332 Obstetrics and Gynecology Board Review •••
BREAST AND OVARIAN CANCER
❍ What are the top three types of cancer diagnosed in women?
Breast cancer.
Lung cancer.
Colorectal cancer.
In men—Prostate (1), lung (2), and colorectal (3).
❍ What is the leading cause of cancer deaths in women?
Lung cancer. Breast cancer is second.
❍ What is the leading gynecologic cancer in women?
Endometrial cancer.
❍ What is the leading cause of gynecologic cancer deaths in women?
Ovarian cancer.
❍ Is there an increased risk of breast cancer associated with estrogen replacement therapy?
There may be a slightly increased risk of breast cancer especially with long duration of use (5 or more years in users
of continuous combined therapy).
❍ Do estrogen users have improved breast cancer survival?
Yes. This is probably as a result of earlier diagnosis but this is controversial after the results of the WHI.
❍ Does estrogen use affect breast cancer tumor differentiation?
Yes. Women on estrogen develop better differentiated tumors.
❍ What is the diagnosis of an adnexal mass in menopause?
Cancer, until proven otherwise.
❍ What type of adnexal mass may be managed conservatively, with serial ultrasounds?
Clear fluid filled cysts without septations, <5 cm.
❍ What is the risk of breast and ovarian cancer in BRCA carriers?
50% to 80% and 40% to 60%, respectively.
❍ Is the risk of breast cancer increased in all postmenopausal hormone users?
Not according to WHI: not in users of Premarin.
❍ What is the recommended screening for colon cancer?
Colonoscopy in women over the age of 50 every 10 years. Alternatives are yearly Hemoccults with sigmoidoscopy
or barium enema every 5 years.