American Board of Internal Medicine (ABIM) Certification Practice Exam

What does breast-conserving therapy entail?

1. Radical mastectomy followed by chemotherapy

2. Wide excision followed by breast radiation

3. Partial mastectomy followed by radiation

4. Only chemotherapy without surgery

The correct answer is: Wide excision followed by breast radiation

Breast-conserving therapy primarily focuses on removing the tumor while preserving as much of the surrounding healthy breast tissue as possible. This approach is designed to treat breast cancer effectively while maintaining the aesthetics of the breast. The correct answer highlights a common regimen for breast-conserving therapy, which involves a wide excision (or lumpectomy) of the tumor followed by radiation therapy. The wide excision involves surgically removing the tumor along with a margin of normal tissue to help ensure that any cancerous cells nearby are also removed. Following this, radiation therapy is typically employed to reduce the risk of local recurrence by targeting any remaining microscopic cancer cells in the breast. This method contrasts with more invasive procedures such as radical mastectomy, which involves the removal of the entire breast along with surrounding tissues, as well as the lymph nodes under the arm, and is not considered breast-conserving. Additionally, the option of chemotherapy without surgery does not fit the framework of breast-conserving therapy, as it does not involve the surgical removal of the tumor. Thus, the selection of wide excision plus radiotherapy accurately represents the intent and methods of breast-conserving therapy.