American Board of Internal Medicine (ABIM) Certification Practice Exam

Which follow-up method is indicated post breast cancer treatment for high-risk patients?

1. MRI of the breast

2. Only clinical examinations

3. Weekly blood tests

4. Annual physical exams

The correct answer is: MRI of the breast

For high-risk patients who have undergone treatment for breast cancer, MRI of the breast is indicated as a follow-up method due to its superior sensitivity in detecting local recurrences and new primary cancers compared to other imaging modalities. This is particularly important for high-risk patients who may have denser breast tissue or other risk factors that could obscure findings on standard mammograms. MRI provides detailed images and can help identify changes in breast tissue that may not be visible on a mammogram. Regular MRI screenings in high-risk patients enable earlier detection of potential issues, which can significantly impact prognosis and treatment options. In contrast, other follow-up methods like only clinical examinations or annual physical exams may not be sufficient alone for high-risk patients, as they do not utilize advanced imaging technology to adequately monitor for recurrence or new malignancy. Weekly blood tests are typically not part of routine follow-up for breast cancer and do not provide information regarding breast tissue changes. Therefore, MRI is the most appropriate follow-up method in this context.