Breast, Chest Wall, and Thoracic Surgery Practice Test

These questions are part of the practice quiz. Start practicing

• What is the usual management of a fibroadenoma?
• Which imaging modality is commonly used to detect distant metastases in lung cancer for staging?
• Breast augmentation involves placing implants at which location?
• Which gender is more commonly affected by SVC syndrome?
• Serum tumor markers are not used for initial diagnosis but are used later for treatment response. Which statement is NOT correct?
• Chondrosarcomas develop at which anatomical location?
• Which condition is most likely to cause a transudative pleural effusion?
• Mammography is _______ if the implant is subpectoral rather than subcutaneous.
• Which condition is a classic cause of increased pulmonary vascular hydrostatic pressure leading to pleural effusion?
• What is part of the recommended management for SVC syndrome?
• Chylothorax is defined as accumulation of which fluid in the pleural space?
• Which chest wall tumor can be classified as either soft tissue or skeletal depending on origin?
• For stage I/II NSCLC, the primary treatment is which?
• What non-drainage therapies are part of hepatic hydrothorax management?
• Spontaneous pneumothorax occurs most commonly in which group?
• Which type accounts for about 50% of malignant soft tissue chest wall tumors?
• Pneumothorax presenting with pleuritic chest pain and dyspnea; which signs might indicate more dramatic presentation due to tension physiology?
• Which non-invasive tools are used for evaluation of the thoracic wall, pleura, mediastinum, and lung?
• Small cell lung cancer (SCLC) is typically treated with which approach?
• Serum tumor markers are not used for initial diagnosis but later used for which purpose?
• If mesothelioma is not operable, what is the recommended treatment?
• Fat necrosis may present as a mass with which sign that can mimic cancer?
• What is the typical treatment sequence for Ewing sarcoma?
• Which cancers are among the most common causes of malignant pleural effusion?
• What are the most common histologies of central primary lung cancer?
• In small-volume hemothorax, what is the expected natural history?
• According to Light's criteria, which combination indicates a transudative pleural effusion?
• Which of the following is an indication for chest wall reconstruction?
• Which organism is NOT commonly implicated in subpectoral abscess?
• Which physical finding may be seen with a lung abscess in advanced cases?
• Pleural fluid analysis in pancreatic hydrothorax typically shows which of the following?
• What is the preferred initial imaging study for evaluating a mediastinal mass?
• Which statement is true regarding primary lung cancer types according to the material?
• What imaging finding defines Pectus excavatum on CT chest?
• Which class of drugs is used to protect bones and treat bone metastases in breast cancer?
• Chills, fever, shock, and subcutaneous emphysema are characteristic of which condition?
• What is the primary goal of therapy for stage IV NSCLC?
• Which test is used to diagnose a pneumothorax most commonly?
• What is the recommended diagnostic approach for suspected subscapular abscess?
• What is the treatment for benign skeletal tumors of the chest wall?
• What is the recommended initial treatment for a breast abscess?
• Which statement best describes the role of muscle or omental flaps in sternum osteomyelitis management?
• Which option is listed as a complication of breast augmentation in the material?
• In the management of hemothorax, what is the recommended initial intervention for a significant bleed?
• Which of the following are complications associated with needle biopsy?
• Congenital chest wall malformation causing concave chest is called?
• Which statement about axillary lymph node dissection in breast cancer is true?
• Which statement best describes the role of screening mammography in detecting breast cancer?
• Advanced mesothelioma progression can lead to which complication?
• Which breast lesion is most common benign tumor in young women?
• What is the natural course of a fat necrosis mass if untreated?
• Infection of costal cartilage and the xiphoid is most likely caused by which mechanism?
• Which pair of surgical approaches are commonly considered in breast cancer management?
• Fat necrosis can occur after which events?
• Which organisms are commonly implicated in the etiology of subpectoral abscess?
• Which statement best describes the relationship between mediastinal mass management and anatomical location?
• MRI can also be used in women with breast implants, prior lumpectomy, or prior radiation, who have decreased sensitivity with mammography. Which imaging modality is used in these cases?
• For suspected empyema, what is the typical sequence of imaging studies?
• Hepatic hydrothorax is most commonly caused by which condition?
• A large, warm, painful soft tissue mass typically in a single rib with an associated pleural effusion is most consistent with which tumor?
• Which mediastinal compartment is most commonly associated with thymic abnormalities?
• Which physical examination finding is most consistent with cardiogenic pleural effusion?
• Solitary fibrous tumor is usually asymptomatic and found incidentally on imaging. True or false?
• Which sarcoma is considered more aggressive than chondrosarcoma?
• Subareolar abscess most commonly occurs in which population?
• Which mechanism contributes to pleural effusion by decreasing intrapleural pressure?
• Which symptom cluster is commonly associated with empyema?
• What Haller index value is used as a threshold for significant Pectus excavatum on CT?
• Negative margins indicate that the edge of the removed tissue contains:
• Premenopausal women with spontaneous multiple duct discharge, unilateral or bilateral, most noticeable just before menstruation suggest which condition?
• The diagnostic workup for fibrocystic breast condition typically includes
• Which tumor's management is typically wide margins with en bloc resection to ensure complete removal?
• Which of the following is NOT listed as a type of primary lung cancer?
• On physical examination, empyema commonly presents with which findings?
• Postoperative adjuvant therapy for breast cancer typically includes which combination?
• Initial management of a small pneumothorax can involve which of the following?
• What is the standard diagnostic approach to confirm Ewing sarcoma?
• Which tumor is classically described as having onion skin periosteal reaction on imaging?
• What is the medical term for fluid accumulation around the lung?
• Which of the following is NOT a cause of posterior mediastinal masses?
• Which imaging modality is critical in staging thoracic cancer, evaluating the extent of metastatic disease, and in post-interventional surveillance?
• What age range is typical for the onset of multiple myeloma?
• Pectus excavatum can result in which type of lung pathology?
• Is breast augmentation related to an increased risk of breast cancer?
• Which complication of a lung abscess requires surgical emergency?
• Which procedure is described as an anterior mediastinotomy to reach lymph nodes not accessible by EBUS or mediastinoscopy?
• Posterior extension of a breast abscess is most likely to produce which type of abscess?
• What is the majority type of primary lung cancer?
• Which of the following is NOT an indication for chest wall reconstruction?
• Which procedures are used to treat Pectus excavatum?
• Pleural fluid in chylothorax typically has which features?
• A lung abscess is best defined by which imaging feature?
• What is the treatment for benign soft tissue tumors of the chest wall?
• Subpectoral abscess can be caused by which of the following?
• Do chondrosarcomas respond to chemotherapy?
• In which demographic is multiple myeloma most commonly diagnosed?
• If chest tube drainage fails to fully drain the hemothorax, what procedure may be performed?
• What finding is associated with chronic SVC syndrome?
• Which of the following is a common cause of empyema?
• For acute mediastinitis due to esophageal perforation presenting within 48 hours, what surgical approach is recommended?
• Which is a potential cause of hemothorax?
• In hepatic hydrothorax, drainage should be performed only if the patient experiences which condition?
• Winging of the scapula and induration of the trapezius muscle are clinical clues for which chest wall infection?
• Choosing a lung-sparing resection over a more extensive resection is most justified when:
• A milky discharge from multiple ducts in the nonlactating woman suggests which condition?
• Which of the following is a standard surgical approach to access a mediastinal mass?
• Core needle biopsy is typically performed under guidance with which imaging modalities?
• Subpectoral abscess presents with erythema, induration of the pectoral region, and painful shoulder range of motion. This presentation most strongly suggests which diagnosis?
• If there is a bloody discharge with a palpable mass, what is recommended?
• Which symptom is commonly associated with a lung abscess?
• Bloody discharge with a mass warrants which action?
• What is the most common cause of an anterior mediastinal mass?
• Which conditions are associated with cardiogenic pleural effusion?
• The rationale for sparing lung tissue during resection centers primarily on:
• Which statement about chondrosarcoma is supported by the material?
• A lung abscess rupture into the bronchus typically presents with which sequence?
• Which of the following are subtypes of non-small cell lung cancer?
• Which procedure is commonly used to access mediastinal lymph nodes that may require sampling when PET is positive, and can be performed via the airway with ultrasound guidance?
• Fibrous dysplasia is an example of which chest wall lesion?
• Which procedure is commonly used to obtain tissue from a centrally located lung lesion for diagnosis?
• Which management option may be considered for recurrent cardiogenic pleural effusions?
• Solitary fibrous tumor of the pleura is typically which of the following?
• Which of the following can cause a pneumothorax?
• For a small peripheral tumor, which resection approach best aligns with the goal of sparing lung?
• Which thymic condition refers to thymic enlargement that is not due to a tumor?
• Which physical finding may be observed in a patient with empyema?
• Which statement is true about screening for breast cancer in high-risk individuals?
• Which symptom cluster is commonly associated with mesothelioma?
• What is the surgical treatment option for end-stage cystic fibrosis?
• Which finding is most consistent with a tension pneumothorax on physical examination?
• Which clinical features accompany osteomyelitis of the sternum?
• Subscapular abscess is typically associated with which etiologies?
• Pleural fluid analysis in hepatic hydrothorax is typically:
• Cryoablation for a biopsy-proven fibroadenoma of appropriate size has which potential complication?
• Which are examples of benign skeletal tumors of the chest wall?
• Which of the following clinical features is commonly associated with hepatic hydrothorax?
• Via percutaneous needle, VATS, or open thoracotomy surgical approaches & may be required if there is concern for cancer or tuberculosis involvement in the pleura/pleural fluid refers to sampling of what?
• Which of the following is NOT a common cause of middle mediastinal masses?
• Does surgical excision have a role in the treatment of multiple myeloma?
• Which of the following describes the typical physical examination findings for a fibroadenoma?
• Which of the following is NOT a cause of an anterior mediastinal mass?
• Which serious condition should always be considered when evaluating subareolar abscess?
• Treatment for pancreatic hydrothorax includes which of the following?
• The cause of pancreatic hydrothorax most commonly involves which of the following mechanisms?
• Which term describes a surgical margin without cancer at the edge of the removed tissue?
• If a PET scan in the mediastinum is positive, which procedures are considered for confirmation?
• Do osteosarcomas respond to chemotherapy?
• Most lung hernias occur in which location?
• Most lung cancers are diagnosed asymptomatically and found incidentally on routine imaging or lung cancer screening programs. Which scenario best illustrates this reality?
• For Aspergillosis, which surgical treatment is listed as an option?
• Cryoablation for a fibroadenoma may cause which complication?
• What is a classic physical exam finding in acute SVC syndrome?
• Which finding is not typical in pleural effusion?
• Which organism is most commonly associated with empyema according to common associations?
• Which intervention is contraindicated in hepatic hydrothorax?
• Which condition is defined by thick, malodorous purulent accumulation within the pleural space?
• For stage IIB/IIIA NSCLC, the recommended approach is which?
• Pleural biopsy can be performed via which approaches?
• Carcinoid is categorized as which of the following in the context of primary lung cancer?
• A unilateral pleural effusion that recurs after multiple drainage attempts and is diagnosed or suspected to be malignant is most consistent with which diagnosis?
• Which flap is commonly used in chest wall reconstruction that requires revascularization?
• Which procedures are used in the surgical treatment of pulmonary tuberculosis?
• The diagnosis of hyperprolactinemia is best evaluated with which tests?
• Which two main strategies are used to manage malignant pleural effusion and prevent re-accumulation?
• What is the diagnostic method for Pneumocystis carinii according to the material?
• Which signs are typical of SVC syndrome?
• What is a surgical treatment option for a lung abscess?
• Which posture worsens symptoms in SVC syndrome?
• If conservative management fails in chylothorax, which intervention is used?
• In the context of rib osteomyelitis, what is the primary goal of rib resection?
• Which radiographic features are most characteristic of chondrosarcoma?
• Elevated labs with breast cancer include which of the following?
• Which surgical management is indicated for infection of costal cartilage and the xiphoid process?
• What surgical approach into the thoracic cavity is used to access the lung for resection, biopsy, pleurodesis and requires the ability to tolerate single-lung ventilation?
• Pulmonary metastases are considered for surgical resection in medically fit patients only if which criteria are met?
• Eosinophilic granuloma is categorized as which type of chest wall lesion?
• Pancreatic hydrothorax is characteristically more common on which side?
• Pleural fluid analysis in empyema is typically exudative. Which option best reflects this finding?
• EBUS stands for which technique?
• Which flap options are described for reconstruction after sternum debridement due to osteomyelitis?
• Which statement best reflects the trade-off implied by the goal of resection?
• Pleural fluid cultures in empyema are typically obtained via which procedure?
• What surgical approach may be employed to excise infected costal cartilage and xiphoid?
• Which procedure has a diagnostic yield of about 60% and is most commonly performed under CT guidance?
• What is a potential fatal complication of untreated SVC syndrome?
• Which cancers have a high likelihood of metastasizing to the sternum?
• What is the most common location for primary lung cancer?
• Lymph node sampling of suspicious nodes via incision 3-4 cm above the sternal notch, dissecting through the pre-tracheal fascia corresponds to which procedure?
• What percentage of fibroadenomas have multiple tumors?
• What is the definitive method for diagnosing breast cancer?
• Which procedure is used to obtain pleural fluid for analysis?
• Which symptom is commonly associated with edema of the vocal cords or trachea in SVC syndrome?
• What is the recommended medical management for a lung abscess?
• Renal hydrothorax is often recurrent in which scenario?
• Which flap is commonly used for chest wall reconstruction requiring revascularization?
• The goal of sparing lung tissue implies what main benefit?
• Stage IIIB NSCLC management consists of which of the following?
• Which of the following statements best reflects standard breast cancer management?
• Which imaging modality is essential to characterize the extent of a suspected lung abscess?
• Fibroadenoma is most commonly seen in which population?
• Thoracentesis or pleural catheter shows exudative pleural fluid analysis. This finding most likely indicates which condition?
• A pleural effusion that is large can cause which of the following?
• Which of the following is a direct description of fat necrosis after trauma or breast surgery?
• Which procedure serves both diagnostic and therapeutic purposes in pleural effusion management?
• Which procedure is commonly used to sample mediastinal lymph nodes for staging lung cancer?
• What is a common treatment for a lung hernia?
• Osteomyelitis of the ribs is most commonly caused by which scenario?
• What is the recommended treatment approach for sternum osteomyelitis?
• Which factor is a risk for fibrocystic breast condition?
• In the management of empyema, which of the following are essential components of therapy?
• In the drainage management of cardiogenic pleural effusion, which statement is correct?
• In surgical oncology, achieving negative margins is essential because it means:
• On CT chest, which finding is commonly associated with mesothelioma?
• Which clinical presentation is characteristic of fibrocystic breast condition?
• What term describes air in the pleural space?
• Which of the following statements about subpectoral abscess is true based on its etiologies?
• Thoracentesis showing exudative pleural fluid with frank blood on collection indicates which condition?
• Transdiaphragmatic movement of abdominal fluid into the pleural space, seen with ascites or pancreatic pseudocyst rupture, is an example of which mechanism?
• Which of the following is NOT part of Light's criteria for exudative effusion?
• Which of the following is a risk factor for spontaneous pneumothorax?
• Which event is associated with fat necrosis according to the material?
• Which condition is most associated with sternum osteomyelitis due to diabetes and sternotomy?
• Primary lung cancer has a high association with which risk factor?
• What is the recommended treatment for chondrosarcoma?
• Which condition is a common cause of transudative pleural effusion?
• What organism is the most common cause of breast abscess?
• What is the prognosis for acute mediastinitis?
• Which statement best describes a fibroadenoma?
• Which imaging modality is used to diagnose benign soft tissue tumors of the chest wall?
• How is fibroadenoma typically diagnosed?
• What imaging modality is used to diagnose benign skeletal tumors of the chest wall?
• Which of the following is a cause of exudative pleural effusion?
• Lymph node visualization through airway for fine needle aspiration of concerning lymph nodes is performed using which technique?
• Which tumor would you most expect to see a sunburst radiographic sign?
• Which technique is the traditional older approach for correcting Pectus excavatum?
• In the context of the goal of resection, negative margins mean the margins are:
• Approximately what fraction of mediastinal masses are asymptomatic?
• Which category is a common cause of chylothorax?
• An indication for surgical management of tuberculosis?
• Which location is more commonly affected by primary lung cancer?
• If a solitary fibrous tumor becomes large, which symptoms may occur?
• What is the pathologic mechanism most commonly responsible for malignant pleural effusion?
• Pectus excavatum commonly presents with which features?
• Which histologic type accounts for 80-90% of all breast cancer?
• Which of the following is NOT an example of a benign soft tissue chest wall tumor?
• What is the most common cause of acute mediastinitis?
• What is the recommended prognosis follow-up for fibrocystic breast condition?
• Pectus excavatum is best described as which type of chest wall deformity?
• Laboratory abnormalities typical of renal hydrothorax include:
• Which are examples of benign soft tissue tumors of the chest wall?
• What is the typical prognosis for malignant pleural effusion?
• Which radiographic finding is classically associated with multiple myeloma?
• Which imaging modality is more accurate than CT for detecting cancer spread to mediastinal lymph nodes?
• What is a likely benefit of sparing lung tissue during resection?
• Which imaging modality is used to guide aspiration in a suspected subpectoral abscess?
• Which NSCLC histology is typically peripheral?
• Inflammatory carcinoma is mentioned in the material as which type of condition?
• Which X-ray appearance is associated with osteosarcoma?
• X-ray shows an onion skin appearance is most characteristic of which tumor?
• Which statement about solitary fibrous tumor treatment is true?
• What imaging modalities are typically used to establish the initial diagnosis of breast cancer?
• Which treatment is appropriate for a subpectoral abscess?
• Renal hydrothorax is most commonly associated with which condition?
• Hepatic hydrothorax is characteristically associated with which of the following?
• Bloody discharge from the breast is most commonly associated with which benign ductal lesion?
• Hemothorax is the accumulation of what in the pleural space?
• What is the recommended diagnostic approach for suspected subpectoral abscess?
• Which statement best describes drainage management for hepatic hydrothorax?
• What is the typical treatment approach for fibrocystic breast condition?
• Which term describes a lump that is indistinguishable from carcinoma on imaging studies, requiring biopsy if imaging is not typical?
• Purulent discharge from the breast typically originates from which condition and requires what treatment?
• Which procedure demonstrates the transudative nature of the pleural fluid in hepatic hydrothorax?
• Which two general categories are listed under types of bronchoscopy in the material?
• Which technology utilizes CT imaging and virtual bronchoscopy to create a 3D roadmap to allow access of lung lesions deep in the parenchyma?
• What is the most frequent lesion of the breast?
• Which treatment options are used for renal hydrothorax?
• Which statement best reflects a complication profile for needle biopsy?
• What is the typical multimodal treatment approach for chest wall sarcomas?
• Indications for chest wall reconstruction include which of the following?
• Central histologies include Squamous cell carcinoma and Small cell
• What is the most common histology of peripheral primary lung cancer?
• Which of the following best defines negative margins?
• A common initial management step for hemothorax due to trauma is which of the following?
• Stage IV NSCLC is typically managed with which approach?
• What is the most common cause of superior vena cava syndrome?
• Which of the following is listed as an 'other' cause of acute mediastinitis?
• What is the principal goal in the treatment of malignant pleural effusion?
• Which fungal infection of the lung may require surgical management such as lobectomy or cavernostomy?
• Which surgical treatment is commonly used for solitary fibrous tumor?
• What is the typical treatment sequence for osteosarcoma as described?
• Which combination represents the diagnostic workup for a suspected lung abscess?
• Pectus excavatum may be associated with which condition?
• What is a key initial diagnostic procedure when evaluating suspected pancreatic hydrothorax?
• Which NSCLC stage commonly involves adjuvant therapy after surgery?
• On chest radiograph, which finding suggests pleural effusion?
• Which procedure is a modern minimally invasive repair for Pectus excavatum?
• Which finding is most characteristic of pancreatic hydrothorax?
• Which statement about medical therapy for fibrocystic breast condition is accurate?
• What is the most significant risk factor for breast cancer?
• What is the latency period for mesothelioma?
• For malignant pleural effusion, which treatment option is used to achieve palliation and prevent fluid re-accumulation?
• Thoracentesis showing transudative pleural fluid is most consistent with which condition?
• Which statement best describes prognosis for malignant pleural effusion?
• Which test panel is often used when evaluating a patient with a suspected thymic mass due to MG association?
• Erythema and induration with fluctuance and spontaneous drainage, with possible osteomyelitis of ribs, sternum, or clavicle, is most consistent with which condition?
• Which statement about MRI in breast cancer screening is supported by the material?
• Infections unresponsive to therapy due to poor blood supply most commonly involve which structure?
• The overall goal of resection emphasizes preserving what?
• ENB stands for which technique?
• What is a primary systemic therapy for multiple myeloma?
• Cancer is more likely to occur in women over which age?
• What is the typical size range for a fibroadenoma?
• Haller index is defined as which ratio?
• In fungal lung infections, when is biopsy for treatment decisions considered?
• In patients with prior lumpectomy or prior radiation, which imaging modality can improve detection due to decreased sensitivity of mammography?
• Which CT finding supports acute mediastinitis diagnosis?
• What is the typical surgical treatment for carcinoma of the male breast?
• What is the term for a defect in the chest wall that can be congenital or acquired through trauma or surgery?
• Solitary fibrous tumor of the pleura is typically benign. True or false?
• If a PET scan in the mediastinum is negative, what is the recommended next step in management?
• Mesothelioma is predominantly which hemithorax?
• MRI is used in special cases such as which tumor location?
• Chondromas are best categorized as which type of chest wall lesion?
• Which diagnostic procedure yields pleural tissue for histologic confirmation of mesothelioma?
• What clinical features are typical of carcinoma of the male breast?
• Which statement best captures the overarching principle behind the goal of resection?
• Which components are typically included in the diagnostic workup for suspected empyema?
• Which procedure involves sampling mediastinal lymph nodes by an incision 3-4 cm above the sternal notch, dissecting through the pre-tracheal fascia?
• What is the main surgical treatment for rib osteomyelitis?
• Which condition is commonly associated with thymoma?
• Which imaging modalities are used to diagnose a solitary fibrous tumor of the pleura?
• Which rare breast lesion presents as a mass often with skin or nipple retraction?
• Which statement is true regarding the management of Ewing sarcoma?
• Anterior mediastinotomy via 2-4 cm incision over the 2nd-3rd interspace to reach lymph nodes that cannot be reached via EBUS or mediastinoscopy is known as which procedure?
• When is surgical therapy indicated for bronchiectasis?
• Carcinoid lung cancer is most commonly treated with which surgical approach?
• In the evaluation of pneumothorax, which imaging modality is used to define bullous disease?
• Hemothorax is most commonly unilateral or bilateral?
• >3-4 cm fibroadenoma: what is recommended?
• For fungal infections of the lung, when is surgical intervention considered?
• What are contraindications to needle biopsy?
• Which of the following describes a risk associated with cystic fibrosis?
• Which radiographic finding corresponds to cartilaginous tumors like chondrosarcoma?
• Which of the following is a risk factor for breast cancer?
• Chest involvement by multiple myeloma is typically associated with what?
• Which condition is often associated with breastfeeding and mastitis?
• Which cancer is among the most common causes of malignant pleural effusion?
• Which modality is commonly used to detect pleural effusion?
• Labs associated with pancreatic hydrothorax include which findings?
• What is the diagnostic approach for mesothelioma?
• What is the preferred treatment for a subscapular abscess?
• Screening mammography detects breast cancer before it has spread to the lymph nodes in about 80% of women evaluated, increasing the 5-year survival to about 85%. Which screening modality is described?
• Decreased vascular colloid oncotic pressure causing pleural effusion is most commonly due to which condition?
• Which radiographic finding is most associated with acute mediastinitis?
• Which statement describes a surgical indication for tuberculosis?
• Which finding is typical of a lung hernia?
• Spontaneous unilateral serous or serosanguineous discharge from a single duct can be due to which conditions?
• Which of the following describes a surgical management option for mesothelioma?
• Mesothelioma is strongly linked to which exposure?
• Which statement best describes a 'negative margin'?
• Which of the following is a complication of a lung abscess?
• High risk patients need both screening modalities. Which pair?
• What is the primary goal of a resection according to the material?
• Fibrocystic breast condition is uncommon in which group?
• Which of the following options correctly lists modalities commonly used to diagnose and stage lung cancer?
• For suspected esophageal perforation causing mediastinitis, which imaging study is commonly used to identify a leak?
• Osteomyelitis of the sternum most commonly occurs after which procedure, especially in diabetics?
• Which histology is considered a central primary lung cancer in the material?
• Which mechanism leads to pleural effusion via decreased intrapleural pressure (atelectasis)?
• Which statement best describes the management of small, stable, asymptomatic pneumothoraces in otherwise healthy patients?
• How is fat necrosis diagnosed?
• Which imaging modalities are commonly used to detect metastatic disease in breast cancer?