if new symptoms occur
- Annually (every year) (Correct answer)
- Every 2 years after the first post-treatment year
Correct answer: Annually (every year)
Annual mammograms are generally recommended for breast cancer survivors to monitor for recurrence or new primary breast cancers.
CBC Breast Cancer Treatment & Survivorship Support 2
Which of the following is a common long-term side effect of axillary lymph node dissection that breast counselors must educate patients about?