American Board of Internal Medicine (ABIM) Certification Practice Exam

What conditions warrant chest wall radiation therapy in breast cancer patients?

1. Only tumors smaller than 5 cm

2. Inflammatory breast cancer and any positive axillary lymph nodes

3. When patients opt for lumpectomy

4. Only if the patient is symptomatic

The correct answer is: Inflammatory breast cancer and any positive axillary lymph nodes

Chest wall radiation therapy is an important treatment modality for breast cancer patients, particularly in specific circumstances that particularly involve aggressive disease features. Inflammatory breast cancer, which is a rare but aggressive form of breast cancer, often requires comprehensive treatment interventions, including surgery and radiation. The presence of positive axillary lymph nodes indicates that the cancer has spread to lymphatic tissues, which typically necessitates more aggressive treatment, including radiation to both the chest wall and any involved lymphatic areas. This strategy helps minimize the risk of recurrence in high-risk patients, ensuring thorough management of the disease. Furthermore, in breast cancer cases where there is a greater likelihood of local recurrence due to advanced disease features, such as those found in inflammatory breast cancer or when there are positive lymph nodes, radiation can play a crucial role in enhancing treatment efficacy. It acts as a local therapy that targets residual cancer cells in the chest area, aiding in overall treatment success and improving patient outcomes. Thus, this treatment approach is warranted in the context of these specific conditions.