American Board of Internal Medicine (ABIM) Certification Practice Exam

Neoadjuvant chemotherapy is given before surgery primarily to:

1. Increase the effectiveness of immunotherapy

2. Shrink tumors and eradicate unseen micrometastases

3. Prepare the patient for radiation therapy

4. Support the patient emotionally before surgery

The correct answer is: Shrink tumors and eradicate unseen micrometastases

Neoadjuvant chemotherapy is administered before surgical intervention primarily to shrink tumors and eliminate microscopic metastases that may not yet be detectable through imaging techniques. The rationale behind this approach is to reduce tumor size, making surgical removal more effective and feasible, while also targeting any cancer cells that have disseminated beyond the primary tumor site. This preoperative treatment can enhance the chances of complete resection and improve overall outcomes for the patient. The ability to address potential micrometastases before surgery is crucial because these small clusters of cancer cells could lead to recurrence if left untreated. Additionally, neoadjuvant chemotherapy can provide vital information regarding the tumor's response to treatment, which can inform postoperative therapeutic strategies and prognostic understanding. Other options do not capture the primary goal of neoadjuvant chemotherapy as effectively. While preparing a patient for radiation therapy or providing emotional support may have some relevance in certain contexts, neither directly correlates with the foundational purpose of neoadjuvant chemotherapy. Furthermore, while immunotherapy may play a role in cancer treatment, neoadjuvant chemotherapy is not primarily aimed at enhancing its efficacy.