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Marco Legal e Processo de Elaboração de Diretrizes

Total questions: 10

Worksheet time: 5mins

Name
Class
Date
1.

Within Brazil’s Unified Health System (SUS), what is the primary scope of the Breast Cancer Clinical Protocol and Therapeutic Guidelines (PCDT) as described?

a)

To regulate private oncology services and insurance reimbursement

b)

To outline procedures and therapeutic regimens currently available in SUS, with updates as new technologies are evaluated by Conitec

c)

To provide international comparative oncology statistics only

d)

To replace all existing national cancer guidelines with a single treatment algorithm

2.

Which statement best interprets the global and Brazilian epidemiology of breast cancer as presented?

a)

Globally, fewer than 1 million new breast cancer cases occurred in 2020, while Brazil reported under 20,000 cases.

b)

Globally, an estimated 2.3 million new cases occurred in 2020; in Brazil, 66,280 cases were estimated for 2020, representing about 29.7% of cancers in women.

c)

Global breast cancer deaths in 2020 were approximately 2.3 million, and Brazil accounted for nearly half of them.

d)

In Brazil, breast cancer incidence is uniform across regions, with no notable differences in risk.

3.

For T2N1**M0/T3N0M0 with grade G1 and HER2 positive, ER negative, PR negative, which stage is indicated?

a)

Stage IB

b)

Stage IIA

c)

Stage IIB

d)

Stage IIIC

4.

In prognostic pathologic classification for breast cancer, the prefix applied after surgical treatment is which of the following?

a)

c (clinical)

b)

p (pathologic)

c)

r (recurrent)

d)

y (post-therapy clinical)

e)

m (metastatic)

5.

What defines isolated tumor cells (ITCs) for nodal classification according to the legend?

a)

Clusters up to 5 mm detected by H&E only

b)

Single cells or small clusters not larger than 0.2 mm or fewer than 200 cells in a single histologic cross-section

c)

Any cells detected only by molecular methods

d)

Clusters 0.2–2.0 mm

e)

Any tumor cells in sentinel node

6.

According to the risk classification adapted from the Saint Gallen consensus, which combination defines LOW risk when all criteria are met?

a)

Negative lymph nodes; pT up to 2 cm; Grade 1; no extensive peritumoral vascular invasion; ER positive; HER2/neu negative; age 35 or older

b)

Positive lymph nodes; pT up to 2 cm; Grade 1; ER negative; HER2 positive; age under 35

c)

Negative lymph nodes; any tumor size; Grade 2–3; ER negative; HER2 positive; age any

d)

Positive lymph nodes (4+); Grade 3; ER/PR negative; HER2 positive

7.

Which statement about radiotherapy (RT) after breast-conserving surgery is most accurate based on the material?

a)

RT is optional and mainly cosmetic

b)

Adjuvant RT aims for locoregional control and reduction of local recurrence risk

c)

RT is contraindicated for cN+ patients

d)

RT is given only if tumor is T4

8.

Regarding dosing approaches, which option reflects a recommendation mentioned for selected patients when available?

a)

Prefer ultrahypofractionation for all patients regardless of stage

b)

Use hypofractionated RT as a safe and effective option compared to conventional fractionation

c)

Avoid CT-based planning to reduce cost

d)

Mandate exactly 25 fractions for every patient

9.

For postmenopausal patients receiving neoadjuvant endocrine therapy, which drug class is noted as an option to expand locoregional surgical possibilities?

a)

Selective estrogen receptor degraders (SERDs).

b)

Aromatase inhibitors.

c)

LHRH antagonists.

d)

Tyrosine kinase inhibitors.

10.

Neoadjuvant chemotherapy is preferentially indicated for operable tumors with which characteristics?

a)

HER-2 positive or triple-negative tumors with T≥2 or N≥1; large primary tumor relative to breast size, positive lymph nodes, need for time before deciding surgery, or biology favoring chemotherapy (e.g., triple-negative, HER-2 positive, luminal B).

b)

Only small T1N0 tumors.

c)

Only ER/PR-positive, HER-2 negative tumors.

d)

Tumors confined to the ducts without invasion.