American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the primary purpose of breast cancer chemoprophylaxis in patients with atypical ductal hyperplasia?

1. To reduce the rate of surgery

2. To increase hormone therapy compliance

3. To decrease the risk of breast cancer

4. To enhance imaging accuracy

The correct answer is: To decrease the risk of breast cancer

The primary purpose of breast cancer chemoprophylaxis in patients with atypical ductal hyperplasia is to decrease the risk of breast cancer. Atypical ductal hyperplasia is considered a marker of increased risk for the development of breast cancer, and chemoprophylactic agents, such as selective estrogen receptor modulators like tamoxifen or aromatase inhibitors, have been shown to significantly lower this risk. By providing these interventions, clinicians aim to improve long-term outcomes for patients who are at higher risk due to histological findings. Other options, while they may touch upon elements of breast care or management, do not capture the main objective of chemoprophylaxis. For instance, reducing the rate of surgery may be a consideration in the treatment plan, but is not the primary intention of chemoprophylaxis. Increasing hormone therapy compliance and enhancing imaging accuracy are important aspects of cancer care but are not directly related to why chemoprophylaxis is administered in the context of atypical ductal hyperplasia. The fundamental goal remains the identification and management of patients at increased risk for breast cancer, making risk reduction the key focus of therapy in this scenario.