A 41-year-old woman comes to the office for the evaluation of a lump on her left breast. She feels, "generally well," and denies having any medical problems. She takes a multivitamin and Tums daily. She stopped smoking after getting married 21 years ago. She drinks wine only on weekends. Her only surgery was a bilateral tubal ligation last year, after giving birth to her fourth child. Physical examination of the left breast reveals a 4 cm lump at the 11 o' clock position and two axillary nodes on the left side. Mammography shows irregular micro-calcifications. The result of the FNA is suggestive for infiltrating ductal carcinoma. Which of the following is the single most important prognostic factor in this patient?

Question

A 41-year-old woman comes to the office for the evaluation of a lump on her left breast.  She feels, "generally well," and denies having any medical problems.  She takes a multivitamin and Tums daily.  She stopped smoking after getting married 21 years ago.  She drinks wine only on weekends.  Her only surgery was a bilateral tubal ligation last year, after giving birth to her fourth child.  Physical examination of the left breast reveals a 4 cm lump at the 11 o' clock position and two axillary nodes on the left side.  Mammography shows irregular micro-calcifications.  The result of the FNA is suggestive for infiltrating ductal carcinoma.  Which of the following is the single most important prognostic factor in this patient?

Quizplus · Accepted Answer

Tumor burden is the single most important prognostic consideration in the treatment of patients with breast cancer. It is based on TNM staging. Patients with stage IV disease have the worst prognosis. The following are other important prognostic factors of breast cancer, in the order of decreasing significance. (Choice B) ER+ and PR+ are good prognostic features. (Choice C) Overexpression of the Her-2/neu oncogene is related to a worse prognosis. (Choice D) The histological grade also tends to reflect the outcome. Poorly differentiated tumors have the worst prognosis. (Choice E) There is currently inconclusive data regarding the prognostic significance of mammogram findings. Educational Objective: Tumor burden is the single most important prognostic consideration in the treatment of patients with breast cancer. It is based on TNM staging.

A 41-Year-Old Woman Comes to the Office for the Evaluation