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Breast cancer screening shared decision-making — MCCQE Part 1 MCQ

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EasyScreeningBreast cancer screening shared decision-makingMCCQE Part 1

A 43-year-old average-risk woman asks whether she should start mammography after a friend was diagnosed with breast cancer. Which of the following is the most appropriate next step?

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Correct answer: A — Discuss benefits and harms and support shared decision-making based on Canadian guidance and provincial programme access

Discuss benefits and harms and support shared decision-making based on Canadian guidance and provincial programme access is the single best answer because the age, timing, examination findings and investigations in the vignette fit Breast cancer screening shared decision-making better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CTFPHC breast cancer screening update, with attention to acuity, safety-netting and local provincial pathways.

Reference: CTFPHC breast cancer screening update