American Board of Internal Medicine (ABIM) Certification Practice Exam

For ultrasound surveillance of breast cancer, which group should be included?

1. Only men diagnosed with breast cancer

2. Women with benign breast conditions

3. Women with BRCA1/2 mutations

4. Women diagnosed with breast cancer after age 60

The correct answer is: Women with BRCA1/2 mutations

In the context of breast cancer surveillance, individuals with BRCA1/2 mutations are in a high-risk category for developing breast cancer. These genetic mutations significantly increase the likelihood of breast and ovarian cancers, making regular and thorough surveillance, including breast ultrasound, essential as part of their ongoing management. Screening methods such as ultrasound can be particularly useful for high-risk populations because standard mammograms may not always be as effective in dense breast tissue, which is more common in younger women. By including women with BRCA1/2 mutations in ultrasound surveillance programs, healthcare providers can better monitor for early signs of breast cancer, increasing the chances of successful treatment if cancer does develop. This proactive approach is crucial given the heightened risks associated with these genetic factors. Other groups mentioned do not warrant the same level of intensive surveillance. For example, while men diagnosed with breast cancer may need follow-up, they are a much smaller population overall and typically have different surveillance guidelines. Women with benign breast conditions or those diagnosed after a certain age do not automatically qualify for the same intense screening protocols unless other risk factors are present. Thus, focusing on women with BRCA1/2 mutations emphasizes the importance of targeted surveillance based on individual risk factors in breast cancer management.