American Board of Internal Medicine (ABIM) Certification Practice Exam

What is an indication for breast conserving therapy in breast cancer patients?

1. Tumors greater than 5 cm with clear margins

2. Tumors involving multiple quadrants

3. Tumors 5 cm or less with clear margins

4. All tumors diagnosed after age 40

The correct answer is: Tumors 5 cm or less with clear margins

Breast conserving therapy (BCT), which typically involves lumpectomy followed by radiation therapy, is indicated for tumors that are small and can be adequately removed while achieving clear surgical margins. Tumors that are 5 cm or less with clear margins allow for an effective balance between minimizing surgical intervention and optimizing oncological outcomes. This approach aims to preserve breast tissue while effectively removing cancerous cells, which is a critical consideration for patients looking to maintain their quality of life. Larger tumors or those involving multiple quadrants could complicate surgical resection and might not be amenable to BCT, as achieving clear margins becomes more challenging. Similarly, age alone is not a determining factor for BCT; rather, the size of the tumor and the presence of clear margins are more definitive indicators for this therapeutic approach.